The Covid-19 vaccine is a fight for those who have no connection to the hospital


As Covid-19 vaccines continue to roll out across the country, many hospitals and clinics are prioritizing their own patients, leaving people lacking a proper primary care physician or hospital-affiliated physician struggling. to find the doses.

Many states chose to distribute the vaccine first to hospitals, which then became the main providers of the vaccine to their own healthcare workers and others who qualified. In many cases, people must have a primary care physician affiliated with the hospital or receive hospital care to receive an injection there.

That means people living in poorer communities without major hospitals often face more difficulties finding access to the vaccine, which is still in short supply. The issue highlights one of the challenges officials face in the effort to vaccinate people fairly.

When Texans 65 and older and with certain medical conditions became eligible for Covid-19 vaccines, Jovana Sánchez-Meléndez, a 35-year-old university technology director near Dallas who has an autoimmune disease, received an email. email from your doctor to sign for an appointment.

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Ms. Sánchez-Meléndez received the vaccine quickly. But he said he couldn’t get appointments for his parents, who work front-line positions like janitors and construction workers and have medical conditions that make them a high risk for Covid-19. His parents weren’t patients at a hospital that had doses.

“You have to know someone who knows someone who knows how to get it, and it’s still not safe,” Sánchez-Meléndez said. Her parents finally found doses, and her father received his first injection on Wednesday, about a month after she received hers.

Similar dynamics have been reported across the country, in states as disparate as California, New York, Iowa, and Alabama. The situation has improved slightly in recent weeks as more hospitals are beginning to make room for non-patient records, health officials said. Also, in some states, major retail pharmacies like CVS are distributing doses, expanding access.

Dennis Andrulis, principal investigator for the Texas Institute of Health, said that nationally 27% of white men, 31% of black men and 41% of Hispanic men do not have a primary care physician. He said hospitals also tend to be located in more affluent areas, leaving poorer neighborhoods with fewer options.

“He has a history of steroid neglect,” Dr. Andrulis said. “If people have access to a doctor in their community and insurance, the door will be more open for them.”

Dr. Georges Benjamin, executive director of the American Public Health Association, said that some of the people who need the vaccine most – workers in hazardous and public-facing jobs – are less prepared to fight for doses if they don’t have a connection to a doctor. Bus drivers, janitors, grocery store workers and others can’t spend their days updating computer screens for vaccine doses the way people who work from home with computers can, he said.

Many doctors and clinics with no ties to a major hospital were left out of the initial vaccine distribution efforts, Dr. Benjamin said. On Wednesday, he said the situation is evolving. “There is certainly an increase in availability, but many of the community doctor providers still don’t have easy access,” he said. “Retail pharmacies should help the situation a bit.”

In Texas, facilities that prioritize their own patients include some designated by the state as vaccination centers. Hospitals said they have expanded access as they have been able to. A spokesperson for the UT Southwestern Medical Center, where Ms. Sánchez-Meléndez received her vaccine, said she treats extremely ill patients and tried to prioritize those who are most likely to be hospitalized if they contract the virus. The hospital has allowed regular access to enrollment for non-patients and has established a vaccination site in an area of ​​South Dallas historically underserved by healthcare.

John DeFilippo received his second injection of the Covid-19 vaccine in January.

John DeFilippo, a 72-year-old man from Houston, signed up for vaccinations in January at the same time as his wife, Marylyn. Your Memorial Hermann Health System physician sent you an email with an appointment link. A few days later, she received a call from a hospital representative asking who her doctor was. Mr. DeFilippo had been treated at Memorial Hermann before and recovered from back surgery there, but his primary care physician was not directly affiliated. He said the hospital canceled his appointment.

A spokeswoman for the health system said it had such a limited supply of vaccines and such a large qualified population that it has had to move in waves. “Like many health systems across the country, we began by offering vaccination to established active patients,” the hospital said. “However, in mid-January, we were organizing a series of mass vaccination clinics throughout the greater Houston area.”

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DeFilippo said he was surprised, not only by the hospital’s policy, but also that it would devote resources during the pandemic to locating and removing non-patients.

“I’m not a stranger to the hospital, but I guess I’m not a client enough,” he said. “She must have investigated me and my doctor, all for one patient.”

He said he was later able to get the vaccine at another hospital.

Write to Elizabeth Findell at [email protected]

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