Kansans with medical conditions soon eligible for COVID vaccine. Will they need proof?
Update: Kansans now eligible in Phase 3 and 4 will not be required to bring medical records or “proof of their health condition,” said a statement from Gov. Laura Kelly’s office on Monday. People will be asked to follow the honor system and self-attest, or self-report, that they are eligible, the statement said.
People who get vaccinated for COVID-19 in Wyandotte County must show proof that they live there. If they are seniors, they must show proof of their age.
If they work there, they must show proof as well, something like a work badge or pay stub.
But what about their health?
Come Monday, Kansans age 16 to 64 will be eligible if they have certain underlying health conditions as the state activates two vaccination phases simultaneously.
Will Kansans have to provide proof of their medical condition to get a dose?
As of late Friday, that answer still wasn’t clear. “We’re in the process of developing further guidance,” said Kristi Zears, spokeswoman for the Kansas Department of Health and Environment.
The department’s secretary, Dr. Lee Norman, said earlier in the week that state health officials would consult with vaccinators to find a “reasonable approach.”
Some counties have already decided their approach. Health officials in Johnson and Wyandotte counties said they will not require documentation of health risks but do require proof of residency.
Missouri, which began vaccinating people with underlying health conditions in January, is one of many states that do not require proof. On March 29, the state will move into the next phase of its vaccination plan, including workers in such areas a manufacturing, government and higher education. On April 9, all adult Missourians will be eligible.
Norman said that so far, Kansans have acted in good faith. “Everybody knows of somebody that’s jumped the line,” he said during a daily University of Kansas Health System briefing. “And nobody thinks that’s the right thing to do … so we do rely on the spirit of fairness and honesty.”
Some states don’t ask for proof of medical conditions to protect people’s privacy. Sometimes, the issue is more how to prove it. In North Carolina, for instance, current and former smokers are eligible for the vaccine.
From New York City to Los Angeles, public health officials rely on “self-attestation” — basically, your word that you have a health condition that qualifies you.
Last month, the nonprofit Kaiser Family Foundation reported that the states that had revealed how they would handle the proof issue — including Massachusetts, New York, Pennsylvania and Virginia — indicated they would either not require proof or rely on self-reporting.
“At least one, however (New Mexico), indicates that validation is required, either through a provider note, emergency department or hospital discharge summary, prescription, or other form of documentation,” Kaiser reported.
In Atlanta, a spokesperson for the Georgia Department of Public Health told a local TV station that health officials do “not have time to be vaccine police” while trying to vaccinate thousands of people. Residents are asked questions about their health on screening forms but don’t have to supply verification.
“Are we just going to be asking patients that? Are we relying on them telling us or the physicians giving us a little history? How do we judge who has that disease?” Steve Stites, the KU system’s chief medical officer, asked Norman.
“Really it puts pressure on the vaccination sites, county by county, to say how do we know?” Norman said. “Are people going to act in good faith?”
The honor system
Missouri vaccination sites — including those run by the Kansas City Health Department and Operation Safe, which is vaccinating thousands of people at Cerner headquarters in the Northland — are not required by the state to ask for documentation of health conditions.
“We really just rely on truthful responses to our interest form and appointment scheduler,” said Kelsey Neth, spokeswoman for the Clay County Public Health Center, an Operation Safe partner.
Nationwide, health officials rely on people doing the right thing, which in this case means not lying about having a health risk.
The Missouri Department of Health and Senior Services encourages vaccinators to use its screening form, or one similar, to register residents, according to spokeswoman Lisa Cox.
For every eligibility phase — be it based on age, job or health — Missourians “must self-attest to their status in a prioritized population and their residency,” the state’s guidance says. Vaccinators are allowed to require other forms of identification to verify residency.
Norman signaled that he wouldn’t mind requiring more from Kansans than just their word.
“I think it would be best if people would bring proof, if they have a pill bottle or something, more than just, ‘Yes, I have asthma,’” Norman said. “Some people have asthma when they’re a kid and haven’t had it since. I would like to think that people will really require ‘actively being treated illness or diseases’ and not just a ‘history of.’”
However, he said, “especially at the mass vaccinating sites … one of the things you don’t really want to do is shuffle through medical records and all sorts of things and slow down the process. We want to keep that moving.
“So is it really worth it to have a tight process for validating? And I think the answer to that is no.”
What’s covered
The Centers for Disease Control and Prevention lists the medical conditions that increase the risk of severe COVID-19 illness. Both Kansas and Missouri largely follow that guidance, though many other states do not.
