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Bioscience-Medicine

Reporter’s Perspective: I Received The COVID-19 Vaccine Under Phase 1B, But It Isn't Easy To Access

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A hospital staff member at CHRISTUS Santa Rosa Medical Center administers the COVID-19 vaccine to me on Saturday, Jan 2.

On Saturday, I was able to receive a first dose of the COVID-19 vaccine along with my mother. It was an off-shoot opportunity via word of mouth at a San Antonio hospital — CHRISTUS Santa Rosa in the Medical Center.

My mother and I are not healthcare workers, nor are we residents in a long-term care facility or first responders — all part of the state’s priority vaccination group, Phase 1A. She is retired and I’m a reporter.

But last week, something changed in Texas’ vaccine rollout. And, while it’s opened up the vaccine to more people, it’s also caused a lot of confusion.

With Little Warning, Texas Added New Eligible Recipients: Phase 1B

On Dec. 29, Texas’s Department of State Health Services made an announcement that caught many in local government and healthcare off-guard. The state authorized vaccine availability to people in a new category.

Known as Phase 1B, that group includes people who are over 65 years old, or who are between the ages of 16 and 65 and have chronic illnesses like diabetes, cancer, heart disease, obesity and other factors that can exacerbate COVID-19’s risk of death or long-term complications.

My mom and I, like many others in San Antonio, qualify for Phase 1B under the state’s guidelines. My mom is 70 and has several health factors that would make fighting COVID-19 difficult. I’m a 34-year-old Hispanic man with Type-2 Diabetes.

That may be great for us, but it’s strained already-stretched healthcare providers. Dr. Colleen Bridger, who serves as incident commander for the City of San Antonio’s response to the COVID-19 pandemic, said asking providers to handle two lines at once is “chaos.”

“One of those lines... is very well defined, very orderly...because that's what we were planning for the last three months,” said Bridger, referring to group 1A. “And then the other line (1B) that literally represents 60% of our population … that's chaos inducing. That creates a scarcity mentality.”

According to Bridger, when Texas DSHS opened up the second tier of vaccination recipients, San Antonio hadn’t yet finished distribution to group 1A.

The most recent figures of distribution show that 31,000 doses of the vaccine have been given to people in Bexar County as of last Tuesday. By Metro Health’s estimates, there are 141,000 people eligible to receive the vaccine in Phase 1A.

There will be plenty of opportunities for vaccination over the next several months, she added.

“Everybody wants to get to the front of the line, and I got that,” said Bridger. “The problem is we only have so many doses to give out, and we only have so many places that have these doses to give out”

Tracking Down Where The Vaccine Can Be Obtained

That chaos could be seen last week as people who suddenly qualified for the vaccine rushed to find somewhere to get it.

On New Year’s Eve, Bexar County’s University Health System announced it was opening vaccinations for Phase 1B via appointments that could be made online. In fewer than five hours, all 17,000 of UHS’s vaccine appointments were filled.

A statement on the UHS website now reads, “Due to an overwhelming response, we currently have no more appointments available. We will open up more slots as soon as we get more vaccine and let you know through our social media and local news outlets.”

Texas DSHS has a list of where vaccines have been distributed. You’ll see many places that look familiar. H-E-B Pharmacy is one, but when you call an H-E-B Pharmacy listed on the state’s website you’re almost instantly met with a recording that says they’re only vaccinating people in the Phase 1A category.

A statement on HEB’s newsroom page reads, “Many of our H-E-B Pharmacy locations are still working through waitlists for healthcare providers in Phase 1A. We will continue to move into vaccinating people in Phase 1B when we receive more allocation of COVID-19 vaccine from the state of Texas.”

This Reporter's Vaccination Story

I found the off-chance availability at CHRISTUS Santa Rosa’s hospital in the Medical Center through word-of-mouth from a long-time friend who sent me a message on Facebook.

This friend — who works in healthcare — told me that vaccines would be available for 1B on a walk-in basis. They found out about it after getting the vaccine for themselves.

I called the hospital’s main number on New Year’s Day and spent about 10 minutes on hold before talking to a staff member. That staffer said they’d be offering the vaccine starting at 7:30 in the morning on Saturday until about 6:30 p.m.

