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VA's Complicated Vaccine Priority System Causes Disparities, Confusion

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Salty Dog

VA's Complicated Vaccine Priority System Causes Disparities, Confusion

9 Feb 2021
Military.com | By Patricia Kime

The Department of Veterans Affairs may be out ahead of many states and federal entities in vaccine administration, but the complexity of deciding who is eligible for the vaccine and when has still left many confused and frustrated.

So far, the VA has administered 1.26 million doses of the COVID-19 vaccine; 305,197 veterans and employees had received both doses as of Monday.

To decide who has priority for the limited vaccine supply, the VA uses an algorithm to sift through its databases and prioritize veterans. But it also considers other factors, such as local availability of vaccine doses, clinical resources and requirements at each hospital or clinic, and the number of COVID-19 infections in an area.

VA officials say the approach has allowed the department to vaccinate a large number of individuals in a relatively short period of time.

Some veterans, however, say they don't understand why they haven't been contacted, despite being what they believe is considered "high risk."

"My husband, a Vietnam vet, has not been contacted to get the vaccine. ... He is 77 with health issues," said a veteran's spouse in the Dallas-Fort Worth area who asked that her name not be used because she wanted to keep her husband's identity private.

He eventually got an appointment through the City of Dallas, not the North Texas VA Health System, she said.

"He had to wait in a car in line for four hours in Dallas to get his vaccine. It was grueling," she added.

Others cited similar problems in other parts of the country.

"I am a combat Vietnam veteran volunteer and 68 years old,” said Dave Moore of Columbia, South Carolina. “I am 100 percent VA disabled with two underlying conditions. ... The Columbia VA has no clue."

The VA is using a software program called the COVID-19 Vaccine Outreach for Veterans that analyzes information from Veterans Health Administration Support Center databases to determine which patients are considered to be in high-risk groups.

The tool uses patient identifiers to weigh medical conditions, age and gender; it also indicates current treatments like chemotherapy or dialysis and other risk factors for severe COVID-19 such as smoking or obesity.

The system then provides a list of prioritized patients to local VA medical centers.

But those medical centers have their own set of conditions to consider when assessing priority, according to VA spokesman Randy Noller.

"VA issued guidance on December 30, 2020, encouraging local flexibility in order to maximize COVID-19 vaccine access and efficiency and limit potential vaccine waste, and this guidance included flexibility to overlap phases and broaden vaccination," he said.

Individual VA health systems deal with factors that include vaccine hesitancy, logistical challenges and their own lists of patients prioritized by risk factors and locale.

At the Veterans Affairs Medical Center in Anchorage, Alaska, for example, any veteran who is 60 or older is being offered the vaccine.

And in Havre, Montana -- a remote location where VA providers flew in with the vaccine for a one-day clinic Jan. 21 -- 239 veterans of varying ages were able to get inoculated.

"Montana is a very large state -- 147,000 square miles. So we have a huge area to cover. We're also a mountain state, so winter travel can be challenging between snow and small county roads. That's part of why we're so thrilled to get the vaccine out across the state," said Montana VA Health Care System Director Judy Hayman.

According to Noller, the VA largely is finishing efforts to vaccinate those categorized as 1a -- including health workers, first responders and those living in residential community settings -- and moving into Phase 1b, or veterans age 75 and older.

According to the Centers for Disease Control and Prevention, patients aged 65 to 74 are considered Phase 1c, as are those ages 16 to 64 with serious health conditions.

But again, priority also can be determined at the local level. As early as November, clinicians at some VA health facilities began drafting lists of patients at high risk for severe cases of COVID.

Vietnam veteran Wes Bickel, 73, receives his care at VA Long Beach Healthcare System in California; he got a text Saturday saying he had been identified as part of a priority group to get the vaccine.

Bickel, who has a heart condition related to Agent Orange exposure, had gotten his first dose the day before through his county, ending several weeks of frustration with the VA.

"Some of my cohorts snuck in line and already received their second shots. … I feel fortunate that I have options and had registered with the county and not relied on just the VA," Bickel told Military.com.

VA Long Beach has had such a strong response from area residents -- including non-veterans -- wanting the vaccine that the facility's phone system went down under the strain of calls last week.

"We know the process to get vaccines has been frustrating even under the best of circumstances, and not being able to reach us only adds to that. Please bear with us as we all navigate the COVID-19 pandemic," officials wrote Friday in a notice to veterans.

The VA is "using every avenue to vaccinate as many veterans and employees as quickly as possible," according to Noller, and the process should go more smoothly once more vaccines are available.

"We've built a system ready to accommodate much larger quantities as the manufacturers move forward. I'm incredibly pleased," said Dr. Richard Stone, the VA acting under secretary for health.

Even as the VA's vaccine effort ramps up, officials are telling veterans that if they have the opportunity to register for the vaccine elsewhere, they should do so.

