I’m high-risk for COVID-19 and eligible for a vaccine starting Monday. What do I need to know?

On Monday, Californians age 16 to 64 with underlying conditions can receive the coronavirus vaccine, adding 4.4 million people to the list of eligible folks. It’s a population that is particularly vulnerable at any age to suffer the worst of the disease, officials said.

But it will also be “challenging,” officials said, citing a liberal screening process designed to balance the need to verify a person’s condition with the urgency of vaccinating as many people as possible.

Officials caution that just because eligibility begins on Monday, it doesn’t mean you’ll be getting a shot immediately. While supplies are increasing at hundreds of clinics, pharmacies, mobile sites and pods from Orange County to Los Angeles to San Bernardino, they remain in limited supply.

Remember, vaccines are still being given to millions of healthcare workers, seniors, frontline workers and teachers, who have priority in the initial phases of the rollout.

In Los Angeles County alone, for example, 2 million people with underlying conditions will become eligible next week, officials said Friday.

The sheer demand sprung concerns about the extent to which people would be properly screened, and whether people would jump the line under the guise of having a medical condition.

For those receiving a vaccine under this qualification, county officials said they were encouraging documentation of a condition but it was not required. Instead, the minimum threshold was that the resident attest to being at high risk, or having a disability that puts them at risk.

“We certainly hope people won’t try to take advantage of the situation,’ said L.A. County Department of Public Health Chief Science Officer Dr. Paul Simon. “We don’t feel like it’s realistic for our staff at the community sites to screen people. We don’t have the medical expertise or the knowledge of the person’s medical history to make that determination. That’s why we’re really urging people to go their provider.”

In essence, officials are leaning on people’s honesty to make it work.

“The reasoning behind self-attestation is that, as you can imagine, it’s going to be really hard to prove or verify individuals having certain kinds of comorbidities,” Orange County Health Care Agency Deputy Director of Public Health Services Margaret Bredehoft said.

You can’t tell someone has diabetes by looking at them, and physicians’ orders and prescriptions come in all kinds of formats, she said, noting there are also privacy concerns with asking people to share their medical records.

Sites from Orange to L.A. County will continue to check IDs to verify a person’s age, residency or workplace and that they have an appointment.

Relying on people’s honesty could allow some to jump the line, and “that’d be my concern,” Regional Center of Orange County Executive Director Larry Landauer said. The center coordinates services for OC residents with developmental disabilities.

“There’s people that absolutely need priority, and they should have something from their doctor.”

Landauer said his and other regional centers are working to get a letter approved by the state Department of Public Health that they can distribute to clients showing they’re eligible for vaccination in the phase that opens Monday.

Who’s eligible?

People between 16 and 64 are eligible if they have one of these conditions:

  • Cancer, current with weakened immune system;
  • Chronic kidney disease, stage 4 or above;
  • Chronic pulmonary disease, oxygen dependent;
  • Down syndrome;
  • Solid organ transplant, leading to a weakened immune system;
  • Pregnancy;
  • Sickle cell disease;
  • Heart conditions, such as heart failure, coronary artery disease, or cardiomyopathies (but not hypertension);
  • Severe obesity (where Body Mass Index is greater than or equal to 40 kg/m2). Check with your doctor to see if you qualify, or try this converter from the CDC; or
  • Type 2 diabetes mellitus with hemoglobin A1c level greater than 7.5%.

State criteria also lays out that a person can be eligible as a result of a developmental or other “significant, high-risk disability,” one or more of the following criteria applies:

  • A COVID-19 infection is likely to result in severe life-threatening illness or death; or
  • Acquiring COVID-19 will limit the individual’s ability to receive ongoing care or services vital to their well-being and survival; or
  • Providing adequate and timely COVID care will be particularly challenging as a result of the individual’s disability.

State officials say this group would include all enrolled users of regional centers, independent living centers; in-home supportive services; community-based adult services and adult day health centers; Medi-Cal HIV/AIDS waivers; Medi-Cal home and community-based alternatives waiver programs; Medi-Cal Assisted Living waiver programs; all-inclusive care for the elderly programs; California Children’s Services program (if the child is 16-21 years old); and the California Genetically Handicapped Persons Program.

Do I need to show documentation of my condition when I get to my vaccine appointment?

No. Under state guidance, confidentiality is protected, so there is no documentation required of a diagnosis or type of disability. But under the state’s guidance, expect to be asked to sign a “self-attestation” that you meet the criteria.

