Well, in NY nobody yet qualifies based on health status. Still too many 19 year old stock boys at stop and shop who have to get one first, so their 64 year old grandmas on chemo have to wait.

I wish I were kidding.

While prioritizing people with health issues makes a ton of sense in theory, I'm not sure how you accomplish it practically/adminstratively. Adds another layer of complexity to a public health care and vaccine distribution systems that aren't exactly firing on all cylinders with what they've got going on right now.

It’s doesn’t seem conceptually any more difficult that prioritizing by profession. You need to claim the employment status to make the appointment and prove it at check in to get the vaccine. You could do that just as easily with a diagnosis. Even easier in many cases, since people with serious conditions are likely associated with a medical center that is itself a vaccine site.

Also, NY will eventually do it, so they’re not avoiding the difficulty, they’re just delaying it until politically favored groups get vaccinated first.

You can prove profession with an employee id. Age with a driver's license. How do you prove a diagnosis to a mass vaccination site or Walgreens?

Honest question, not snark.

And just to reiterate...I think the system is already overloaded....look at the lines in Florida. First come, first served, no appointments. If they can't figure out how to set up a system for scheduling, how will they identify the people with "right" comorbidities?

Oklahoma's registration site has a list of comorbidities that you can check, but I don't know how it works. It may just be the honor system, which doesn't bode well. Or maybe you'll have to show up at the vaccination with a form signed by your doctor. I guess we'll find out when they get to that part of Phase 2.

Each state is rolling its own system as far as I can tell.

Illinois has no statewide registration. Some counties have set up online registration and are sponsoring mass vaccination clinics.

In Cook County, if you're in Chicago there's one system administered by the Chicago Dept of Health; I haven't looked closely at what it does. If you live in suburban Cook County, you're under the Cook County Department of Health. You can register to be notified where you can get vaccinated once your phase comes up, but there's currently no appointment scheduling system. I heard there will be several mass vaccination sites in the county; not sure if it's the county or the state that is setting those up.

Some hospital systems are doing their own registration systems for their patients. We've heard from one of the three hospital systems that we have doctors in. They said they'd be sending out invitations to register, and that it was possible that you'd have to see your PCP before they let you register. But it's a scheduled appt that you can only set up if you get an invitation. They could do what jon is proposing, but I have no clue how many people fall under their umbrella of care.

I have no idea how health care happens in non-urban areas. Do they have the big hospital systems and doctor groups, or are there more independents?

Public health is not well-funded. It's been stretched to its limits over the last year. I'm pretty sure they have few if any technical resources to help them plan and set up these systems. I described earlier what's happening in Washington in a rural area. It's a bottom/up grassroots kind of effort.

They're doing the best they can.

There are so many online "my chart" health things now. In my case, each one contains my health history, tests, and treatment if something occurred. But I also wonder if it would violate HIPAA if the vax people required folks to provide a health history.

I've heard from more than one source that if you linger at a vax clinic at the end of the day, you may be able to get a vaccine simply because they don't want to toss out the leftovers.

quote:

Originally posted by wtg:
How do you prove a diagnosis to a mass vaccination site or Walgreens?

If you look at the states that are doing it they're asking for a doctor's note or some official documentation of the diagnosis. But again the people with the most serious conditions are likely associated with a medical center which is itself a vaccine site.


Most of the transplant patients I know got it at their transplant centers.

Figuring out how to get transplant patients the vaccine early would be pretty easy. Big hospital system with access to the necessary records. And patients who have to see their doctors on a very regular basis. And there aren't that many of them.

I thought you were speaking broadly about people with more garden variety health issues like diabetes, etc.

quote:

Originally posted by wtg:
You can prove profession with an employee id. Age with a driver's license. How do you prove a diagnosis to a mass vaccination site or Walgreens?

Honest question, not snark.

Yes, and so the back office staff of a firm that processes insurance codes gets vaccinated because they "work for a health care firm" while people with serious health conditions wait because they're not working.

As Jon has noted, it's just as easy to have an official document from a medical practice putting you in a vaccine group as it is to have a badge from a company that "proves" you deserve a vaccine based on employment.

Diabetes is an official diagnosis. You wouldn't walk in with a note from your cousin saying "so and so has diabetes."

The system is full of holes (and inequities) that people will take advantage of if they're inclined to do so.

I think it's a nontrivial technical and planning exercise to make it better.

To be honest, there are some basic things that could be done fairly simply, like creating a HIPAA-compliant "vaccine approval" form of some sort that a licensed doc's staff could create en masse for their patients.

I'm coming from an unusual perspective. As part of the federal CARES act, I (and thousands of other organization representatives around the US) have been asked to implement programs in 1-2 weeks in order to roll out and track federal fund use. It's been a nightmare, but it is a solvable problem. It's just not being prioritized because there is no money that is attached to it.

My 2c.

My DIL got her vaccination early this morning. Greg drove her there and while they were at it they gave him one too.

Got an email from my primary care physician today, instructing me to fill out a form to get on a list. Now I am on two lists.

Yahoo!

quote:

Originally posted by rontuner:

quote:

Originally posted by Daniel:

quote:

Originally posted by jon-nyc:
By the way I'm a huge fan of the First Dose First plan. Props to Biden for going with it. It will obviously save lives.

What's the First Dose First plan?

Instead of holding back doses to guarantee a second dose for everyone that gets a first dose, give out all the doses available to get more people through the first round. Then hope more doses come down the pipeline to get people the second doses...

NYT op ed from a couple of infectious disease/vaccinology docs arguing for First Dose.

https://www.nytimes.com/2021/0...vaccine-booster.html

I think the First Dose strategy makes a ton of sense, especially for the Moderna vaccine. It has an 80 percent effectiveness rate ten days after the first dose.