"We want to encourage Veterans to get the COVID vaccine as soon as it becomes available to them," said Dr. Sophia Califano, the VA's deputy chief consultant for preventive medicine, in a release. "We believe this is the best path forward and the best way to protect you and your family."



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How Veterans, designated caregivers can get COVID-19 vaccine from VA

Posted on Tuesday, February 9, 2021 4:00 pm Posted in Health, Top Stories by Adam Stump

As of Feb. 3, 2021, VA is providing COVID-19 vaccine to the following groups:

  • Veterans living in VA long-term care facilities
  • Veterans who already receive care at VA and are at high risk from COVID-19 based on VA and Centers for Disease Control and Prevention (CDC) risk criteria. At many VA health care facilities, this group includes all Veterans who are at least 75 years old. Each facility will determine when Veterans in this group can receive a vaccine. They’ll base this decision on vaccine availability, local needs, and the strict vaccine storage and handling requirements of the vaccines.
  • Family caregivers who are enrolled in VA’s Program of Comprehensive Assistance for Family Caregivers (PCAFC). PCAFC Caregivers are eligible for vaccination when the Veteran they care for becomes eligible. VA will tell the family caregiver if they can get a vaccine when VA invites the Veteran to get one.
  • VA health care personnel. Vaccinating VA health care personnel helps continue to provide care for Veterans.

VA is first prioritizing Veterans who are actively receiving health care from VA. If Veterans are not currently receiving health care through VA, find out eligibility and how to apply here.

How can Veterans find out when they can get the vaccine?

Veterans and caregivers can sign up for an easy way to stay informed about getting a COVID-19 vaccine through VA at https://www.va.gov/health-care/covid-19-vaccine/stay-informed.

When Veterans and caregivers sign up, VA will also ask about vaccine plans. A local VA health facility may use this information to determine when to contact Veterans and caregivers once their risk group becomes eligible.

Note: VA will contact every eligible Veteran in each risk group. Veterans don’t need to sign up to get a vaccine.

How will VA contact Veterans when they’re eligible to get a vaccine?

Veterans enrolled in and eligible for VA health care can receive personalized COVID-19 vaccine information from VA in three different ways.

1. By text message

VA’s VEText program reminds Veterans of upcoming appointments via text message. Veterans may also receive text message updates about availability and scheduling for COVID-19 vaccines.

Veterans may receive one of three different types of messages. All text messages will tell Veterans their facility is offering the vaccine and will come from the short phone number 53079.

Some facilities will invite the Veteran to make a vaccine appointment directly by text message.

Other facilities will provide instructions on a number to call to schedule a vaccine

Some facilities are also using text message to notify Veterans of vaccination events, such as drive-through clinics, for eligible risk groups.

Every enrolled Veteran with a cell phone number listed in their health record is automatically enrolled receive text messages. Veterans who receive care at VA should make sure their cell phone number is up to date in their VA.gov profile. This is the number a VA health facility will use to contact a Veteran by text. Veterans can update phone numbers online at https://www.va.gov/profile/. Veterans can also update contact information during check-in at an appointment. Please don’t call a facility to update a phone number.

Learn more about VEText at https://www.va.gov/HEALTH/VEText_FAQs.asp.

2. Via email

Veterans who sign up to stay informed about COVID-19 vaccines will receive general updates via email. Veterans who subscribe to Vet Resources or My HealtheVet may also receive periodic updates about VA’s vaccination efforts along with helpful reminders. Emails from VA will always come from a va.gov email address.

VA is also using email to let Veterans know about upcoming opportunities to get a vaccine at their local VA health facility. These emails may also contain information on why a Veteran should consider getting the vaccine, which vaccine they may receive, and instructions on how to make an appointment or when to arrive for a vaccination event.

Veterans who receive care at VA should check their VA.gov profile at https://www.va.gov/profile/ to make sure their email address is up to date.

3. Via U.S. Postal Service mail

VA is also sending out letters in the mail to tell Veterans how to receive the vaccine.

Veterans who receive care at VA should check their VA.gov profile at https://www.va.gov/profile/ to make sure their mailing address is up to date.

Second dose reminders

After a Veteran receives the first dose, they will receive follow up information reminding them to come in for their second dose. These reminders may come via VEText, email or regular mail—the same ways the Veteran received the first notification.

More information

Find answers to general VA COVID-19 vaccine questions at https://www.va.gov/health-care/covid-19-vaccine/.

To receive ongoing updates about VA’s COVID-19 vaccine efforts and to indicate your interest in getting the vaccine once you’re eligible, visit https://www.va.gov/health-care/covid-19-vaccine/stay-informed.

Read the Moderna COVID-19 vaccine fact sheet at https://www.fda.gov/media/144638/download.

Read the Pfizer-BioNTech COVID-19 vaccine fact sheet at https://www.fda.gov/media/144413/download.

Adam Stump is a public affairs specialist with VA’s Digital Media Engagement team. He is a retired Air Force Veteran who served 20 years, including two deployments to Afghanistan for detention operations and special operations.

