I am “at risk”, how, and when, can I get my COVID vaccine?

Likely not until early 2021. California is following the CDC’s advice in prioritizing certain health care workers and long-term care residents, a group that it is calling phase 1A.

The state has developed a detailed tier system for its first wave of vaccines. Since there won’t be enough doses initially to immunize all health care workers and long-term care residents, priority will go to older medical professionals and residents of skilled nursing facilities. Younger health care workers and less medically vulnerable long-term care residents will need to wait longer.

The federal Advisory Committee on Immunization Practices recently recommended the second priority group (phase 1B) should include frontline essential workers and people over 75. In doing so, the panel tried to balance the competing interests of keeping society functioning, by protecting essential workers, and saving lives, by protecting elderly Americans who are most likely to die if infected. 

Most states, including California, have signaled that they’ll largely abide by the federal panel’s guidance. But states are allowed to set their own priorities. On Monday, Gov. Gavin Newsom said more than 70,000 first doses of the Pfizer vaccine were given last week and that the state expects more than 560,000 doses to be delivered before the end of the year. Newsom also announced that 672,600 doses of the newly authorized Moderna vaccine is expected to be delivered this week.

Last week, California’s own expert advisory panel presented its preliminary recommendations for who should get the vaccine next, suggesting education and childcare workers, first responders such as police officers and firefighters, and food and agricultural workers including grocery and restaurant workers. Older Californians, unless they fall into one of these essential worker categories, were not included in the working group’s highest priority within the second group to be vaccinated. 

The California panel is expected to issue its final guidance for the second vaccine priority group this month. Once that happens, state and county officials are expected to abide by that guidance in distributing still-scarce vaccine doses. But in a state as large and diverse as California, individual counties will have some leeway in arranging the line. That has sparked a lot of lobbying by unions and other interest groups who argue their workers are more essential than others. 

Where can I get a vaccine?   

It’s available only in hospitals and long-term care facilities to start, and only to the phase 1A group. After that, California plans to work with hospitals, pharmacies and mobile clinics to distribute vaccines. The state may also partner with colleges, universities and correctional facilities to ensure younger and incarcerated Californians have an opportunity to get a vaccine.

How will residents of nursing homes and other long-term care facilities get the vaccine? 

The federal government has contracted with CVS and Walgreens to administer the COVID-19 vaccines at no cost to long-term care residents and staff. The two national drugstore chains say that more than 48,000 of the 50,000 skilled nursing and assisted living communities in the U.S. are participating in the program. However, Los Angeles County has opted to administer vaccines directly to long-term care staff and residents rather than relying on the drugstore partnership.

Source: From California Department of Public Health Allocation Guidelines for COVID-19 Vaccine During Phase 1A: Recommendations, AARP’s The COVID-19 Vaccine Distribution Plan in California and CalMatters.Org

Jennifer Abrams, MD, December 22, 2020