Seniors must be the priority for vaccine – AARP-RI, by Herb Weiss

By Herb Weiss, contributing writer on aging issues

Last month, in a statement by the Rhode Island Department of Health (RIDOH) received a recommendation from the Rhode Island COVID-19 Vaccine Subcommittee for hospitals to begin vaccinating front line hospital workers against COVID-19. This recommendation was made at an emergency meeting of the Subcommittee. RIDOH has accepted the recommendation and has communicated to hospitals that they may begin vaccinating these workers, as soon as vaccine arrives.

Two doses will be needed for someone to be fully immunized, as we know. Rhode Island receives weekly vaccine deliveries. At this point 1/2 of those are kept in storage for that second shot. Expect to see changes in the vaccine distribution system. Whether it comes before January 20th in the form of changes in where and how the vaccine is delivered, or after January 20th, when President-elect Joe Biden has said he will release all of the vaccine to the states. It’s time for Rhode Island to be ready for any of these changes.

Epidemiologists, primary care providers, pharmacists, pediatricians, long-term care advocates, ethicists, nonprofit leaders, school leaders, faith leaders serve on Rhode Island’s COVID-19 Vaccine Subcommittee.  This group is responsible for performing an independent review of the process for evaluating the safety and efficacy of the vaccine. The Subcommittee is advising RIDOH on how to prioritize distribution of the vaccine to ensure that it is done equitably, and in a way that best protects the State as a whole.

Making COVID-19 Vaccine Available Throughout the Ocean State
Some history just before the vaccines were made available in RI: “After a rigorous scientific review, we know that COVID-19 vaccine is safe. We also know that it is one of the most effective vaccines ever developed,” said Director of Health Nicole Alexander-Scott, MD, MPH in her Dec. 14 statement. “In the coming weeks and months, as vaccine becomes more available, getting vaccinated will be one of the most powerful things you can do to keep yourself and the people you love safe from COVID-19. We are going to work to ensure that every person in every community in Rhode Island has access to the vaccine, especially those communities hardest hit by this virus,” she said.

Added, Philip Chan, MD, MS, Consultant Medical Director for RIDOH’s Division of Preparedness, Response, Infectious Disease, and Emergency Medical Services, “We have never had a vaccine that has been – or will be – more closely monitored than the COVID-19 vaccine. Teams of scientists at the national level have been scrutinizing thousands of pages of technical data for weeks, focusing on vaccine effectiveness, safety, and the manufacturing process, and our own local review has happened here in Rhode Island. I absolutely plan on getting vaccinated when it is my turn,” said Chan.

The national vaccine trials for the COVID-19 vaccine involved tens of thousands of people to make sure they meet safety standards and people of different ages, races, and ethnicities. There were no serious safety concerns. (When vaccinated against COVID-19, people do sometimes develop post-vaccination symptoms such as soreness at the spot of the shot and headaches. This is normal, healthy, and expected. It means your immune system is working to develop protection.) Several systems are in place to do ongoing safety monitoring of the vaccine. There have been some allergic reactions, all handled well by stand-by medical intervention – almost everyone experiencing reactions knew they were at greater risk for them.

As of January 8, the last update on RIDOH’s COVID-19 Data Tracker, out of the 31,541 does administered, 29,743 have been vaccinated with their first of two doses, only 1,798 people were fully vaccinated with two doses. Don’t look for the roll out of COVID-19 to take days or weeks, it will take months to complete, warned RIDOH officials. 

Phase 1 of the vaccination program is expected to run through late March. At press time, the state is currently working its way through the top three tiers of this phase, including hospital staff, healthcare workers, EMS personnel, home health and hospice workers, nursing home staff and residents, high-risk incarcerated persons, first responders, school nurses, and even hard-hit communities. 

