Background on Vaccine Access in California

 

California Vaccine Quick Read:

What’s High Risk?

People can be high risk related to COVID-19 in different ways. 

Example 1 – Exposure: Sam has several in-home caregivers who help them wash and change positions, so they are closely exposed to several people on a daily basis, putting them at high risk for catching COVID. 

Example 2 – Conditions: Jol has a disability that reduces his lung capacity and he has diabetes. HIs disability and medical condition put him at high risk of developing severe COVID if he catches it.

Example 3 – Combination: Deidre is 63 and incarcerated for forgery. Deidre has a major heart condition that puts her at risk for severe COVID, and she is at high risk of catching it because she is in a congregate setting. She finishes her sentence in three months, but if she catches COVID, she is at higher risk of dying from it due to her age and condition.

The Problem

California has completely deprioritized people with high risk disabilities/medical conditions from the COVID vaccine rollout, forcing people to continue taking extreme precautions including putting off desperately needed medical care that can affect short and long-term health, or risk their lives to get care. California has also deprioritized other high-risk people, including incarcerated people and those in certain high-contact positions.

The Solution

California must include people at high risk in the same tier as those over 65 years of age. California must not burden people with high risk disabilities or medical conditions by refusing to treat them at community sites, instead making them go to inconvenient locations that may or may not have the vaccine in stock.

What We Can Do About it

Click here to take action and help hold California and Governor Newsom to their promise of equity in vaccine rollout.

 

California Vaccine Deep Dive:

California was issuing vaccine priority on a tiered system which included healthcare workers, veterinarians, and people living in long-term care facilities.  

In the tiered system people with disabilities were in category 1C. Category 1C was not an acceptable priority category for individuals that are at high risk of serious COVID  complications. These same people are also at risk for potential discrimination in a care rationing situation. 

The federal government issued guidance to prioritize individuals 65 and over and individuals with underlying medical conditions which increase the risk of serious, life-threatening complications from COVID-19; California decided to only implement half of what the federal government suggested and decided that people 65 and older would would be prioritized along with healthcare workers and other individuals that were prioritized in category 1A and 1B tier 1. After these individuals, the state would switch to an age based system. His change left people with disabilities, higher weight people, and people with medical conditions that put them at higher risk of severe complications from COVID not being prioritized at all. Many of these individuals have been putting off crucial medical care because it is too risky for them to go out, which may have a permanent impact on their level of disability and health. 

The state of California says one of their main goals in vaccine allocation is equity.

Image description: Screenshot from the Drafting Guidelines Workgroup: that says, “The Workgroup reaffirmed prior recommendations from CDPH: 1. Phase 1a: Complete immunization of the healthcare workforce and long-term care facilities. 2. Phase 1b Tier1: Immunize individuals age 65 years and older or working in the essential sectors of agriculture and food, education and childcare, or emergency services. 3. The Drafting Guidelines Workgroup continues to strongly emphasize equity in its recommendations and in the implementation of immunization against COVID-19.

Not giving priority to people at high risk of serious complications from COVID will have a disproportionate impact on communities of color. This is not equity and is unacceptable. 

Disability and higher weight advocates continued to advocate for individuals with medical conditions or disabilities that would put them at higher risk of serious complications from COVID. 

After public pressure, California’s Vaccine Working Group recently announced that after category 1B tier 1 California would likely prioritize individuals with certain disabilities and conditions that put them at higher risk of serious complications from COVID. 

However, California is also currently proposing a restriction that we would make it so this  higher risk group would only be able to receive the vaccine from healthcare providers that could verify medical records. 

This is unacceptable because it is making it harder for disabled people and people with medical conditions to get the vaccine, especially for the most impacted communities of color. This requirement was not listed when we were prioritized in category 1C. There is no need for this requirement – individuals can get a letter from a doctor confirming that they are eligible.

It is clear that advocacy around vaccine priority is not over.

Image description: Screenshot from the Drafting Guidelines Workgroup: that says, “In response to the updated proposal, the Drafting Guidelines Workgroup recommends: The next group includes but is not limited to:

• • Individuals 16-64 years with underlying serious medical conditions or disabilities that increase their risk of developing severe COVID-19.
    • Applies only to settings, such as health systems or other clinics (but not mass clinics or other local health department clinics) where underlying conditions or disabilities can be verified through access to medical records.
    • The qualifying health conditions and disabilities need to be defined with sufficient specificity that eligibility for the Phase can be determined when patients request an appointment for the vaccine.
    • Implementation plans should include outreach and assistance to individuals who have barriers to making appointments for the vaccine or access to the vaccine.
    • These groups are prioritized after Phase 1b, Tier 1 due to their large numbers and comparative aggregate risk of severe outcomes. 
    • An alternative proposal limiting eligibility to individuals with multiple (e.g. more than 3) underlying medical conditions was also raised for discussion. 
  • Local health departments emphasized their crucial role in immunizing residents in local correctional facilities and homeless shelters. “