Covid-19 vaccines for people with underlying health problems vary by state

McCulloch, 27, lives with type 1 diabetes, as do his twin sister and father. The disease increases the risk of serious illnesses if they receive Covid-19.

“One of the first things my father told me when I was diagnosed was that I would have to fight for myself and my health for a lifetime,” McCulloch told CNN. “So when I came in and managed to get the vaccine … I felt a great sense of relief.”

Since then, many states have started vaccinating the next priority groups, like other essential workers, the elderly and – more recently – people with comorbidities or underlying medical conditions that put them at increased risk, such as diabetes.

“At the end of the day, 40% of all deaths caused by Covid-19 are among people with diabetes, not just type 1, but also type 2,” said McCulloch, project manager for the American Diabetes Association. Although, according to the association, diabetes affects only about 10% of the United States population.

But the initiative to vaccinate people with diabetes and other diseases has not been uniform across the country. In some states, people with comorbidities are not yet eligible to receive the vaccine – and in the states where they are eligible, there are variations in the conditions that make someone eligible for the vaccine and whether the paperwork is necessary to confirm that condition.

The underlying conditions that qualify

Most states that are vaccinating 16- to 64-year-olds with certain comorbidities are defining conditions eligible under the guidelines of the US Centers for Disease Control and Prevention on which conditions are associated with an increased risk of serious illness due to Covid- infection. 19.
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The CDC notes that adults of any age with the following underlying conditions are at an increased risk of severe Covid-19: cancer, chronic kidney disease, COPD, Down syndrome, heart problems, obesity and severe obesity, sickle cell disease, smoking and type diabetes. 2. The list also includes people with weakened immune systems due to solid organ transplantation and pregnancy.

Some states include only some of these conditions on their list of eligible conditions, while others may require a person to live with two or more of these conditions to be eligible.

In New Hampshire, for example, having two or more illnesses qualifies you for the Phase 1b vaccine, if your conditions are checked by a medical professional, but having only one condition puts you in Phase 3A, which has not yet started.
In Ohio, those with developmental or intellectual disabilities in addition to certain congenital, developmental or early-onset and hereditary conditions are eligible for vaccination, according to the state Department of Health website.

The state of Colorado, where McCulloch lives, has not started vaccinating people with certain comorbidities or underlying health problems, such as cancer, heart problems or diabetes.

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McCulloch was able to receive the first dose of the Modern vaccine because a local pharmacist who vaccinated McCulloch’s mother mentioned that the pharmacy had some extra doses of the vaccine that needed to be administered quickly. Otherwise, the doses would expire and could not be used.

“They asked if she knew anyone who lived with diabetes, heart disease, all that stuff – and she said her husband and two daughters lived with diabetes,” said McCulloch. “So I was able to go.”

When McCulloch arrived at the pharmacy to get the vaccine, the pharmacist asked for proof that McCulloch lives with diabetes. McCulloch said she showed the pharmacist a glucose monitoring sensor on her arm, some of her medical data that she tracks on an app and her health insurance information.

“Because I was in the right place at the right time, I was able to get in line and get my first shot,” said McCulloch. She is due to take her second dose on February 15.

“I recognize that I have a very privileged position, because of the way the rollout was done and because my mother is a special education teacher,” said McCulloch.

“For example, my father and twin sister have not yet received the vaccine,” she said. “This is part of the problem now – is that state rules vary widely and, at the end of the day, people with comorbidities deserve to receive the vaccine as much as other people.”

Where people with comorbidities are eligible

People with certain comorbidities and underlying conditions are currently eligible to apply for Covid-19 vaccinations in nearly a dozen states: New Hampshire, New Jersey, Pennsylvania, Texas, New Mexico, Virginia, Mississippi, Ohio, Missouri, Nebraska and Montana, according to a CNN analysis of public health department websites.
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Some of these states have started vaccinating this group, while others are just beginning pre-registration. Within a state, it can vary from municipality to municipality.

In some other states, vaccinations are scheduled to begin soon this month.

In New York, people with comorbidities and underlying conditions can apply for vaccination appointments starting on Sunday and vaccines are scheduled to start on Monday.
“As the state’s effort to vaccinate health workers nears its end this week, we are changing these doses to prioritize New Yorkers with pre-existing comorbidities and conditions – a group that has felt the weight of COVID’s destructiveness in first hand, “New York Governor Andrew Cuomo said in a press release this week.
In Illinois, the state plans to expand eligibility for the vaccine on February 25 to include people with comorbidities, underlying diseases and disabilities.

On Wednesday, Illinois Governor JB Pritzker said in a press release: “Once we get enough vaccine supplies, we don’t need to waste time protecting a wider part of our most vulnerable population.”

‘Some … will be in the honor system’

But how individuals confirm their underlying conditions differs from place to place.

In some states, such as New York and New Mexico, documentation is required at vaccination appointments to prove that you have an underlying medical condition. For example, New Yorkers must provide a medical certificate, medical records or a signed certificate.

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In New Mexico, the state Department of Health notes: “Individuals must be prepared to verify medical qualification conditions. To do this, individuals can provide a note from a provider, emergency department or discharge summary, bottle prescription, prescription or other validation form. ”

In some other states, such as New Jersey, Texas and Virginia, no documentation is required.

Texas State Department of Health Services spokeswoman Lara Anton told CNN in an e-mail on Thursday: “We don’t want to create barriers that prevent people from being vaccinated. To confirm chronic medical conditions, providers should consult the person’s medical history. If a provider does not have access to the person’s medical history, the person can reveal their qualified medical condition. They do not need to provide documents to prove that they qualify. “

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Each state is different “and some of these vaccine registration processes will be on the honor system,” said Lori Tremmel Freeman, executive director of the National Association of County and City Health Officials, known as NACCHO.

As someone living with high blood pressure, Freeman said he pre-registered for a vaccine on an online waiting list in his community of Prince William County, Virginia, in the category of underlying health problems. Covid-19 vaccines will be administered to this priority group as soon as the county moves to the next vaccination phase.

“In the case of my own jurisdiction, pre-registration for those with underlying conditions is based on an honor system to tell the truth,” she said. “I didn’t have to provide proof of medication, a diagnosis of the underlying disease or anything like that.”

Freeman said there are several ways in which residents can learn about their eligibility for the Covid-19 vaccine, such as through the local health department, community organizations or religious community.

McCulloch, who received his first dose in Colorado, certainly waits when his twin sister and father will be eligible to be vaccinated in their communities.

“I believe in health and science,” said McCulloch. “This is fundamental to the health and safety of our population.”

CNN’s Ashley Ahn contributed to this report.

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