Finally, those in the final two tiers of Phase 1 to be vaccinated include outpatient providers (Dentists, primary care), Dialysis Center workers and death care professionals, expected to begin Jan. 25, and adults over 75 years of age, expected to start by February.  Phase 2 is expected to kick-in by late March.  A number of factors are being considered to target the distribution of COVID-19 vaccinations a persons age, high-risk conditions, occupation and geography.  And don’t forget – changes are coming in distribution – sooner rather than later to increase total vaccines given which will move these timelines.

Make Older Rhode Islanders a Priority

AARP Rhode Island, representing 132,000 older Rhode Islanders, has called for Governor Gina Raimondo to make the state’s seniors a priority in its time-line for on distributing COVID-19 vaccine.  The Jan. 8 correspondence, cosigned by Kathleen Connell, State Director of AARP Rhode Island and Phil Zarlengo, the group’s State President, called on Raimondo “to increase COVID vaccination transparency,” as it relates to older Rhode Islanders.

“In order to increase public awareness of vaccine allocations and improve confidence in a fair distribution process, it is important that all Rhode Islanders have access to accurate and transparent information,” states the AARP Rhode Island’s correspondence.  AARP Rhode Island asked the Governor to include the numbers of Rhode Islanders vaccinated by age and other criteria on a daily/weekly basis on RIDOH’s COVID-19 Data Tracker.  Specifically, the largest state-wide advocacy group called for the state’s website to include:

1. the numbers and percentages of older Rhode Islanders by race and ethnicity, that have been vaccinated.

2. the number of Rhode Islanders vaccinated and their age demographics on a daily/weekly basis.

3. a clear and easy-to-understand schedule of vaccine administration for all populations; and the process by which individuals may seek and obtain a vaccine.

4. the numbers and percentages of long-term care residents, by facility, that have received their first and second doses of vaccines.

5. the numbers and percentages of long-term care staff, by facility, that have received their first and second doses of vaccines.

Over 50?

While acknowledging the many challenges the state officials must tackle in determining how to equitably, safely and effectively distribute COVID-19 vaccines, Connell and Zarlengo call for Rhode Islanders age 50 and older to be made a priority in receiving a vaccine.

“The data clearly show that the older people are, the higher risk they face if they contract COVID-19.  Given that older individuals are at a greater risk of death from COVID-19, we strongly urge you to ensure that Rhode Islanders age 50 and older are prioritized to receive a vaccine.  These individuals must be given priority access to vaccines, in addition to those individuals receiving care in nursing homes and other long-term care facilities,” they say. 

“For years, the long-term care system has been shifting away from institutional care in nursing homes to home and community-based settings (HCBS). Here in Rhode Island, a significant percentage of long-term services and supports are provided in the home or settings such as assisted living facilities, residential care facilities, veterans homes, and in individuals’ own homes,” says Connell and Zarlengo, stressing that this why the state should prioritize seniors, especially those with underlying conditions, receiving care in these additional settings and the staff providing care, to receive a COVID-19 vaccine.

Finally, Connell and Zarlengo urge Raimondo to ensure that all providers fully comply with established state procedures for vaccine distribution and prioritization. “We urge you to investigate and take swift action against anyone who attempts to commit fraud, including by inappropriately selling the vaccine or intentionally providing vaccines to those who do not meet qualifying criteria in an attempt to circumvent the distribution process,” they said, noting that “public confidence in the vaccine and its fair distribution is dependent on the state’s strong oversight and enforcement.” 

“We urge public health officials at the state and local level, as they decide on vaccine allocations, to rely on the evidence and make plans backed by science.  As production is ramping up, AARP is advocating hard to ensure every older American who wants to get the vaccine can get it.  It’s also vital that distribution plans for authorized vaccines are smoothly implemented.  There’s no time to waste: it’s time for full-scale mobilization, and any delays or early bottlenecks in distribution systems need to be addressed urgently,” says AARP Executive Vice President and Chief Advocacy & Engagement Officer, Nancy A. LeaMond

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Herb Weiss, LRI’12, is a Pawtucket writer covering aging, health care and medical issues. To purchase Taking Charge: Collected Stories on Aging Boldly, a collection of 79 of his weekly commentaries, go to herbweiss.com.