Feds tell states to vaccinate all people 65 and older now, but RI disagrees

On Tuesday, the Trump administration told states to open vaccinations to all people 65 and older.

But Rhode Island doesn't intend to follow suit.

Under Rhode Island’s plan, all adults 75 and older will not start getting vaccinated until February or March. That’s unless they fall under a category that the state is already vaccinating — which includes hospital workers, nursing homes, first-responders, certain inmates and staff at the Adult Correctional Institutions, and the hard-hit city of Central Falls.

People 75 and older would also come after the start dentists, blood donation staff and funeral home workers, currently slated for the week of Jan. 25, under Rhode Island's plans. (Though some groups will start getting vaccinated sooner than others, they don’t have to finish vaccinating before another group begins; there will be, the state has long said, some overlap)

"The biggest challenge we are facing right now is supply," Rhode Island Department of Health spokesman Joseph Wendelken said in an email. "We are only getting 14,000 doses a week, which is a tiny fraction of the state. We will be vaccinating some older adults in Phase 1. We need to vaccinate older adults in increments, given the limited supply we are receiving."

According to Wendelken, 190,000 people in Rhode Island are 65 or older; the state is only getting 14,000 doses of vaccine a week for all Rhode Islanders.

Wendelken added: "We don’t want to get into a situation like Florida did where they opened up vaccine to populations that they did not have enough supply to vaccinate. That resulted in a tremendous amount of confusion and resulted in unsafe situations, such as older adults camping out for hours at immunization sites."

Older people have borne a disproportionate brunt of the COVID pandemic, with the risk of death jumping for every decade of age. As of the end of December, 98% of COVID deaths in the state were among people 50 and older, with 82% of COVID deaths among people 70 and older.

In pressing states to open up eligibility to people 65 and older, federal officials on Tuesday said some states had micromanaged the process, standing in the way of broader access to the most vulnerable people.

“It’s simply much easier to manage allocating vaccines and appointments to everyone 65 and older rather than narrower and more complex categories,” U.S. Health and Human Services Secretary Alex Azar said at a news briefing Tuesday.

In addition to vaccinating people 65 and older, states should also administer them to younger adults with a documented comorbidity, U.S. Centers for Disease Control and Prevention Director Dr. Robert Redfield said.

Also, the federal government will now release more vaccines, rather than holding back second doses in reserve, Azar said. The incoming Biden administration had already announced similar plans. Both of the COVID vaccines authorized in the United States require a second dose.

The United States now has a patchwork of vaccination phases as policymakers try to balance the functioning of society, preventing the most deaths possible and the desire for equity in underserved communities. Central Falls, for instance, is predominantly Latino.

New York state, for its part, quickly adopted most of the new federal guidance, and people there who are 65 and older can start getting vaccinated, Gov. Andrew Cuomo announced Tuesday.

The state has a website where people can check their eligibility. Florida says it’s "putting seniors first," and has administered more than half of its vaccines to people older than 65. Connecticut next week will open up its vaccination appointments to people 75 and older, Gov. Ned Lamont said recently, and the state's advisory committee is recommending that people age 65 and older be in phase 1B, though it's not clear exactly when that would start.

Detailed data on who's gotten the vaccine in Rhode Island isn't available.

Dr. Ashish Jha, the dean of Brown School of Public Health, has advocated for an age-based distribution system: By the end of January, once health-care workers and long-term care residents are done being vaccinated, the United States should vaccinate everyone 55 and older, starting with the oldest first, Jha said.

For the other 150 million Americans, we should use a lottery system, Jha and a co-author wrote in The New York Times.

“There are plans that try to take into account the disproportionate toll of Covid-19 on people of color, the inability of certain workers to avoid exposure, and the higher risk of illness and death in the elderly and in individuals with underlying health conditions,” Jha and Dr. Robert Wachter wrote. “But in their well-meaning effort to achieve equity and fairness, these plans threaten to become excessively complex — and thus ripe for manipulation by the privileged, including myriad interest groups that are vying for a place at the front of the line.”

A U.S. Centers for Disease Control and Prevention tracker says Rhode Island is in 16th place in the nation among states for getting first shots into people’s arms, with 3,559 doses per 100,000 people. It’s ahead of Massachusetts and New York, but lags other New England states, including regional leader Connecticut, which has administered 4,128 doses per 100,000 people.

Two shots, one developed by Pfizer and BioNTech and the other by Moderna, are currently authorized for use in the United States.

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This article originally appeared on The Providence Journal: Feds tell states to vaccinate all people 65 and older now, but RI disagrees

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