When Christine Yano joined the COVID-19 vaccination center at the Forum earlier this month, she came armed with proof that she was eligible.
Although she was only 33 years old, she qualified because she is the mother of triplets triplets with chronic lung disease.
She showed a letter to the staff of the Department of Development Services and another from one of the agency’s regional centers. In her arms she kept a stack of medical records that offered more evidence, including a prescription for oxygen from her children.
But workers at the site denied her the shot. According to them, the letters may be false.
“They basically said, ‘Try somewhere else, we’ll not take you,'” Yano said.
As California prepares to accommodate millions of people with disabilities or underlying health conditions, confusion about paperwork can become a major problem at the front of the vaccination line.
Qualification requires proof, but state and local officials have yet to determine what documents are needed, or a straightforward way to sort rogue documents from real documents.
At vaccination sites, staff regularly encountered people using forged documents to try to get shots.
Barbara Ferrer, director of public health in LA County, said earlier this month that “hundreds” who are not eligible are trying to get vaccinated every day.
“Some of these people went to great lengths to qualify when making appointments with people who qualify first,” Ferrer said.
For most people, verifying suitability was not an issue. Those over 65 have a California identification or driver’s license. Healthcare workers show a license plate or other employee identification.
But it gets more complicated for families like the Yanos who qualify as health workers, under the caregiver category.
For confirmation, they need a letter from the Development Services Agency and another from one of its regional centers. But problems arose after copies of the letters began to circulate among those who were not eligible.
Next month, up to 6 million more Californians with disabilities and underlying health conditions will qualify for vaccinations. The state has yet to determine what kind of proof they need. It could contain a letter from a doctor on the correct letterhead, a statement from a federal or state agency, or some other form.
Verification can require a dizzying amount of paperwork, as the soon-to-be-eligible categories contain a variety of underlying conditions, including cancer, chronic kidney disease, Down syndrome and pregnancy, among others.
“It’s clear to me that the Department of Public Health and the Surgeon General are really concerned about fraud,” said Andy Imparato, executive director of Disability Rights California, a nonprofit group for the disabled. He hopes that problems in the past will not cause an overly cumbersome process in the future, especially not for people who are less mobile or ill.
“If the system requires you to see a doctor and get a detailed letter from a doctor, there will be a lot of people in California who will find it difficult to do so, even if there was no pandemic,” Imparato said.
Potential barriers can complicate access to the system, advocates fear.
‘Many people with disabilities, especially those from sub-communities, do not have access to regular healthcare providers. We do not want to create additional inequalities, “said Judy Mark, president of United Disability Voices.
Civil servants, aware of growing concerns about verification, included the issue at meetings of the Public Advisory Committee on Vaccines and a task force that includes members of the departments of aging, development services and health and human services. Meanwhile, health officials from across the state are awaiting guidance.
“It’s almost an impossible task to place it on each country to determine what type of verifications are appropriate,” Ferrer said.
Meeting the requirements for people like Yanos who are already eligible for vaccinations became a problem when the province was hit by the apparent counterfeiting scheme.
Several people took one of the written letters, copied it and then distributed it to others. It is not clear how many foster families have been affected.
Similar reports from family caregivers who were foiled by forgeries earlier this month have appeared in Facebook groups and in media reports.
Yano and her husband, John, struggled to keep up with the medical needs of their triplets – Riley, Peyton and Skylar. The babies were born at 26 weeks early and initially had oxygen for 24 hours for a chronic lung disease. Their delicate condition posed a new threat when the pandemic struck. Because of their weak lungs, they were more vulnerable to the effects of the coronavirus, as well as the potentially deadly multi-inflammatory syndrome known as MIS-C that infects children exposed to the virus.
Christine did not expect any problems as she drove from her home in El Segundo to the Forum Vaccination Center. Her husband had been vaccinated at Dodger Stadium four days earlier, and the county had accepted her request for an appointment.
But when she showed the staff the same documentation that John used, they were not convinced. So she showed them more paperwork, yet they said they could not determine if the letters were authentic.
The next day Christine tried again – and was rejected again. Staff told her that they only vaccinate licensed health workers that day.
With her third attempt at Dodger Stadium, she is once again denied. But this time, she did a supervisor, who examined her records and allowed her to be vaccinated.
Christine rolls up her sleeve, for herself and her family, and gets the chance.
“We have four children under the age of 4. It is definitely a relief to know that we will be able to look after them,” she said.
This story originally appeared in the Los Angeles Times.