How will you be informed when it is your turn to get the COVID-19 vaccine? It’s complicated.

Will you receive a message from your doctor? Are you going to read about it online? Or will you have to check the Centers for Disease Control and Prevention website to find out when it’s your turn to get in line?

As COVID-19 vaccines are distributed to limited groups of people in the United States, how people find out they are eligible to receive their vaccines will not be as clear as long as supplies remain limited, according to policy and public health experts and health plans. state vaccinations.

“I think it will be a bit obscure,” said Katie Greene, a visiting political associate at the Duke-Margolis Health Policy Center.

“I wouldn’t be surprised if thousands of people were left out because of the information gap,” added Tinglong Dai, a professor at Johns Hopkins Carey Business School who studies operations management and business analysis in healthcare.

Vaccine distribution has largely been left to the states, and with an “isolated and decentralized health care system” in the United States, as Dai said, people may not know when they will be eligible to receive the vaccine. And they may have to be proactive to find out where they can get one and to prove that they meet the criteria to be next in line.

In Phase 1a of the vaccine launch, health professionals and residents of long-term care facilities are prioritized, groups that are easy to reach because they are in different locations, Greene said.

During the next phase, people aged 75 and over and essential frontline workers should be prioritized, according to the recommendations of the CDC’s Immunization Practices Advisory Committee. Thereafter, Phase 1c will include people aged 65 to 74 and people aged 16 to 64 who have high-risk medical conditions, along with other essential workers.

“These are much more difficult groups to reach,” said Greene.

Hence he expects some confusion and inefficiency as distribution continues in late winter and early spring, when supply is still growing and more, but not all, people are eligible to receive the vaccine.

“It will be a very complicated screening process,” he said, adding that it will not be consistent across healthcare providers.

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Federal officials with Operation Warp Speed ​​expect around 50 million people to have received their first of two vaccines from the COVID-19 vaccine by the end of January, Health and Human Services Secretary Alex Azar said earlier this week. week.

Two vaccines, one produced by Pfizer and BioNTech and the other by Moderna, have already received emergency use authorization from the US Food and Drug Administration. A Phase 3 clinical trial for the Johnson & Johnson vaccine completed enrollment, and another vaccine candidate from AstraZeneca and the University of Oxford is expected to occur a few weeks later.

Azar said the government must have enough supplies so that all Americans who want a vaccine can get it by the summer of 2021.

In the middle stages of deployment, state and local public health officials will have a lot of work to do to clearly define and communicate who is eligible, said John Brownstein, director of innovation at Boston Children’s Hospital.

“At the state level, there will be important nuances in terms of eligibility,” said Brownstein.

“Everyone wants to know their place in the queue. I think people will be watching.”

Pre-registration, eligibility sites and emails

The federal government left it up to the states to implement mass vaccination programs. Like many other policy decisions in the pandemic – from testing protocols to restrictions – states will have to adapt their vaccine launches to their specific needs, including how they communicate eligibility, said Greene.

State vaccine distribution plans submitted to the CDC earlier this year largely cover how states will communicate with their residents, and plans vary in how eligible people will be informed.

At this time, health professionals being vaccinated discover, through their employer, the facilities that are providing the vaccine. CVS and Walgreens are planning to enter tens of thousands of long-term care facilities to provide initial doses to residents and employees.

Many states’ plans say they will rely on traditional media campaigns and mention governor press conferences, outreach to community groups and text and e-mail campaigns.

As the vaccine becomes more available, the New York plan says its residents will also check a website for a “vaccine eligibility screening tool and a vaccine delivery location finder”.

Health department sites in Colorado and Virginia have crawlers that show that they are still in Phase 1a of deployment.

In Maryland, residents will be able to pre-register for the vaccine through the state’s existing immunization information system, says the state plan. The health department will send texts and emails to pre-registered individuals who have not yet received their vaccine.

Greene said the Maryland pre-registration plan is “a very innovative approach”, but it depends on how many people can use the system.

Online systems for informing people about eligibility are as good as acceptance, said Dai. For example, a hospital can use a registration system, such as MyChart, to send alerts to people that they are eligible. But if a patient never sets up their MyChart, they may not find out unless they contact them.

