RALEIGH
North Carolina will make COVID-19 vaccines available to anyone age 65 and older and all health care workers, regardless of whether they are exposed to coronavirus patients, the state announced Thursday.
The new eligibility rules partially match a change in guidelines announced by the federal government on Tuesday. Alex Azar, U.S. Secretary of Health and Human Services, said vaccinating everyone 65 and older would be simpler and make the process go faster.
Under North Carolina’s previous phased system for distributing the vaccine, people age 75 and older were eligible to get inoculated starting last week. Hospitals and counties have been scheduling their first clinics for people in that age group, and so far demand has far outstripped available supply in most areas.
Gov. Roy Cooper first announced the change Thursday to members of the N.C. Association of County Commissioners. It is also now reflected on the state Department of Health and Human Services’ vaccination website, yourspotyourshot.nc.gov.
North Carolina started distributing vaccine last month for hospitals to administer to front-line employees who work with and around COVID-19 patients. A federal program, run through CVS and Walgreens, also began inoculating residents and employees of nursing homes and other long-term care facilities.
Now, all health care personnel who work around patients are eligible.
The new criteria put people age 65 and older ahead of other front-line essential workers, such as firefighters and teachers. Under the old plan, the next groups to qualify for vaccination after people 75 and older would have been front-line health care workers and essential workers age 50 and older followed by front-line health and essential workers of any age.
Dr. Mandy Cohen, the state Secretary of Health and Human Services, says the state’s goal is to make the prioritization plan easier to understand and execute. North Carolina shifted to a simplified system with five groups, doing away with different phases and built-in subcategories that were to be used to prioritize who gets the vaccine.
“We know there has been more confusion than there needs to be, and so we are definitely hearing the message about simplicity and speed,” Cohen said. “That’s why we’re trying to really be clear: What we’re vaccinating right now is all health care workers and those 65 and older.”
Competition for limited vaccine supply increases
The change will widen the pool of people now seeking vaccination, making the competition for the limited supplies of vaccine more fierce. Joan Seymour of Cary, who is 79, said this will make it even harder for her to get her shot now.
“Wake County isn’t even setting up appointments until 19 January,” Seymour wrote in an email. “Now I’ll have to contest appointments with additional millions over 65. It’s not fair.”
There are just more than a million North Carolinians between 65 and 74 years old, according to estimates from the N.C. Office of State Budget and Management.
DHHS previously estimated that there are about 435,000 people in North Carolina older than 75. The health department also estimated that there are an additional 292,000 direct health care workers who were not initially eligible to receive vaccine.
Many doctors and others in health care support the change, said Tatyana Kelly, vice president of planning, strategy and member services for the N.C. Healthcare Association, which represents all 130 hospitals in the state.
The health problems that make people vulnerable to COVID-19 often begin at age 65, Kelly said. And, she said, only vaccinating people 75 and older leaves out a disproportionate number of people of color or with low incomes who have lower life expectancy on average.
“We really need to focus on making sure those in marginalized and under-served communities can get the vaccine quickly,” Kelly said. “You have a higher ratio of people, to be honest, who are white in the age 75 and up group.”
Kelly said there already isn’t enough vaccine to go around, and that won’t change with the new criteria. Like everyone involved in the vaccination process, she urged patience.
Since vaccine distribution began a month ago, North Carolina’s total allocation has been 706,075 first doses; both vaccines require two doses. That’s more than a million doses less than it would take to vaccinate everyone who’s now eligible.
Cohen acknowledged that vaccine remains in limited supply. She said the state is now receiving about 120,000 doses a week and that it’s working with hospitals, health departments and others to get all of it to people within seven days.
“We have less vaccine in our state than the number of people who are eligible to get it at this moment,” she said. “For those who are 65 years and older, you could get vaccine starting now, but that doesn’t mean vaccine is available for you today or an appointment is available for you today.”
