SACRAMENTO, Calif. (CN) — People with severe disabilities and underlying conditions as well as inmates and homeless residents could be prioritized for the Covid-19 vaccine under new guidelines being mulled by California officials.
Pointing to alarming mortality rates for people with chronic health issues that have contracted the coronavirus, health officials told a state vaccine advisory panel Wednesday people under the age of 65 with disabilities should be considered in the next eligibility group.
Under California’s current scheme, counties are directed to focus immunizations on the health care industry, seniors and frontline workers. But with vaccine supply expected to increase in the coming weeks and months, officials said they are preparing to include the at-risk groups that have so far been left out.
“It’s clear that there’s still more to be done,” said Dr. Oliver Brooks, member of California’s Community Vaccine Advisory Committee. “This is the next group that we’re looking at.”
Under the framework introduced during the committee’s virtual hearing, disabled people between the ages of 16-64 could request appointments to get the vaccine with eligibility determined by providers able to access applicants’ medical records. The shots would ultimately be administered at smaller clinics separate from the various mass-vaccination sites already in operation.
During the three-hour meeting, Brooks and Dr. Rob Schechter said the proposal to expand eligibility was based on studies showing that people with disabilities are 2-3 times more at risk of dying due to Covid-19 than those without.
They added that local health departments would be responsible for immunizing inmates and people in homeless shelters if they are included in the next expansion but didn’t speculate as to when the expanded pool would go into effect.
The list of qualifying conditions is still a work in progress, but health officials said they are also considering allowing people with three or more underlying health conditions to get the shot. The group is meeting again Friday to finalize its recommendations before sending them to Governor Gavin Newsom for consideration.
“We really want to get this right,” said Dr. Erica Pan, advisory committee co-chair.
While they are likely to be included in the next round, it still could be a long wait for the state’s disabled or incarcerated residents as Pan admitted there is not close to enough supply to immunize the groups already eligible as it is.
To cover the over 11.5 million combined seniors, health care and essential workers, the state will need 23 million doses. As it stands, the state has received just over six million doses from the federal government and is expected to receive just two million more over the next two weeks.
Wednesday’s hearing comes amid a growing wave of frustration regarding the state’s and more specifically Governor Gavin Newsom’s handling of the vaccine effort.
Less than a quarter of respondents in a recent University of California, Berkeley poll approved of the job the state has done in distributing the potentially life-saving vaccines while 40% rated Newsom’s performance as poor or very poor.
The panel heard Wednesday from a variety of concerned and irritated Californians ranging from experts, residents and even judges.
A group of professors from UC Berkeley’s school of public health urged the state to take an “equitable and anti-racist” approach to the next stage of vaccinations, saying the current system is unfair.
“The current approach needs to take into account the twin pandemics of structural/toxic racism and Covid-19 that is creating a syndemic for communities of color in California,” the professors said in a joint comment letter.
The professors said the state should publicly release information about vaccination rates per race and use it to pin down potential racial disparities. They noted that early indications point to whites getting vaccinated at a much higher clip than Blacks and Latinos in California.
Of the nearly 300 letters sent to the committee in advance of the hearing, many older residents reiterated they remain confused by the state’s ever-changing rules as to when they or their parents can get their shots.
“I have been scanning websites to better understand the guidelines that determine priority but don't see anything helpful,” said Susan Morita.
In her letter, the 62-year-old San Diego resident said she and her partner have rarely left the house since he suffered a traumatic brain injury last year.
“How do vulnerable patients arrange to obtain the vaccinations as soon as possible?” Morita asked about her partner who is over 65.
State judges, bar associations and public defenders are also jostling for position and warned the committee that the lights could go dim in courthouses if court employees aren’t quickly given higher priority.
“Regardless of the precautions we might take, the nature of our work — which involves talking to different groups of people all day indoors — puts us at risk. If court employees don't get vaccinated soon, courts will have to shut down,” said Donald Proietti, Merced County Superior Court Presiding Judge.
Another state judge wrote that she nearly died after presumably catching Covid-19 at the courthouse and is still fighting off the virus one month after being infected.
“My head hurts every time I move my eyes. Every day is a struggle to maintain my oxygen level,” said Sacramento County Superior Court Judge Maryanne Gilliard.
While the committee and governor figure out who is up next for the precious vaccine, the role the private sector will play in the vaccination effort is becoming clearer.
Last week Newsom tapped insurance giant Blue Shield of California in conjunction with Kaiser Permanente to take control over the vaccine distribution from the counties.
Newsom said while county agencies have laid the groundwork for the vaccination program, the state needed to step in and take a more aggressive approach as California fell behind the nationwide average.
As the mammoth process of immunizing 40 million people continues, Blue Shield is expected to take over the distribution process, streamline data collection and help the state log demographic information.
CEO Paul Markovich said the not-for-profit insurer is up for the task of tracking and coordinating the administration of doses considering it already serves millions of Californians and has connections with over 60,000 doctors. Under the terms of the contract, which are expected to be released by the state later this month, Blue Shield will be reimbursed for its services but is prohibited from making a profit.
“These are such valuable commodities, they are so important, that the only way to maximize performance is to know at all times what performance is,” Markovich told the committee. “We need to ensure there’s equity in that distribution and administration.”