29are being treated—or state-run vaccination clinic that might get
them vaccinated sooner. And that’s fine, say most doctors and
public-health officials, who at this point are focused more on
ensuring that as many people get their shots as quickly as possi-
ble than on establishing and policing complex priority policies.
“We’re encouraging our patients
to get the vaccine where they can
get it first,” says Glazier of UCLA.
“Los Angeles County isn’t using a risk
stratification at their mega vaccination
sites, and we are very candid about the
model we are using given the amount
of doses we have. If they can get vacci-
nated at Dodger Stadium, then we en-
courage them to do that.” Glazier says
the UCLA system will re cord that vac-
cination in the patient’s health record
and drop them from future COVID-19
vaccine invitation lists.
The challenge experts are worried
about is figuring out how to help people with chronic health
conditions who aren’t linked to a network like UCLA, Duke, Or-
lando Health or others around the country— without further bur-
dening the rollout. Not only are they harder to reach, but it will
be harder for vaccinators to validate that they qualify for a shot.
It’s not likely that states will require letters from doctors or otherverification of their condition, since that
would add a layer of bureaucracy that
would further slow the push of vaccines
into people’s arms. “Anytime you have to
prove something, that gets awkward at
the point of service,” says Ralls. “I don’t
know how that is going to play out, and
haven’t heard anything about a plan for
public distribution other than people
saying they have a medical condition.”
That’s a hurdle pharmacies, which are ex-
pecting to be the next large dispenser of
vaccines to the public, will soon have to
face as more people with these conditions
turn to their local pharmacies for shots.
In Maryland, Chan says the state
is working with community leaders
to reach more people who aren’t con-
nected to a doctor or health system, re-
gardless of whether they have an un-
derlying health condition, to make sure
more residents get vaccinated. They are
currently jumping off their existing vac-
cination data to figure out where people
aren’t getting vaccinated and, to the extent possible, determine
how many people with existing health conditions might live
in those areas so officials can start directing more doses there.
“You can’t look at somebody and know whether they have
an underlying condition or not,” Chan says. “So we’re work-
ing with community organizations,
and they’re giving us feedback about
the degree of outreach we’ll need and
how we can almost walk the commu-
nity to actually identify and find those
individuals.”
Such efforts will take extra effort
and resources but are an integral
part of the vaccine rollout—which,
to date, hasn’t been the focus of the
COVID-19 vaccine campaign. “We’re
trying to play catch-up because
most of our efforts so far in COVID-
19 have focused on making vaccines
and testing them, and not so much
on delivery,” says Dr. Daniel Hoft, director of the St. Louis
University Center for Vaccine Development. Thinking more
deeply about the mechanics of the rollout will be crucial to
making sure that members of the next priority group stepping
up to be vaccinated get their shots when they need them,
where they need them. VACCINE RECIPIENTS SHOW
OFF THEIR RECORD CARDS
AFTER GETTING INOCULATED
AT SIX FLAGS AMERICA
IN BOWIE, MD., ON FEB. 6‘We are really
trying to avoid
the Ticketmaster
free-for-all approach.’
DR. EVE GLAZIER, UCLA HEALTH,
PRESIDENT OF THE
FACULTY PRACTICE GROUPSARAH SILBIGER—GETTY IMAGES