Demand exceeds supply
Katye Griffin, the executive director of the N.C. Association of Local Health Directors, agreed with Cohen, warning that the high demand for vaccine is already outpacing the limited supply for those who already have made an appointment to receive the vaccine.
“We may need a week or two to incorporate newly revised groups and guidance since appointments and events have already been scheduled,” Griffin said.
In New Hanover County, for example, the health department announced that appointments were booked through Friday with people 75 and older. When the department receives next week’s shipment, it plans to open appointments to those who became eligible with Thursday’s announcement.
UNC Health set up 15 vaccination clinics in 12 counties this week and says its ability to inoculate people is limited by the availability of vaccine. Spokesman Alan Wolf said the health system will adjust its screening and scheduling system to allow those 65 to 74 to make appointments.
Those appointments were already full this week. Still, UNC applauds the state for broadening its eligibility criteria, Wolf said.
“We continue to see too many older adults who are getting really sick and ending up in our hospitals,” he said.
Allan Goldberg of Raleigh doesn’t want to join them. Goldberg, 76, says he’s a heart attack and cancer survivor who tried to schedule a vaccination at Duke Health and UNC, and learned the only appointments available were in Kinston. He thinks the vaccine rollout has been poorly handled and doesn’t see why the priorities should be changed.
“With 65-and-overs now eligible, they can have the thrill of joining me in the ‘no appointments available’ queue,” Goldberg wrote in an email.
Advice from federal government shifts
The change in guidance from the federal government caught state officials off guard on Tuesday. Cohen says the state developed its plan based on guidelines from the Centers for Disease Control and Prevention and said her office would quickly review the changes.
Cooper expressed frustration Tuesday with the timing of the new directive.
“One of the continuing problems we have had with the federal government is that they have continued to shift their advice on what the priorities of the vaccine should be,” Cooper said at a press conference two hours after Azar announced the changes in Washington.
The wider criteria are part of a broader federal strategy to increase the pace of vaccinations, which have lagged nationwide.
Azar said the federal government would ship all the vaccine it currently has on hand, rather than holding some back for the second doses that both vaccines require. He said production has become reliable enough that the second doses can be shipped straight from manufacturers to the states.
Azar also announced that in two weeks the federal government will begin allocating vaccine to the states based on the number of residents 65 and older and on what percentage of a state’s previous vaccine shipments have been given out.
Azar said his department would like to see states broaden the distribution channels for vaccinations to include pharmacies and mass inoculation events.
On Thursday, the state Department of Health and Human Services announced large community vaccination events in 21 counties, including Wake, Mecklenburg, Durham, Orange, Chatham and Johnston. Links to the websites of the organizations putting on the events can be found, listed by county, at covid19.ncdhhs.gov/findyourspot.
People with underlying health problems must wait
North Carolina is not adopting all of the eligibility criteria recommended by the Trump administration. Azar and CDC Director Robert Redfield also urged states to begin vaccinating anyone under 65 who has a documented health condition that makes them vulnerable to COVID-19.
Under the state’s new vaccination system, people age 16 to 64 with “high-risk medical conditions that increase risk of severe disease from COVID-19” will be eligible to get the vaccine in Group 4, after front-line workers.
John Welfare of Waxhaw said he is angry that the state decided to make people 65 and older eligible for vaccine now but not younger people like himself with underlying health problems.
“I have a highly compromised immune system and COPD, but now hundreds of thousands of otherwise healthy people just jumped in front of me while I am a sitting duck for this horrible disease,” Welfare wrote in an email. “This is grotesquely unfair and infuriating.”
Cohen ended her press conference by noting that some sort of prioritization system is necessary because of the limited supply. She said if North Carolina used all the vaccine at its disposal, only about 6% of the state’s 10.5 million residents would get at least an initial dose.
“Which means we have to do the work we’ve done all year long, which is wear a mask, stay socially distant and wash your hands often,” she said. “Please do stay home and only go out for essential business. Remember, there is a lot of virus here in North Carolina.”
This story was originally published January 14, 2021 10:35 AM.
