As COVID-19 vaccines become more available to older Texans and those with underlying health conditions, confusion remains about how those who qualify under the state’s rollout plan are expected to demonstrate their eligibility.
Health care providers have access to medical records and can reach out to eligible patients about the vaccine. But state or locally run vaccination sites don’t have medical files.
And while health officials want initial vaccines to go to those at higher risk of developing serious illness — a move that will lessen the burden on overwhelmed health care systems — they also don’t want to make it hard for people to get vaccinated.
Currently, Texans eligible for the vaccine under the state’s plan include front-line health care workers and those in long-term care facilities, known as phase 1A, and those over 65 and people 16 and older who have underlying health conditions, known as phase 1B.
Health conditions on the state’s list include, but aren’t limited to, cancer, chronic kidney disease, chronic obstructive pulmonary disease (COPD), Down syndrome, certain heart conditions, organ transplant recipients, obesity and severe obesity, pregnancy, sickle cell disease and type 2 diabetes.
The state health department told health care providers to refer to medical records to confirm underlying health conditions. If the provider doesn’t have access, people eligible under phase 1B can disclose their conditions — but they don’t have to provide documentation, said Lara Anton, a spokeswoman for the department.
“We don’t want to create barriers that would prevent people from getting vaccinated,” Anton said. “It’s important to remember that every person vaccinated helps slow the spread of the virus.”
Dallas County’s health department, which the state has designated as a vaccination hub, is focusing on those over 75 and has not yet opened appointments to younger people in the 1B category. When they do, health officials won’t require medical records, said Dr. Philip Huang, director of the county’s health department.
While it’s possible someone could be dishonest about his or her 1B status, people should remember the goal of phased vaccine rollout is to “make the limited vaccine that we have practical,” Huang said.
“We hope people will all understand and hope everyone would rather protect their grandparents and their mother and other people’s grandparents and mothers, and understand this is in all of our best interests,” he said.
Dr. Matt Richardson, director of Denton County’s health department, also a vaccine hub, said the county has done its best to balance ensuring that people are eligible and honest about their status and getting “as many doses in as many arms as possible.”
“It would bother us if people weren’t being truthful, and yet that is a small price to pay,” he said, adding that the ultimate goal is to get the community to reach herd immunity as quickly as possible. “It would bother us much more if we were withholding vaccines and delaying an efficient, effective process.”
Tarrant and Collin counties’ health departments also have been designated as vaccine hubs. A spokesperson with Collin County said patients are not required to provide medical records to get an appointment. Tarrant County did not respond to requests for comment.
Dr. John Carlo, chief executive of Prism Health North Texas, said changing eligibility criteria at Dallas County’s vaccination site, which is intended to provide vaccines to underserved communities, and data that showed initial COVID-19 vaccines went to more affluent, northern neighborhoods bothered him more than the idea of people skipping the line.
“If we focus more on how we actually are successful at reaching those that need to be reached, and less worried about turning people away that don’t seem to fit the criteria, I think it’s going to be better served to the community,” Carlo said.
Dallas County contended with the same question about verifying eligibility when vaccines became available during the H1N1 flu outbreak, Carlo said. He served as director of the county’s health department at the time.
Carlo said the H1N1 vaccine rollout wasn’t as complex or widespread as the COVID-19 rollout. The logistics and distribution guidelines were entirely up to the county, he said.
Because it was a flu virus, officials decided to first focus on children with underlying health conditions. He said the department considered requiring parents to provide documentation, but ultimately realized it would be an onus on both parents and health officials.
“Once you have 300 people in line, you’re not going to be able to sit there and screen that,” Carlo said. “As soon as you start turning too many people away, you disenfranchise folks. The ultimate question is, if you turn them away that day, will they ever come back? And then you’ve kind of defeated the whole point, which is to get the vaccines out there to everybody as soon as possible.”