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Salty Dog

The VA Has Now Administered More COVID-19 Vaccine Shots Than 42 US States

2 Feb 2021

Military.com | By Patricia Kime

As he rolled up his sleeve to receive his first dose of the Moderna COVID-19 vaccine, Department of Veterans Affairs Press Secretary Terrence Hayes said he was excited to get a shot that will decrease the likelihood he'll bring the coronavirus home to his family.

"My wife is a very asthmatic person, so I definitely need to take all the precautions to ensure that she is staying healthy," Hayes said shortly after receiving the vaccine at the VA's headquarters in Washington, D.C.

Hayes, a retired Army master sergeant, received one of a million doses the VA had distributed as of Tuesday. According to the department, 582,000 first doses and 44,000 second doses of the Moderna or Pfizer-BioNTech vaccine have been delivered to veterans, while more than 401,000 doses have been given to VA employees.

An additional 1,200 have been administered to personnel from other federal agencies that work with the VA, according to officials.

Across the entire U.S., roughly 32 million vaccine shots had been administered as of Feb. 1, according to New York Times compilations. The VA's million-shot milestone puts it ahead of states including North Carolina, New Jersey and Washington; it has administered more vaccine doses than the states of Oregon and Louisiana combined. Only eight U.S. states have administered more vaccine doses to date. On Tuesday, the state of Illinois, which has a population of 12.67 million according to the last census, also administered its millionth vaccine dose.

The Department of Defense has administered about 500,000 vaccine shots to date, according to the Times.

Dr. Richard Stone, acting under secretary for health for the Veterans Health Administration, was among a dozen clinicians at the VA's headquarters in Washington, D.C., administering the vaccine to essential workers in the building this week.

Stone, a retired Army physician, said he is pleased with the progress of delivery across the system nationwide, adding that the department administers its weekly allotment of more than 108,000 doses "in three to four days."

The VA has the capacity, he added, to administer 600,000 doses a week.

"We built a system ready to accommodate much larger quantities as the manufacturers ramp up," he said.

According to Stone, the rate of vaccine acceptance among VA employees is between 80% and 83% -- far higher than the rate of 60% reported in December among the general U.S. population, according to a survey by the Pew Research Center.

One of the reasons VA employees are eager to get the vaccine, he said, is that the department has been "hit really hard."

"We're doing health care and taking care of some pretty sick patients. The willingness to take the vaccine has been overwhelming," Stone said.

Since the beginning of the outbreak, more than 209,000 VA patients have been diagnosed with COVID-19. Roughly 9,200 have died, including 1,800 in January alone -- the deadliest month to date for VA patients, surpassing the record in December of roughly 1,700 people.

VA employees also have succumbed to the virus: As of Tuesday, 121 had died.

The VA began delivering vaccines late last year, starting Dec. 14 with Margaret Klessens, 96, a World War II veteran who lives in a VA community living center at the Edith Nourse Rogers Memorial Veterans Hospital in Bedford, Massachusetts.

The VA is delivering vaccines at more than 215 sites across the country, with plans to expand to additional sites as vaccine supplies increase.

But officials said that until manufacturers increase delivery -- and new vaccines become available, likely in March -- "many facilities may temporarily run out of vaccines for short periods of time."

In addition to announcing the millionth vaccine milestone, VA officials have started posting data on the number of veterans who have received a COVID-19 vaccine by facility -- data that will be updated daily, according to acting VA Secretary Dat Tran.

As of late January, the VA was in "Phase 1B" for administering COVID-19 vaccinations to veterans, including those who are 75 years of age or older, serve as essential workers, have an underlying health condition requiring chemotherapy or dialysis, or are organ transplant recipients.

Stone said the vaccine has proven to be safe for the VA's vulnerable patient population: The department has recorded adverse reactions in fewer than 30 patients who received the vaccine -- mainly fainting or a rapid heart rate, and zero hospitalizations.

The VA has been contacting veterans who are eligible for vaccination to schedule appointments; those who would like additional information can go to the VA COVID-19 vaccines webpage, visit their local facility's website or contact their doctor.

Hayes received the vaccine because he is considered an essential worker who interacts with the public frequently. He said he hopes that his decision to get the vaccine will influence others -- including members of his own family -- to get it.

"My family down South is very hesitant to take the vaccine for various different reasons that are legitimate so I wanted to ... help them understand that it's best to get the vaccine -- not just to protect themselves but to protect their family and anyone they come in contact with," he said.



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On 2/11/2021 at 4:13 PM, Salty Dog said:


Add one more to the list. I had my first Covid-19 vaccination today. The second one will be March 13th, same time, same place. There doesn't seem to be any confusion here with the VA.

The state of Michigan has no clue though from the feedback I get from family and friends. 30 year olds are reportedly getting the vaccination in Detroit while 78 year olds and older are still waiting.

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