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This article has been updated.
All adults in Texas will be eligible to receive a COVID-19 vaccine starting Monday, March 29, the Texas Department of State Health Services announced Tuesday morning.
With vaccine supplies expected to increase next week, the state’s Expert Vaccine Allocation Panel (EVAP) has recommended opening vaccination to everyone who falls under the current Food and Drug Administration emergency use authorizations, which is anyone 18 or older. Texans age 16 or older are eligible to get the Pfizer vaccine with parent permission. EVAP is the team of appointed external and internal subject-matter experts who have developed vaccine allocation strategies as recommendations to the Texas Commissioner of Health.
Despite the state’s promise that supplies of the vaccine will increase beginning next week, local leaders expressed concerns Tuesday that demand will exceed supply at uncharted levels.
“It’s been really easy for the governor to say … let’s vaccinate everybody. It’s easy to say that, but you got to have the vaccines to be able to do it,” Bexar County Judge Nelson Wolff said during Tuesday’s county commissioners meeting. “We’ve been shortchanged in San Antonio, and we’ve had to stretch our limits. And all the things we want to do, we can’t do unless we have the vaccine so … the federal government’s gonna have to step up and hopefully bypass the state and get them here.”
Low vaccine supply has been limiting for all local vaccine providers, said Dr. Erika Gonzalez, president and CEO of the South Texas Allergy & Asthma Medical Professionals (STAAMP).
“I am hoping that the fact that they have opened it up to all adults means that more vaccines are available for distribution,” she said. “We have slowly started to see more vaccines being distributed to community vaccination centers and this is a very promising and optimistic sign.”
San Antonio Metropolitan Health District spokeswoman Michelle Vigil said the City will give a detailed update regarding the state’s announcement and on how it plans to distribute vaccine doses during the Tuesday evening COVID-19 briefing.
Prior to the DSHS announcement Tuesday, those eligible for the vaccine in Texas were residents in the 1A, 1B, and 1C groups, which included frontline health care workers, adults 50 and older, teachers and educators, seniors living in long-term care facilities, and anyone with a chronic illness.
“We are closing in on 10 million doses administered in Texas, and we want to keep up the momentum as the vaccine supply increases,” said Imelda Garcia, DSHS associate commissioner for laboratory and infectious disease services and the chair of the Expert Vaccine Allocation Panel, in a DSHS statement. “As eligibility opens up, we are asking providers to continue to prioritize people who are the most at risk of severe disease, hospitalization and death – such as older adults.”
The DSHS is still directing vaccine providers to prioritize people who are 80 years or older when scheduling appointments and has asked providers to allow anyone in this age group who comes in for a vaccination to move to the front of the line, whether they have an appointment or not.
WellMed is still working out details for how its operation will change in light of the news, said Dr. Michael Almaleh, WellMed’s local chief of cardiology and specialty care.
“When crowds develop, it can be very, very concerning,” he said. “[It’s a] behavior that is in direct conflict with what we’re preaching, which is social distancing.”
Gonzalez had similar sentiments about the state’s demand that those 80 or older be allowed to cut the line, even without an appointment.
“Not only as a business owner, but as a physician, this recommendation does not support a smooth workflow or consistent process of vaccine distribution and can definitely make an already challenging process more difficult,” Gonzalez said.
Having vaccine clinics without appointments can create an environment of chaos and this puts patient safety at risk, she said. Gonzalez added appointments should be encouraged and providers should still advocate for the vaccination of Texas’ most vulnerable populations first.
“At STAAMP, we will continue to work hard to get as many people vaccinated as quickly and safely as possible,” Gonzalez said. “Our efforts to help our community stay safe will not stop and we will work within all of the DSHS recommendations to the best of our ability to make this happen.”
Next week the DSHS will launch a website to allow Texans to register for a shot through some public health providers. The public will be able to enroll in the Texas Public Health Vaccine Scheduler to identify upcoming vaccine clinics hosted by DSHS or a participating local health department and will be notified when new clinics and appointments become available. Texas residents can find additional providers through the DSHS Vaccine Information page.
According to the DSHS press statement, online registration will be the best option for most people. The DSHS will also launch a toll-free number to help anyone lacking internet access make an appointment with a vaccine provider.
Barriers such as lack of internet service, a need for transportation to an appointment, and/or lack of access to nearby health care facilities will be issues both the state and local governments need to keep in mind as vaccine distribution ramps up, said public health specialist and epidemiologist Cherise Rohr-Allegrini.
While Rohr-Allegrini said she is thrilled to hear all Texas adults will be eligible for a vaccine as of Monday, she said issues like vaccine distribution equity will still need to be addressed for the state to reach herd immunity.
As of Tuesday, Texas has administered more than 9.3 million doses of the COVID-19 vaccine, equating to more than 6 million people with at least one dose and more than 3 million fully vaccinated.
Disclosure: Dr. Erika Gonzalez is a member of the San Antonio Report board of directors, and her practice STAAMP is a San Antonio Report business member.