By CHRISTINE CONDON BALTIMORE SUN | FEB 01, 2021 AT 5:00 AM
Starting Monday, adults in
Maryland who are hospitalized with certain health conditions will be eligible
to receive COVID-19 vaccines, according to the Maryland Department of Health’s
latest clinician guidance.
But the list of qualifying
conditions is short, and the news comes while vaccine appointments remain
difficult to obtain. People who are not hospitalized but are diagnosed with
these conditions won’t be able to be vaccinated until Phase 2 of the rollout.
The newly eligible groups
are:
·
Cancer patients in active treatment
·
End-stage renal disease patients requiring hemodialysis
·
Chronic Obstructive Pulmonary Disease (COPD) patients, especially
those who are oxygen-dependent or steroid-dependent
·
Solid organ transplant recipients
·
Sickle cell disease patients
·
Diabetic patients (Type 1 and Type 2)
When Gov. Larry Hogan first
publicized the eligibility expansion Tuesday, he simply said vaccinations for
“severely immunocompromised” people could begin Feb. 1, and that they would be
administered through “hospital-based providers.” It was not immediately made
clear that these immunocompromised groups had to be hospitalized to qualify for
vaccinations.
The news that only
hospitalized patients would be eligible starting Monday left some groups with a
feeling of whiplash. Still other groups, representing immunocompromised
patients excluded from the list, were concerned about the lack of vaccine
access.
The dismay, several
organizational leaders said, is heightened by the overall difficulty of the
process to secure a vaccine appointment.
The Maryland Sickle Cell
Disease Association sent out a message to its members last week stating that
everyone with the disease would be able to seek vaccination appointments
Monday. But now, the organization will have to correct the record, said Derek
Robertson, its president.
“When we have to say that,
‘Oh, it’s not everybody. It’s just if you’re in the hospital,’ I think there
will be disappointment,” Robertson said.
But he’s just as worried
about the general confusion surrounding appointments for all eligible
Marylanders, he said.
“What’s frustrating is the
system where you’re basically being told: ‘Go find an appointment where you
can,’” said Robertson, who has scoured websites of providers around the state
to try to register his 78-year-old mother-in-law for a vaccine appointment.
Robertson said
immunocompromised people should have been wrapped into the vaccine rollout
earlier.
“There seems to be an
emphasis on who would be most likely to be exposed,” Robertson said, “as
opposed to who could probably get the most sick.”
Maryland’s initial priority
list of immunocompromised groups also differs a bit from the U.S. Centers for
Disease Control and Prevention’s list of people at increased risk
for severe COVID-19 cases. That list includes people with heart
conditions such as coronary artery disease and people who are pregnant, are
obese or smoke. None of these groups are included on Maryland’s list just yet.
Dr. Mariell Jessup, chief
science and medical officer for the American Heart Association, said the
organization isn’t weighing in on each state’s decision to include or exclude
people with certain heart conditions from vaccination. Deciding which
immunocompromised people should be first in line raises plenty of thorny
questions, she said.
“In the best of all
possible worlds, everybody would get a grade,” Jessup said. “But, we just don’t
have that ability to do that.”
Also excluded from
Maryland’s list are hospitalized patients suffering from conditions like
HIV/AIDS and cystic fibrosis, who the CDC says “might be at an increased risk”
for severe coronavirus symptoms.
“We are monitoring this
closely and await formal guidance from Maryland to see how the state will
incorporate all at-risk conditions identified by the CDC, including CF, in
their plan,” wrote Ashley Mahoney, a spokesperson for the Cystic Fibrosis
Foundation, in a statement.
Seeing Maryland’s list was
a frustrating moment for Lynda Dee, executive director of AIDS Action
Baltimore.
“It’s very disappointing
for the HIV community,” Dee said.
Dee said policymakers could
open up vaccination specifically to HIV patients who are severely ill, such as
those with at least one comorbidity, or those with fewer CD4 cells — white
blood cells that indicate the relative health of a person’s immune system.
“It’s very important for
the government and the Maryland Department of Health to distinguish between
people who are sick with HIV and people who are not,” she said.
Of the roughly 10 states
that have opened up vaccinations to immunocompromised people so far, many have
stuck to that CDC plan, said
Jennifer Tolbert, the director of state health reform at the Henry J. Kaiser
Family Foundation, a national nonprofit that analyzes health issues, although
some have excluded smokers.
Maryland may have chosen to cut down the list because of the limited supply of vaccine available, she said.
“It is a trade-off in terms of how you balance the desire to get as many people vaccinated as possible without completely overwhelming the system, and potentially vaccinating people at slightly lower risk before people at higher risk,” Tolbert said.
How to sign up
for the coronavirus vaccine through Maryland counties, hospitals »
Marylanders searching for
appointments can check the state vaccination website, and visit the
website for their county health department or medical provider. Appointments are difficult to
come by, especially for seniors, people without computers and
those who lack digital fluency.
Eligible Marylanders have complained
about the scarcity. Anyone over 65 is already eligible, as are
health care workers, nursing home residents and staff members, and teachers,
among others.
The vaccination
registration issues have caused considerable consternation, which could be
hurting the vaccine effort more than it’s helping, said Dr. Eric Toner, a
senior scholar at the Johns Hopkins Center for Health Security.
“I would have preferred
that they not open up vaccine eligibility as quickly as they did,” Toner said.
“People who recently have been added … it gives them the misperception that
there is vaccine available for them.”
Baltimore Sun reporter
Hallie Miller contributed to this article.
Christine Condon is a breaking news and
environment reporter for The Baltimore Sun. Christine is a recent graduate of
the University of Maryland, College Park. She's also worked as a reporting
intern for McClatchy's Washington D.C. Bureau and Baltimore's The Daily Record.
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