The walk-up availability was not publicized on the CHRISTUS’ website or any social media accounts I could find.

We tried our luck.

When we arrived at 5:45 a.m., there were already about 40 people in line. An hour later, another 70-80 had lined up behind us. The people in line during this predawn hour ranged in ages — like from elder parents with their adult children — everyone in line was wearing masks and some brought foldable lawn chairs.

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Joey Palacios / Texas Public Radio
About 40 people wait in line CHRISTUS Santa Rosa in the Medical Center for the COVID-19 vaccine in this photo taken around 6:00 am on Saturday, Jan 2.

Shortly after 7:00 a.m., a hospital staff member came outside and told those in line that people considered 1A and those who had previous appointments would be given priority over walk-ins.

Two lines would form. The left would be for walk-ins and the right for appointments and healthcare workers.

Hospital staff handed out forms to the walk-ins. My mother and I had to sign and initial the form, showing we understood the vaccine was approved under emergency use authorization. We also had to agree to show up for our second dose.

We reached the door to get inside by 8:42 a.m.

The operation inside was well organized. We were handed the CDC Vaccination Record Card that indicated we would receive the Pfizer vaccine.

We went down the hall and waited outside a room with about about half a dozen vaccine recipients inside.

Once two people came out, we went in and handed our forms to two staff members. They asked us which arm we wanted. It was a quick poke like any other shot.

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Joey Palacios / Texas Public Radio
By 7:30 am the line had significantly grown.

Once the jab was done, I was handed a timer with a 15-minute countdown. Vaccine recipients are kept around to make sure there are no adverse effects from the shot. On the table was a QR code that took me to an online booking system where I signed up for my second dose.

Once outside, I saw the line now wrapped well around the building — at least 250 people were waiting.

All of this happened on a Saturday morning, less than a week after the state announced the new authorizations. It’s not clear, though, how often the vaccine will be available in this manner at this hospital or at other providers.

Dr. Bridger said there have been a handful of instances of one-off distributions in San Antonio over the last few days, but they’ve been difficult to track.

“It’s just like a couple hours here, a couple hours there, pop-up vaccination events without any sort of coordination or advanced communication — that's happening,” she said.

Trying To Manage Two Lines At Once

A spokesperson for CHRISTUS Santa Rosa said in an email that vaccine prioritization remains for healthcare workers and those in Phase 1A. However, “to ensure that CHRISTUS Santa Rosa continues to be good stewards of the vaccines allotted to us by the state, we have occasionally give doses to those in Tier 1B,” said Nikela Pradier, a CHRISTUS Health Public Relations Specialist for South Texas & Southeast Texas.

She acknowledged the new state guidance but said the hospital system is working on another method of distribution and people seeking the vaccine who are not healthcare workers should not arrive at the hospital for the vaccine.

“…as our hospitals continue to care for patients with COVID and other medical needs, we are working to turn this process over to specific clinics and outpatient care locations, which are better prepared to provide this type of care to large groups of the public,” she said.

The CHRISTUS hospital system expects to launch a registration system for this sometime next week.

“We are quickly working through a process that we hope will allow the public to determine if they fit into these groups and, if so, to sign up for an appointment to receive their vaccine,” she added.

CHRISTUS Health’s website lists vaccine distribution for Phase 1B could be ready by Monday, Jan. 4, for some locations in Texas, but did not specify where.

Dr. Bridger says she and San Antonio Metro Health were not critical of these types of distributions. “The (providers) who have received doses of vaccine are being told, ‘You need to get that vaccine into as many people as possible in as short of time as possible,'" she said.

Metro Health will try to help track any of those events that could take registration.

“We're trying to put a little bit of structure to it. We're trying to set up a website where people can check and really get legitimate information about what's available where; if events are happening that have pre registration, we’ll have those registration links on that website,” she said.

Added to that, Bridger said Metro Health would consider a system to identify where at-risk populations are high so vaccine providers can see where the need is greatest.

“We're gonna be working on a map that says these geographic locations need to be prioritized for sites for vaccine administration, she said.

The vaccine is a high priority for many as cases accelerate across the country. I — like many others who have received the vaccine — still need to find those vaccination opportunities for other members of my family like my father and grandmother. Until a system is in place, tracking it down remains a challenge.

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