Snowbirds receiving COVID-19 vaccines

Residents worry about limited supply of shots

Snowbirds and other visitors who typically come to enjoy the state’s warm winter weather are joining Arizonans as they roll up their sleeves to receive the COVID-19 vaccine.

Some year-round Arizonans are frustrated that non-residents are tapping the state’s limited supply of doses.

But from a public health perspective, it’s important to protect everyone who is in the community, health officials say.

Plus, the more doses administered overall, the better.

State health officials’ intent to vaccinate anyone in Arizona has been clear from the start.

Dr. Cara Christ, the state health director, told The Arizona Republic in early December, before the first doses even arrived in the state, that vaccines would be available to residents, snowbirds and visitors alike.

“Vaccines is one of those things that we make available no matter if you’re a winter visitor, if you’re here visiting from another country,” Christ said. “Because of the impact that the diseases that you vaccinate against have on the community, we want to make sure that we’re protecting everybody.”

State officials have used Arizona’s expanded winter population as part of their requests to the federal government for more doses.

Gov. Doug Ducey said this week on CNN that the state needs more doses in part for that reason.

“We’ve got a lot of people that come to Arizona. It’s a beautiful day here. Today, it’s 68 degrees. And people migrate here from other cold weather states. They need vaccinations as well,” Ducey said. “We need more. And we’re asking everyone to hustle it up because we want to get that vaccine in people’s arms.”

Christ at a Monday vaccine event said Arizona is “a fabulous place to come” and draws many winter visitors. There are also more migrant farmworkers in the state this time of year, she said.

“We know that our population increases during the winter. We have made that known to our federal partners — that we need additional doses to be able to account for this increase in population.”

It’s unclear how many non-residents have received shots in Arizona so far because the state does not publish any demographic data about individuals vaccinated.

There’s also a difference between winter residents or long-term visitors receiving shots and those coming into the state just to get the vaccine. That “vaccine tourism” phenomenon has been reported in Florida, prompting a new rule requiring permanent or seasonal residency. It’s unclear whether vaccine tourism is a prevalent issue in Arizona.

Many public health experts do not encourage vaccine tourism, but say that from a disease-prevention perspective, as long as people are visiting Arizona and qualify for the priority group that’s being vaccinated, it makes sense to vaccinate them.

“As long as they are within the priority population, I’m not quite sure what difference it makes,” Dr. Georges Benjamin, executive director of the American Public Health Association, said Tuesday at a news briefing.

“Remember that if somebody is coming to a warm weather state for the winter, they are going to be there and therefore they run the risk of getting infected or infecting someone else,” he said. “So we want them to be vaccinated.”

Benjamin is not trying to encourage vaccine tourism, he emphasized.

“You know, I’m not asking anyone to hop on a plane and go someplace where they can get vaccinated, hop back on a plane and go home,” he said. “For me, let people get vaccinated where they are as long as they are in the priority population.”

‘People are getting these shots without any questions’

For South Dakota residents Joe and Gina Kafka, who are spending their seventh winter in Arizona, that approach makes sense. Joe Kafka is 73 and his wife is 67.

They have been trying to sign up for one of the state-operated sites but so far have not been successful, though they are still hoping to be fully immunized by the time they leave their winter residence in Apache Junction in April to return to South Dakota.

“It is without a doubt safer” to get immunized in Arizona as soon as possible than to wait until they go home, said Joe Kafka, a retired journalist. The vaccine “works both ways,” he said — it’s safer for the people getting immunized, but also for anyone they are coming in contact with, he said.

But that’s not how Mesa resident Lawrence Gretz sees it.

For Gretz, the vaccination process in Arizona feels unfair. He doesn’t think winter visitors should be getting vaccinated here because, in his view, it takes vaccine supply away from permanent residents. Arizona has been allocated its vaccine supply based on population, but the population here swells in the winter, he said.

Neither Gretz nor his 87-year-old mother has received a COVID-19 vaccine because Gretz no longer drives long distances and Phoenix Municipal Stadium and State Farm Stadium are too far away, he said.

“People are getting these shots without any questions,” Gretz said. “The governor and whoever did this, ADHS, they should have planned this ahead of time. People should get shots in their home states before they come.”

Gretz said the best-case scenario for both himself and his mother is to get vaccinated at a pharmacy near their home. Maybe if the supply wasn’t going to visitors from outside Arizona there would be more doses for pharmacies, he said.

