Millions of Californians with disabilities and underlying health conditions will be eligible for the COVID-19 vaccine on Monday, but continued dose shortages as well as ongoing uncertainty about verification and qualification still hold potential barriers to entry.
The expansion is an important step for the emergence of the state from the pandemic. The new guidelines issued by health officials on Thursday allow people at high risk to prove themselves eligible – a major victory for advocates who are worried that people will not be able to meet. documentation to verify their disability or underlying condition.
But adding an estimated 4.4 million Californians to the fitness list would place additional burdens on a vaccine supply that has grown gradually but not significantly. California reserves 40% of its offerings for people in communities that are employed and 10% for teachers. And there are still many people 65 and older who are also waiting for their vaccinations.
Further tight necessities: The state also increased on Monday the admission to people living or working in high-risk community housing, such as homeless shelters and confinement facilities, and employees in public transport and airports.
President Biden, who expressed confidence in the offer predictions during his national speech on Thursday night, said he believes every adult can be vaccinated by the end of May.
The high-risk group of new individuals consists of ten categories: those who are pregnant or have cancer; chronic kidney disease of stage 4 or higher; chronic lung disease; Down syndrome; an affected immune system from solid organ transplantation; sickle cell disease; heart disease such as heart failure, coronary artery disease and cardiomyopathy (excluding hypertension); severe obesity; a type 2 diabetes mellitus.
With population estimates for Monday’s group ranging from 4 million to 5 million, and with other eligible groups of about 13 million, nearly half of all California residents will be eligible for the vaccine.
For those with disabilities and advocates, who have been campaigning for access for a long time, admission may not be soon enough. By 2020, 86% of people who died from COVID-19 in LA County had an underlying condition, according to the Department of Public Health.
“There’s a tremendous sense of urgency for this group,” said Sarah Sultan, 35, a LA resident who is pregnant and diabetic. “It is likely that this group has a severe COVID, is hospitalized and dies of COVID.”
Yet many members of the high-risk group said they had been in the dark about where to go, what to do and how to qualify. And because of ambiguity about the definition of some medical conditions, some people are still wondering if they qualify, including people with asthma.
Some of these questions were addressed as guidance released by the California Department of Public Health Thursday night. The details include some specific examples of people who are eligible for admission but who are not explicitly listed, including those who use independent centers, in-home support services, and community-based adult services.
The admission of the new guidance for self-declaration raises confusion about how high-risk people may qualify. Lawyers have long insisted on a process that will not create unnecessary barriers, especially for those who are less mobile or intellectually disabled. According to the guidelines, people do not have to disclose what condition they have, but only that they are eligible, dr. Paul Simon, chief scientific officer at the LA County Department of Public Health, said Friday.
“This is great news,” said Emma Alvarez-Gibson, 45, who is diabetic and has been in quarantine for a year. ‘People at high risk have been extremely careful from the start. Many of us feel a little toy, given the way the state has flip-flopped. ‘
Officials have said for weeks that they are working on such guidance. Its absence has sparked much anxiety, and many people in the endangered community have said they have not yet heard from their doctors or the state’s My Turn system.
“None of the systems that were meant to keep me informed actually did,” Alvarez-Gibson said.
Appointment slots for people with underlying conditions should be open Monday, Simon said.
In creating the latest suitability group, the ten categories eligible for the vaccine were drawn from a list of disease control and prevention centers with underlying problems with known evidence of high risk of COVID-19.
The state also includes a broader, non-specific category of “individuals who are likely to develop serious life-threatening illnesses or deaths due to COVID.” Because it can be applied to a variety of other disabilities and underlying problems, it has made many people wonder if they qualify.
Conditions such as asthma, for example, are not explicitly mentioned, and although type 2 diabetes is, type 1 diabetes is not. The broad language is intended to enable local healthcare providers to use their best clinical judgment to determine who is eligible for the shot.
Dr. Jeffrey Luther, a member of the state’s vaccine advisory committee and a board member of the California Academy of Family Physicians, said Wednesday that he asked questions of patients about their suitability.
“I got a message from a patient who said, ‘I have asthma and I’m obese. Does that mean I’m qualified? ” Luther said that without clear guidance it was difficult to answer the question.
LA also struggles with vaccine levels and is working to address issues of mobility, accessibility and equity, even if the new groups are eligible. The challenge is that the allocation of the single-dose vaccine Johnson & Johnson will come to a halt over the next two weeks while the company works to increase production.
“Given the limited amount of vaccine, we will be challenged by expanding the suitability,” Simon said Friday.
The state guidelines for people at risk essentially trust residents that they are eligible, but some officials have expressed concern that the lenient rules will be abused by people who lapse underlying conditions. People forged documents and used access codes intended for use in high-risk communities.
Simon asked at a news conference on Friday that residents do not abuse the loose guidelines for people at risk by not being eligible. “We do not feel that our frontline staff is able to screen and make decisions about who or who is not eligible,” he said. “We urge people not to use it.”
The province is creating limited clinics for people with underlying conditions on high-capacity sites, Simon said, and provincial sites will provide driveways and accommodation for people with disabilities.
Officials urged people to seek vaccinations with their healthcare providers as their first step.
In turn, several health care groups in the region, including UCLA Health, Kaiser Permanente, Cedars-Sinai, and the LA County Community Clinic Assn., Said they would use their electronic health records to identify patients in their systems who met the clinical criteria. . and reach out directly to them.
“Our hope is to vaccinate as many Kaiser Permanent members as possible with underlying conditions,” said Dr. Michael Morris, director of Kaiser Permanente, Southern California, said the COVID-19 vaccination program. He added that they “are already starting to reach out to all of our newly eligible members with underlying conditions, starting with those at the highest risk.”
While it may be encouraging to see sectors and activities reopen as more and more people are vaccinated, some in the risk community have said it is difficult to shake the feeling that they have been forgotten.
‘Very [disabled and chronically ill people] has remained completely isolated in their home for the past year, ”Sultan said. ‘Many of us expected that this group would be able to receive the vaccination sooner, and that the information on how we make appointments would be clear … Disabled, high-risk and chronically ill people were treated as completely disposable and irrelevant . ”
Judy Mark, president of the LA-based advocacy group Disability Voices United, said people with disabilities can feel powerless within the state because they do not have a union like farm workers or health workers, and that they do not have paid lobbyists or formal representation. as a voting block.
“Most of us are overwhelmed with our own lives,” she said. “We should have been on the list much earlier.”
Still, Monday’s extended fitness gave her reason to hope after a long, difficult and isolated year.
“I have to say, I still do not feel so optimistic,” she said.