Sun Sentinel Palm Beach Edition
State’s vaccine plan creates confusion
Doctors, pharmacies try to determine who is eligible
Vaccines for COVID-19 just became available to a lot more people in Florida, creating confusion as doctors, pharmacies and health officials try to figure out what it will take to get a shot.
Publix said Monday no documentation would be required for a vaccination under Friday’s executive order by Gov. Ron DeSantis that extended eligibility to anyone under 65, provided their doctor determined they were “extremely vulnerable” to the disease.
But the governor’s order stated some sort of paperwork would be needed, stating “Such physician determinations shall include a statement that the patient meets the defined eligibility criteria established by a form prescribed by the Florida Department of Health.” Meredith Beatrice, spokeswoman for the governor, said the state will provide a form for doctors to fill out.
Walmart, which is updating its scheduling system to reflect new eligibility, said it’s undetermined whether a patient will need a doctor’s note. Holy Cross Hospital in Fort Lauderdale said it would give shots to those under 65 who meet the new
criteria, but it will start with patients already part of its health group.
And Dr. Alina Alonso, director of the Florida Department of Health’s Palm Beach County office, said in a public forum Monday that physician notes will be required and must specify which of a restricted number of conditions qualify the person for a vaccination.
“What I am afraid of is that the physician is just going to write that the patient is at high risk,” she said Monday during a roundtable discussion on the impact of COVID-19 hosted by U.S. Rep. Lois Frankel. “If that happens without verification of those exact conditions, everyone is going to get a note from the doctor and it’s going to be a mess.”
Publix said it will rely on the patient’s word that a doctor says they qualify.
“As outlined in the Governor’s executive order, currently individuals need only communicate they have a qualifying condition as determined by a doctor in order to receive the vaccine, and we are not asking for documentation at this time,” the company said in a statement Monday.
The governor’s order does not list any criteria, leaving the determination entirely up to the discretion of the physician. But the following conditions place people at increased risk of “severe illness” from COVID-19, according to the U.S. Centers for Disease Control: ▪ Cancer; chronic kidney disease; chronic obstructive pulmonary disease; Down syndrome; heart conditions such as heart failure, coronary artery disease and cardiomyopathies; weakened immune systems from organ transplants; obesity; pregnancy; sickle cell disease; smoking; and type 2 diabetes.
▪ In addition, the CDC said people with the following conditions “might” be at increased risk of severe illness from the COVID virus: Asthma; cerebrovascular disease; cystic fibrosis, high blood pressure; a weakened immune system from blood or bone marrow transplant, HIV, use of corticosteroids or immunity-weakening medicines; neurologic conditions such as dementia; liver disease; pulmonary fibrosis; thalassemia; and type 1 diabetes.
Although it had been possible for people under 65 to receive vaccinations, the shots were administered under limited conditions, with only certain hospitals giving them out.
Under the governor’s order, any site in the county offering vaccines can now give them to someone with a doctor’s note that clarifies what condition allows them to qualify — but they need an appointment, Alonso said.
Those sites include retail pharmacies like Publix and Walmart, or mass vaccination sites at county parks or health centers. Until now, only hospitals were allowed to vaccinate people under 65 with conditions that put them at risk.
In Palm Beach County, Dr. Larry Bush said he already is getting calls from patients who want a letter verifying their high risk. While he is providing those letters, Bush said he’s hoping his practice will get vaccines to give out themselves.
The Johnson & Johnson single shot COVID vaccines don’t require deep freeze and will be much easy for doctors to administer, he said.
“I am sure those are the vaccines that will go to doctors’ offices,” Bush said. “To get them for your patients, you have to be registered for the Florida SHOTS program. Most physician groups are, but some are not.”
Florida Rep. Omari Hardy of Lake Worth said he is concerned that poorer people in the county with underlying conditions don’t have doctors who can write them a prescription. “They don’t have healthcare and they can’t see the doctor easily. Obtaining that letter will be more difficult for some than for others. I am afraid we are going to see disparities play out all over again.”
Alonso said anyone can go to a federally qualified health center in their county regardless of ability to pay and get seen by a doctor who can give them a note that allows them to get vaccinated.