Who gets a shot, when

Vaccine rollout has begun, but concerns remain

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CALLICOON, NY — Dr. Paul Salzberg got a shot. It made sense because he’s the doctor for the Care Center at Sunset Lake. But under current NYS vaccine rollout guidelines, his staff—including a nurse who administers COVID-19 tests—was not eligible for shots until Monday, January 4. 

Their shots were delayed, even though they administer COVID-19 testing. Even though they’re treating sick patients, some of whom may have the virus. Even though they are just a handful of personnel, and if they get sick, Callicoon could potentially suffer because they aren’t there to treat people. 

“It’s been a point of contention for family doctors across the state,” Salzberg said. 

Frontline health care workers and those in long-term care have been first. The frail elderly are more likely to suffer seriously, and would require complex care. So giving them priority conserves resources. But what about essential workers who might be more likely to spread the disease to the general public? What about the rest of us?

Doctors and support staff in large medical facilities were given access. Members of hospital auxiliaries were on the intial list. But family practitioners not affiliated with large institutions were not prioritized, Salzberg said.

“I am very relieved,” Salzberg said, on hearing that shots would be available to his staff, “because if we didn’t have the opportunity to get the vaccine,” he said, “we might have had to stop doing COVID testing; we might have had to stop seeing patients in the office.” 

Vaccine doses, right now, are limited. The New York Times found that in New York, 170,000 doses of the Pfizer vaccine were sent out by the end of the year, and 346,000 doses of the Moderna one. (An additional 170,000 doses of Pfizer are expected early this year.) Pennsylvania declined to answer questions. 

These shots are prioritized. The Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices (ACIP), a group of medical and public health experts that offers guidance on
vaccine-preventable disease in the U.S., put together a list of guidelines. 

“The ACIP’s recommendations are just that, recommendations,” said Dr. Susan Bailey, president of the American Medical Association.  “They’re not binding.” 

But they’re regularly cited, suggesting that states are generally following them. 

Phase 1a offered shots to certain health care personnel and residents in long-term care facilities. Phase 1b, published on December 20, added non-health-care frontline essential workers. Then, 1c adds those “aged 65–74 years, persons aged 16–64 years with high-risk medical conditions and essential workers not recommended for vaccination in Phase 1b,” according to the CDC.

Lower priority for staff, including nurses, “has been a problem for the New York State Academy of Family Physicians,” Salzburg said. “Not only have I had trouble but other doctors across New York State have, too.” 

Asked whether the right people are being prioritized, Dr. Leon McDougle, president of the National Medical Association, said, “With the Phase 1 rollout of the vaccine, I would say yes.” But “we need to build equity into the plans... to prioritize closing the outcome gap” for Indigenous and Latino people, he said, adding that the ACIP is working on it. 

Prisoners are another high-risk category. Groups like the National Medical Association, the National Bar Association and Rainbow PUSH, Dr. McDougle said, “have advocated for an adequate response for treating persons who are institutionalized.” 

Independent doctors aren’t “putting anyone down for getting a vaccine,” Salzburg emphasized. But he was concerned.

Especially in a rural practice, if staff are sidelined, there’s a limited pool of people to replace them.

Now that they’ve all had the shot, then eventually the community can get vaccinated too. “Hopefully we’ll have vaccines [available] in our office,” he said. “We’re praying we do.” And that it’ll be soon.

Laurie Stuart contributed reporting to this story.

For more about vaccine distribution in Sullivan County, visit www.sullivanny.us/Departments/Publichealth/COVIDVaccines

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