“The central problem is that we don’t have a national vaccination waiting list, and not even for individual states or counties,” said Dai, comparing it to the national organ donor registry.

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As the implementation expands, the CDC manual on vaccine delivery says it will also develop a screening tool for people to determine their own eligibility. This tool will refer them to, an existing platform that connects the public to information about where they can get seasonal flu shots, travel shots and other routine vaccines.

Brownstein, who led the development of, said the tool will play an important role in helping people find a vaccine once they know they are eligible. He expects information about the COVID-19 vaccine to be available on the website from early 2021.

In November, the Department of Health and Human Services also announced that it would partner with drugstore chains in the United States to provide vaccines as supplies become more available. This partnership is expected to cover 60% of pharmacies in the U.S., HHS said.

CVS said in a statement that the public will be able to make appointments to obtain the vaccine at their online pharmacies or by calling 800, once the vaccine is more widely available.

“We will be promoting availability and raising awareness through various channels as we approach the deadline and the dates and prioritization are determined,” Mike DeAngelis, senior director of corporate communications at CVSHealth, told USA TODAY via email.

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‘These are things that we will have to find out quickly’

As the implementation enters the next phases, some states, however, may be left behind in relation to others, complicating the image of who is eligible at a given time.

Vaccines are allocated according to the number of adults in each state, but that does not mean that it will correlate with the number of high-risk people there.

A USA TODAY analysis published this week found which states do better because they have fewer residents in high-risk categories and which states may be left behind, still vaccinating health workers while others advance to a broader population.

Greene and Brownstein said that it will be up to state and local public health officials to define who fits into each phase to lessen confusion.

“There will be some gray areas and professions where it is not clear which group you fit into,” said Brownstein.

Having employers to facilitate the process will make these gray areas simpler, Greene said, but the challenges may persist, especially in smaller work environments with less reach.

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Similar issues may arise with regard to underlying conditions and comorbidities. Someone’s age is easily verifiable at pharmacies and vaccination clinics, but an underlying condition that puts someone at increased risk for COVID-19 complications may not be, said Greene.

Dai described a scenario in which someone received care in the hospital system for an underlying disease, but has since moved on and plans to receive the vaccine in another hospital. If these hospitals use different online records that do not communicate easily with each other, the individual may make their own contact.

“There must be some level of expectation from some people who are not going to push the limits,” added Brownstein.

If someone would need a medical certificate to verify their condition, it would be a requirement that the vaccine provider would have to establish, but Greene said there would be a risk of increasing barriers and accessibility for people who may not have access to an attending physician. primary.

“These are things that we will have to find out quickly,” she said.

Who gets the vaccine first? Here’s who the CDC recommends.

The CDC’s Immunization Practices Advisory Committee recommended that the phased distribution of the vaccine go to the following groups first:

Phase 1a: Frontline health professionals and people in long-term care facilities.

Phase 1b: People aged 75 and over and essential frontline workers, in the following categories:

  • Rescuers such as firefighters, police

  • Teachers, support staff, daycare staff

  • Food and agriculture workers

  • Manufacturing workers

  • Correction workers

  • US Postal Workers

  • Public transport workers

  • Grocery store workers

Phase 1c: People aged 65 to 74, people aged 16 to 64 with high-risk medical conditions and other essential workers. The medical conditions listed are:

  • Obesity

  • Type 2 diabetes

  • COPD or chronic obstructive pulmonary disease

  • Cardiac condition

  • Chronic kidney disease

  • Immunocompromised state by solid organ transplantation

  • Sickle cell anemia

  • Pregnancy

  • Smoker (current or with a smoking history)

Workers in this category include:

  • Public health workers

  • Transport and logistics workers

  • Food service workers

  • Construction workers

  • Financial workers

  • IT and communications workers

  • Energy workers

  • Media workers

  • Legal workers

  • Public safety engineers

  • Water and sewage workers

Contributing: Elizabeth Weise, Dennis Wagner, Donovan Slack and Aleszu Bajak

Follow USA TODAY’s Ryan Miller on Twitter @RyanW_Miller

This article was originally published in USA TODAY: Vaccine COVID: When can I get it? How will I be notified that I am eligible?