Vaccination clinics, local health departments and the state don't have the resources to confirm that everyone who signs up for a Covid-19 vaccine is eligible to receive a shot. The system relies on people to tell the truth about their status.
The rules detailing who is permitted to receive a Covid-19 vaccine dose involve a growing list of medical conditions and occupations.
And competition for an appointment remains fierce, as demand for the vaccine still outpaces the supply.
So who double-checks to ensure vaccinations go only to those eligible? The answer, for the most part, is no one.
As eligibility has expanded from front-line health care workers and nursing home residents and staff to broader categories of people, such as those with a qualifying medical condition, it is harder to confirm that someone is, in fact, entitled to receive a vaccine dose.
And state and local health officials don't have the time or staff to verify eligibility, whether at the time someone signs up for a vaccine or at the vaccination site.
When will Gov. Andrew M. Cuomo act on President Biden's directive to open Covid-19 vaccinations to all adults?
"We're going on people being honest and doing what they're supposed to do," said Daniel J. Stapleton, Niagara County's public health director. "When you open up the eligible groups too quickly, before you finish the eligible groups before them, that's the kind of problem you run into."
This leaves open the possibility people are jumping the Covid-19 vaccine line to receive a dose weeks or months before they would otherwise be eligible.
Individual examples have made the national news, such as the Florida "grannies": two young women who posed as seniors to try to get vaccine shots.
But medical experts say it is impossible to know whether this is a serious problem. A complicated vaccination process with the goal of getting as many shots into arms as quickly as possible naturally is vulnerable to some abuse.
Still, said Dr. Jack Freer, a retired professor of medicine at the University at Buffalo and medical ethics expert, "the more people vaccinated the better society is going to be."
There are a number of factors, including a lack of reliable broadband internet, that make it harder for people living in rural areas to make vaccination appointments.
The vaccination process, at its foundation, relies on people to tell the truth.
For example, people claiming to have an eligible underlying medical condition, such as diabetes or cancer, must confirm this status when making the appointment, but they are not required to obtain a doctor's note or bring medical records to the vaccination clinic.
People claiming that their occupation makes them eligible must bring a valid work ID or other document showing where they are employed, according to state guidelines. But in some categories, only public-facing employees are eligible for the vaccine, and a work ID or pay stub may not confirm this status.
State Health Department spokeswoman Jill Montag said anyone making an eligibility claim is attesting the information's accuracy.
"If you are, in fact, not eligible, you are filing a false instrument, a misdemeanor punishable by up to a year in jail," Montag said in an email.
Providers also face financial penalties if they vaccinate people who failed to certify their eligibility.
In Western New York, where more than 10% of the population is Black, African Americans represent fewer than 5% of the people getting shots.
'No way of knowing'
Early on, it was easier to determine eligibility, officials said. Hospitals oversaw the vaccination of their own employees, for example, and nursing homes coordinated with pharmacies to vaccinate their residents and employees.
When New York made seniors who don't live in long-term care facilities eligible for the vaccine, a group that includes those as young as 60 now, it was simply a matter of checking a driver's license or other photo ID to confirm age. And certain, wide-ranging categories – such as anyone who works in a school district or who is registered with the Veterans Affairs health care network – also are easier to verify.
But new categories present new wrinkles when it comes to determining eligibility, such as whether someone is a "public-facing" government worker or nonprofit employee.
"We as vaccine providers have no way of knowing that," said Christine Schuyler, Chautauqua County's public health director, who asked state health officials this question.
The medical categories, too, are more challenging to verify, officials said. They include obesity, moderate-to-severe asthma, a weakened immune system and diabetes.
It is impractical and invasive to ask people to bring documentation of a medical condition to a vaccination clinic, where it's important everything runs smoothly, Schuyler and others said. It can't fall to the workers staffing the clinics to confirm eligibility, she added.
"You cannot have someone bring a pill bottle, per se. We didn't require a physician's note. You can't ask what the condition is," Schuyler said. "But we did have a separate attestation form that people did sign."
The Erie County Health Department said that it follows state guidance. Stapleton and Schuyler said that their departments and physician offices don't have the staff resources available to double-check eligibility.
"It puts everybody in a bad situation as it is," Stapleton said.
“The supply’s still somewhat constrained, but it does appear to be improving," said Dr. Thomas Madejski, an Orleans County physician.
'Another piece of the inequity'
Are people improperly snatching vaccination appointments that should go to someone else? It is impossible to measure, but examples abound, such as the two women, aged 44 and 34, who were turned away and issued trespassing warnings in February after trying to get vaccinated at an Orlando, Fla., drive-through clinic, according to the Orlando Sentinel.
Health officials in Clark County, Ind., recently decried a "substantial lack of morality" in a Facebook post after they say they turned away as many as 30 people in one weekend for lying about their eligibility for the vaccine, including people claiming to be clergy who minister to virus patients, the Louisville Courier-Journal reported.
Dr. Robert Zielinski, an oncologist and associate medical director of Buffalo Medical Group, said he isn't surprised. Buffalo Medical Group received a one-time allotment of vaccine doses to administer to its eligible employees and other health care workers.
The registration link made its way into the hands of people who clearly weren't meant to receive the vaccine, Zielinski said, such as an advertising rep who claimed eligibility because his agency had done promotional work for a medical group
"That's not really a health care worker," Zielinski said.
Staffers also turned away a 90-year-old man, using a walker, who came with a group of caretaker family members also seeking the vaccine, because they weren't in the 1-A eligibility group at the time.
Is there any practical way to prevent vaccine line jumping? Zielinski suggests having physician practices give out vaccinations because they know their own patients, a position shared by Stapleton.
Buffalo Medical Group, for its part, cross-checked its electronic health records and sent boilerplate letters to patients who were eligible because of age or because they met the state's criteria for medical conditions .
Even if it's happening all over the country, is lying about eligibility a big issue?
Covid-19 vaccines are a limited resource, but not a finite one. People who do this would have received a shot at a later date. And they are only delaying the vaccine for other people, not preventing them from receiving a dose.
"They'll be able to get it, you've just gotten in the way. It's just another piece of the inequity," Zielinski said. "Just like the way the distribution has gone on, your computer access, your computer savviness and your persistence are all likely to get you in line sooner than somebody else."
Freer, the retired UB professor, points to the greater good of getting as many people vaccinated as soon as possible, through a fallible process riddled with confusion from the beginning.
He said lying about vaccine eligibility isn't as serious a problem as, for example, people fraudulently obtaining opioids or other powerful painkillers.
"It seems there's bigger fish to fry," Freer said.
March 21, 2021 at 04:05PM
https://buffalonews.com/news/local/with-no-easy-way-to-verify-covid-19-vaccine-eligibility-people-are-on-the-honor/article_d81c94de-88b3-11eb-9e76-7fff458b8087.html
With no easy way to verify Covid-19 vaccine eligibility, people are on the honor system - Buffalo News
https://news.google.com/search?q=easy&hl=en-US&gl=US&ceid=US:en
No comments:
Post a Comment