Doctors to decide who gets vaccinated

Governor says physicians will make call on vaccines for who under 65 is vulnerable

It will be up to doctors to decide which “extremely vulnerable” people under age 65 will be allowed to get COVID-19 vaccinations in Florida, Gov. Ron DeSantis said Wednesday, clearing up confusion over how newly eligible residents will prove they qualify.

“[Doctors] have seen how this virus is impacting different folks,” DeSantis said. “They can take a look, and they can make that determination based on those underlying conditions.”

DeSantis’ executive order allowing Floridians with medical conditions under 65 to get vaccines from doctors, pharmacists and advanced nurse practitioners with a doctor’s note was issued Friday without any fanfare. A second order issued Monday required doctors to fill out a state-mandated form.

But that form was not available online until late Tuesday night, and it doesn’t require the physician to indicate which condition the patient has, nor does it include a list of conditions that qualify. Instead, it merely asks for the physician’s name, license number and a signature certifying that the doctor has “determined that the patient is extremely vulnerable to COVID-19 for the purposes of receiving a COVID-19 vaccination in the state of Florida.”

DeSantis said he was trusting physicians to be in the best position to decide and said he hopes to be able to get vaccines into their offices when the supply allows for it.

“We’re really putting that in the hands of the medical doctors rather than us arbitrarily picking and choosing,” DeSantis said.

“Because the fact of the matter is if we picked certain things we may leave some out.”

For weeks, doctors have been fielding questions on the subject from concerned patients. But in recent days, requests have escalated.

“I will say that, since the guidelines were approved to start vaccinating vulnerable populations, that demand has been very strong,” said Dr. Victor Herrera, associate chief medical officer at AdventHealth Orlando and an infectious disease specialist. “There is a very high level of interest.”

But exactly who should be deemed extremely vulnerable is likely to vary from one patient to the next, he said, depending on individual circumstances. And different health organizations have formulated different criteria.

At AdventHealth, for instance, experts from various specialties joined forces to create standards based on guidance from the federal Centers for Disease Control and Prevention. The list includes transplant and cancer patients, those with severe kidney or respiratory conditions and individuals with Down syndrome and sickle cell disease, among others. The hospital expects to have vaccinated 7,000 “extremely vulnerable” patients by week’s end.

Herrera said patients who think they qualify should discuss the vaccination with their doctors.

“The conversation with the individual provider is very important. Pregnancy, for instance, is one of the diagnoses that many organizations have added to the list of patients who are vulnerable. … But if the patient also has diabetes, that is a [greater] level of risk.”

DeSantis initially authorized people under 65 deemed “extremely vulnerable” to be vaccinated in his late December order, but he said only hospitals could do the inoculations, and hospitals have had only limited doses. The expansion this week allows the vulnerable to get the shots at a retail pharmacy, doctor’s office, one of the new federal mass vaccinations sites and at least some county sites.

DeSantis also revealed the first two Walgreens sites in the state to offer the vaccine through the Federal Retail Pharmacy Program, both in Pasco County north of Tampa.

Walgreens now joins Publix, Walmart, Winn-Dixie, CVS and others offering vaccines to those who sign up through those companies’ various online portals.

Walgreens will do its first shots at two locations beginning Friday from appointments made on its website at walgreens.com starting Thursday. The sites can do 80 shots a day on weekdays and 60 a day on weekends, DeSantis said.

Speaking from Zephyrhills, DeSantis was also on hand to announce a pop-up vaccine site in Pasco and a similar one in Polk County that were going to be doling out 3,100 vaccines in the next three days.

The announcements come on a day that the state’s COVID-19 vaccine distribution shifted with new FEMA-run sites opening, including one at the west campus of Valencia College in Orlando, and an expansion of who can get the vaccine.

This week, DeSantis expanded the list of those who could be vaccinated to include K-12 teachers, sworn law enforcement officers and firefighters age 50 and older.

President Joe Biden said Tuesday his desire is to get all teachers and school staff vaccinated by the end of March, no matter their age.

DeSantis didn’t say much about the federal sites, saying, “we’re helping when we’re asked, but it’s a federally driven thing.’’

DeSantis also signaled he may adjust his order to include day-care workers to the list of those 50 and older that could be vaccinated.

“I’m supportive of that. We may have to change the order, but I think that would be totally reasonable to include them,” he said.

DeSantis said he’s targeting the Johnson & Johnson supply, which he expects to get by the end of the week, to be able to accomplish the 50 and over vaccinations of teachers, law enforcement and firefighters.

He said he hopes to be able to announce state-run pods with various counties’ law agencies and school districts.