“I have numerous medical problems, and my mom is 87 and only has one lung,” said Gretz, a retired correctional transportation officer who moved to Arizona from Illinois 14 years ago.

“They should have just got the message out that if they come here (to Arizona) without a vaccination, they can’t get one here. I feel that should be for the residents. States are allotted only so many shots.”

Gretz said he’s also concerned about Canadians “using U.S. tax dollars” to get vaccinated in Arizona. He has called several elected officials to voice his concerns, he said.

‘It is a strain on us’: La Paz County population mushrooms in winter

La Paz County in western Arizona is one of a handful of regions across the state that mushrooms with winter visitors each year and the expanded population has amped up the county’s need for COVID-19 vaccine doses.

The year-round county population is about 21,000 people, but that increases up to five-fold when snowbirds flock each winter, health officials said. Currently, there are an estimated 75,000 to 100,000 winter residents in La Paz County, and most of them are older than 70, the county said.

That poses a significant challenge for vaccination efforts, as the health department sees a responsibility to vaccinate as many people as possible, regardless of home state.

“It is a strain on us because we do have a lot of people from other states here that are wanting the vaccine, and as a health department, it’s our goal to protect the health of our citizens, whether they’re residents or visitors,” said Greg Bachmann, La Paz County Health Department’s emergency preparedness and response coordinator.

“We certainly don’t want our visitors getting COVID. We only have one community hospital here in La Paz County with 26, 28 beds, so we can’t have hundreds of people getting sick,” he said. “That was one of our concerns: how do we take care of these thousands and thousands of snowbirds based on our county allotment of vaccine?”

To Dr. Tom Frieden, president and CEO of Resolve to Save Lives, a nonprofit global health organization, “a person is a person and over 65 is at higher risk,” no matter where they are living.

“The more we reduce the number of outbreaks and clusters, we reduce viruses, we reduce the risk of more dangerous variants, not only in the U.S. but globally as well,” said Frieden, a former director of the Centers for Disease Control and Prevention, during a Tuesday news briefing.

“Uncontrolled transmission anywhere is a risk everywhere. We can see more resistant, mutant virus strains that may evade vaccination or may evade natural immunity . ... So I would say that although we do our health care by state, not only within the U.S. but globally, we really have to reduce differences between areas.”

Pima County official: Vaccinating visitors is ‘very defensible’

Initially, La Paz County received vaccine doses from the state based on its year-round population, according to county health officials.

The county was receiving about 100 doses a week for the first month; after requests to the state health department, that has increased to about 1,000 doses a week to account for the seasonal population swell.

Most of the snowbirds live in the county for four to six months to avoid the cold weather in home states such as Montana, Idaho, Washington, Oregon, the Dakotas, Minnesota, Nevada or Utah, Bachmann said. The county has not had as many Canadian residents as normal because of travel restrictions, he said.

La Paz County health officials suspect they may get more “vaccine tourism”-type visitors in the coming months as well, especially from California because Arizona’s registration rules may be more lax.

The La Paz County health department has heard some complaints from residents who are frustrated visitors are taking up doses, but “by protecting the snowbirds, we’re also protecting hopefully our residents,” Bachmann said.

“We’ve heard through several different people at ADHS that they really don’t want to have a restriction on who gets it as long as they fit the criteria (priority phases), as this is a federal asset, so it is open to people living in the United States,” Bachmann said. “Our goal is to keep people healthy and safe and by not limiting it, we’re trying to provide the best protection to everybody that we can.”

In Pima County, officials say vaccinating visitors who spend time in Arizona and are in a priority group is “the right thing to do” and is “very defensible” from a population management disease prevention perspective.

“It is important for people who are vaccine eligible, people who are vulnerable to disease, to be vaccinated first,” Dr. Francisco Garcia, chief medical officer for Pima County, said during a Tuesday briefing. “Sometimes those people will be snowbirds, sometimes they will be visiting faculty, sometimes they will be other folks who may only reside here transiently.”

Vaccinating people who are at high risk helps lower mortality rates and prevents more vulnerable people from getting ill, and it also “keeps the amount of infection in our community lower,” Garcia said.

“We have a responsibility to these folks, but in order to meet that responsibility we need larger volumes of doses,” he said.