Confusion surrounds state’s vaccine plan

Eligibility mishaps have allowed some to get inoculated early

Confusion about eligibility for the COVID-19 vaccination and a lack of safeguards to prevent not-yet-eligible people from making appointments has allowed some residents to receive a shot before they’re technically allowed, raising concern that the state’s most vulnerable residents aren’t being adequately prioritized.

Responding to the confusion, which has unfolded on multiple fronts in recent days, and to “ensure there is clarity,” acting

Department of Public Health Commissioner Dr. Deidre Gifford recently reminded health districts and other vaccine providers of the “absolute necessity of adhering to the governor’s direction on allocation.”

Currently, the state is in Phase 1B of vaccinations, which will eventually include more than 1.3 million residents. But the state is rolling out eligibility in subphases, meaning that the different Phase 1B groups will be vaccinated at different times.

Because of their greatly increased risk of dying from COVID-19, residents age 75 and older are at the front of the Phase 1B line and are currently the only group eligible to receive the vaccine. (Those eligible under

Phase 1A, which included health care workers and nursing home residents, can also still receive the vaccine if they have not yet done so.)

Others in Phase 1B, including residents between the ages of 65 and 74, frontline essential workers such as teachers and residents with

underlying conditions that put them at increased risk of COVID19 are not yet technically eligible for the vaccine.

But since Phase 1B began Jan. 18, there have been numerous snafus.

Not-yet-eligible teachers have been vaccinated by the hundreds. Residents age 65 to 74 report scheduling vaccination appointments and, in some cases, actually receiving their first shot.

In some cases, state officials said that school districts have mistakenly uploaded their entire staff rosters — not just nurses, who were eligible as health care workers — to the state registration system. In other cases, it is still unclear why there weren’t appropriate safeguards in place to prevent people from making vaccine appointments who weren’t eligible.

For the elderly residents struggling to make vaccine appointments, the stakes could be high. Gifford’s Jan. 17 letter to vaccine providers connected the out-of-order vaccinations with the lack of appointments available to residents who are 75 and older.

“There are many individuals 75 years and older across the State who have not yet been able to secure an appointment to receive a COVID-19 vaccine,” Gifford wrote in her letter. “Conducting outreach and scheduling for [other populations] is at direct odds with this goal of ensuring access for individuals 75 years and older.”

Misunderstandings

In several instances of out-of-order vaccinations and vaccination appointments, those involved told The Courant that the mishaps were largely a result of their confusion over eligibility. A number of the mix-ups seem to be the result of misunderstandings on the part of the residents making the appointments, coupled with a lack of safeguards in the scheduling systems themselves.

When administrators in the Berlin Public Schools instructed not-yet-eligible staff to make vaccination appointments, they thought they were following the guidelines, Superintendent Brian Benigni previously told The Courant.

And when Cromwell Public Schools didn’t actively advise not-yet-eligible staff against making appointments, Superintendent Enza Macri said it was because she didn’t know what the rules were.

But the confusion isn’t just within school districts.

Kathleen Cassidy, a 67-yearold retiree who lives in Hartford, is technically not eligible for the vaccine until later in Phase 1B. But last weekend, she said, she easily made a vaccination appointment at a Trinity Health of New England site.

And on Tuesday, Cassidy received her first dose of the Pifzer-BioNTech vaccine. She provided The Courant with a copy of her vaccination confirmation.

“I went and set up an account under Trinity Health ... [and] the message popped up ‘65 and older,’ ” Cassidy said on Wednesday. “And they had appointments ... so I had it done yesterday.”

Cassidy said that when the scheduling system allowed her to make an appointment, she believed that meant she was eligible to receive the vaccine.

Trinity Health of New England’s spokesperson, Kaitlin Rocheleau, confirmed in an email that “some additional patients within Phase 1B have been able to utilize the VAMS registration tool to schedule and receive their COVID-19 vaccine.”

Rocheleau added that the health system is urging residents not to register for appointments unless they are 75 or older, but that vaccinators will not turn away anyone with an appointment.

At Hartford HealthCare, another of the state’s large health systems, chief clinical integration officer Dr. James Cardon said through a spokesperson Jan. 17 that the health system is “following guidelines” when it comes to vaccinations.

A spokesperson for the health system declined on Thursday to comment further.

A shifting tone

Faced with the reality that the state’s instructions are not always being followed, officials have hardened their message of leniency into one of responsibility.

“Any intentional violation in the allocation of this scarce resource risks damaging the credibility of the entire program and will not be tolerated by [the state Department of Public Health],” Gifford wrote in her Jan. 17 letter.

Two days later, at a Tuesday press briefing, Gov. Ned Lamont said he wants people to “respect the process” that the state has laid out.

“If I think it’s being abused, if I think it’s not an honest mistake, we’re going to have to be strict because otherwise people feel like they’re being cheated,” Lamont said. “I appreciate that.”

The focus on following the rules — although it comes without threats of penalties for any unintentional mistakes — is a marked change from earlier this month, when officials including Lamont underscored the importance of simply getting shots into people’s arms.

“You’ve seen that the heavy hand, very narrowly determining who gets vaccinated and who doesn’t, has tended to slow things up,” Lamont said earlier this month. He added at the time that Connecticut was instead “working with our health care providers, trusting them to make the right decisions, giving them a little leeway so we can get the vaccines out as fast as we can.”

At the time, Connecticut’s approach contrasted sharply with that of neighboring New York, where vaccinators could face fines if they administered the vaccine to people who were not yet eligible.

But Connecticut officials said even then that the goal was to strike a balance between needless micromanagement and total chaos — the goal was not complete leniency, but a middle ground.

The numbers

While state officials’ stricter messaging obliquely acknowledges the messy rollout, the state has not given an estimate on how many residents may have been mistakenly vaccinated.

“We don’t have an exact number ... but we think the number is very small in the grand scheme of things,” said the state’s chief operating officer Josh Geballe at a Thursday press briefing. “It’s going to be a very small percentage, a very small number.”

The number is at least in the hundreds — the CT Mirror reported that a Wednesday vaccination clinic administered shots to about 300 school staff from three school districts.

That one vaccination clinic is just a snapshot. It does not include the other districts across the state that have also allowed their staff to sign up, and Geballe said Tuesday that the state believed about a dozen districts did so. It also does not include residents such as Cassidy, who were able to sign up for appointments independently from their employers.

But even without estimated numbers, Gifford’s Jan. 17 letter to vaccine providers shows that the state is treating the out-of-order vaccinations as a real problem. It’s a problem that Gifford’s letter also ties to two additional problems: the country-wide shortage of vaccine doses and the fact that some seniors have struggled to make appointments.

Gifford, according to her letter, sees the vaccination of not-yet-eligible residents as a noteworthy threat to the state’s vaccine program.

“The Governor has directed [the state Department of Public Health] to implement an allocation strategy that focuses on the risk of severe disease and death, with an emphasis on health equity and health disparities,” Gifford wrote. “We know that you share those priorities with us, and we need your further cooperation to ensure a continued smooth vaccine program, and public confidence in the effort.”