Riverside County spokeswoman Brooke Federico said adults who show up for a vaccine appointment next week will be shown a screening sheet with a list of various illnesses and asked if they fall into one of those categories.

“If the resident answers in the affirmative, they will be vaccinated,” she said via email. “No note from their doctor or copy of medical records are required.”

Residents should make sure they are eligible before scheduling an appointment, Federico added.

“It’s possible appointments will be filled quickly,” she said, adding that more appointments are opened each week as the county receives more vaccine doses.

How do you get a vaccine, if you’re in this high-risk group?

County Public health officials recommend checking with your health provider first. While supplies are limited, some health systems and their affiliated clinics are vaccinating — and they may have appointments available.

For instance, in San Bernardino County, officials were asking residents to first ask their health care providers about vaccinations, county spokesman David Wert said via email.

If you don’t have a provider, or your provider doesn’t offer vaccinations, you can make an appointment through the county’s vaccination website or hotline, Wert said.

“If they make an appointment at a public vaccination clinic or pharmacy, we are asking them to bring a form of verification of their high-risk medical condition or disability, which mirrors the guidance from the state,” Wert added.

Don’t be surprised if your provider reaches out to you first.

For example, Kaiser Permanente’s supply continues to increase.

“We will use this increased supply to significantly increase the number of our members we are able to vaccinate,” according to a statement from the giant provider. “Kaiser Permanente has already begun reaching out to our newly eligible members with underlying conditions, starting with those with the highest risk.”

Beyond a health provider, here’s how to get an appointment if you’re newly eligible:

  • Online at the state’s MyTurn system,  www.myturn.ca.gov. You can access the site in English, Spanish, Tagalog, Vietnamese, Mandarin, Cantonese, Korean and Japanese.
  • If you don’t have access to the internet, you can the state’s COVID hotline at 1- 833-4CA-4ALL (Monday through Friday, from 8 a.m.-8 p.m., Saturday through Sunday-8 a.m. -5 p.m.).
  • Book an appointment with your local health department.  Not all health departments are connected to the state’s MyTurn site for such appointments. Appointments at San Bernardino County clinics are made through the PrepMod website. In L.A. County, it’s VaccinateLACounty.com. In Orange County: othena.com. Riverside County:  myoptumserve.com/covid19. In the City of L.A., it’s, carbonhealth.com.
  • Throughout March, pop-up clinics are spring up throughout communities, and they are targeted for areas particularly hard hit by the virus. Check with your local city for more details.

Can I get a vaccine at home, if I can’t get to a vaccine site?

Counties across Southern California are expanding ways to get vaccine to neighborhoods where they are needed most. Mobile unit teams are expanding. For options, state officials recommend checking with your health care provider, local public health department, or your local pharmacy.

Simon said the L.A. County is working with health plans and partnering with such groups as Meals on Wheels to identify homebound people and then direct mobile teams to them. They are also piloting a program in which L.A. Fire Department paramedic would assist in give the vaccination. If that program works, the county could expand to other cities’ fire departments, Simon said.

How do I get transportation to a vaccine site?

Like the mobile teams, transit programs are also expanding. For instance, in February Metrolink began offering a direct connection to Los Angeles County’s COVID-19 vaccination site at  Cal State L.A. There’s a station located near the new “walk-up vaccination center” that opened in February. The center is open 7 days a week from 9 a.m. to 7 p.m. Get more Metrolink information here.

According to state officials, if you receive Medi-Cal through a managed care plan, contact your plan’s member services to request help for transportation to received covered benefits.

If you get Medi-Cal through Fee-for-Service (FFS), you can access a list of Non-Medical Transportation providers in your county of residence, and you can contact them directly to arrange a trip to your appointment.

Can you get a vaccine outside of your county?

Counties are honoring appointments made by people who live or work in those counties.

Will other medical conditions be added?

At the moment, it’s not likely.

On Friday, Dr. Mark Ghaly, the state’s Health and Human Services Agency secretary, said the list of conditions from the state was modified from the Centers for Disease Control, which had included smoking.

But smokers did not make it to the state’s list.

“We put out a list of chronic conditions similar to the CDC list,” Ghaly said. “Some smokers will be captured by other conditions on the list but it is not one of the conditions on its own. We worked hard with a number of individuals with some representation from counties to get the list narrowed so we feel like we are focusing on the most vulnerable first. Hoping counties don’t modify that part of it.”

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