“I think it would be a really great time for people to touch base with their physician, or their primary care, or their specialty providers to really make a case for having a vaccine in phase three and four,” said Norman.
As of Monday people with these health risks are eligible for the vaccine in both states: cancer, obesity, pregnancy, chronic kidney disease, chronic obstructive pulmonary disease (COPD), heart conditions, a weakened immune system due to organ transplant, Down syndrome, sickle cell disease and Type 2 diabetes.
Kansans with Type 1 diabetes, liver disease and moderate to severe asthma — all of which are on the CDC list — will also be eligible, but those aren’t qualifying health conditions in Missouri.
“Some of these other conditions, yeah, may put you at high risk but may not,” said Dr. Dana Hawkinson, medical director of infection prevention and control at The University of Kansas Health System.
“But really obesity and diabetes have shown time and time again to put you at further risk of those adverse outcomes.”
According to the CDC, being obese might triple your chance of being hospitalized if you get COVID-19.
‘Chomping at the bit’
Kansas had divided medical conditions between Phases 3 and 4 based on level of risk cited by the CDC.
But Norman said he had heard “from a lot of medical people and people in associations around the state how very difficult it would be to separate out those people with severe medical risk in the 16 to 64 age group from ‘other’ medical risks.”
The CDC provides guidance, “but when you look at it as a doctor or you look at it as a person with those risks, there’s no bright line that separates a lot of them,” Norman said. “Why would Type 2 diabetes be in (phase) three and Type 1 in (phase) four? Why would cystic fibrosis be in 4 and not in 3? So some of them just became not so much (up) for debate but just how you do it?
“So we decided with the increased vaccine coming to the state that we’re just going to put it out there.”
Norman said a lot of people are “chomping at the bit and we do know that there’s people who have not gotten it yet that are absolutely great candidates,” including nearly 19,000 Kansans being treated for cancer, he said. “We know they’re at risk and we’re going to be glad to vaccinate them.”
But even as Kansas and Missouri move to make hundreds of thousands more residents eligible for the vaccine, they do so without knowing exactly how much vaccine is coming their way, or when.
More than 600,000 Kansans will suddenly be eligible at a time when residents who are already qualified are still scrambling to find a dose and counties, including Johnson, are still vaccinating people in previous phases.
“If you thought that phase 2 was large, now this is going to be a much larger group,” Dr. Sanmi Areola, director of the Johnson County Department of Health and Environment, said during a COVID-19 briefing on Facebook this past week.
“The next four and five weeks (are) going to be very busy in the county. We’re going to do our very best to create more opportunities and get the vaccine into more arms as possible. No question, patience will be required.”
Vaccine 101
To find out if you’re now eligible for a COVID-19 vaccine, see covidvaccine.mo.gov/priority in Missouri and kansasvaccine.gov in Kansas.
Here are a few tools to use in your search for the shot:
▪ Balls Food website, ballsfoodspharmacy.com (includes Hen House, Price Chopper, Sun Fresh and Payless pharmacies). Slots are posted about once a week on Fridays, a company spokeswoman said.
▪ Appointments at Walmart pharmacies show up at midnight. See walmart.com/COVIDvaccine.
▪ Kansas’ tool is Find My Vaccine, at kansasvaccine.gov/160/Find-My-Vaccine. It shows where doses are going each week but not if the providers actually have any on hand.
▪ Missouri lists vaccine providers at covidvaccine.mo.gov/map but again makes no guarantees on supply.
▪ The Twitter account @kcvaccinewatch lists available appointments, and when they disappear.
▪ vaccinespotter.org: Vaccine Spotter scouts available appointments at select locations — Walgreens, Walmart and Hy-Vee among them — in each state.
▪ goodrx.com/covid-19/vaccine: GoodRx collects vaccine inventory and appointments from thousands of locations across the country.
Public health officials advise people to put their name on as many interest forms — some are called surveys — as possible. A few local ones:
▪ Jackson County: jacohd.org/covid-19-vaccine-survey-tool. 816-404-9883.
▪ Johnson County: jocogov.org/covid-19-vaccine. If you need assistance or a Spanish translator, call 913-715-2819.
▪ Wyandotte County: wycokck.org/COVID-19. If you cannot complete the form online call 311 and dial 1 for the COVID Hotline.
▪ Clay County: operation-safe.com. A community phone line also offers up-to-date vaccine information: 816-415-3250.
▪ Area hospital systems also offer vaccine clinics.
This story was originally published March 20, 2021 at 5:00 AM.
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