Michigan vaccination priorities include people with IDD living with their families or in their own homes

Michigan has expanded eligibility for vaccination to all people over 65 years old, as it continues to vaccinate people in the highest risk categories. This includes people with intellectual and developmental disabilities (IDD) living at home with their families or in their own homes, as well as residents of long-term care facilities and their caregivers.

My two sons live in a licensed group home that is a long-term care facility under the vaccination guidelines. All six residents of the group home received their second shots more than a week ago. None have experienced significant side effects. They are all fine.

When people with IDD live at home with their families or in their own home, they usually receive services through the Community Mental Health (CMH) system, funded through Medicaid waivers. Medicaid waivers allow CMH to provide for their care at home as an alternative to an institutional setting such as an Intermediate Care Facility for people with IDD or a skilled nursing facility. People with IDD, regardless of where they live, are more vulnerable than the general population to bad outcomes from the virus and are among those given priority for vaccination by the state and county health departments.

In Washtenaw County, many families were notified to sign up for vaccinations for their disabled family members, unpaid family caregivers, and paid CMH caregivers. They were asked to complete a survey for the county department of health and then to wait for more information about when and where to be vaccinated. Rather than being given the option of in-home vaccination, some were informed of large vaccination centers, where they would have to bring their family member, increasing the risk of exposure to the virus and having to deal with problems such as their family member being unable to wear a mask or to comply with social distancing rules. Part of the problem was that the survey did not ask for or take into account the special accommodations needed by people with IDD in setting up vaccinations.

Just Us Club, an activity program for adults with IDD in Ann Arbor that my sons attended in non-COVID days, maintains contact with families and sent out emails to help them overcome delays and barriers to vaccination.

I suggested that families use “magic words” when contacting the county health department to help them flag their request involving people already prioritized for receiving the vaccines:

“It sounds like Just Us Club families are having difficulty getting the county to respond and schedule a time to give vaccinations. I looked at the survey and, as usual, it is mostly about organizations and healthcare without any special consideration of the minority population of people with DD. They may just be overwhelmed, but it might be useful for people to use 'magic words' where they can fit them into an answer on the survey or in correspondence with the county. Among those magic words are 'Developmental Disabilities' or 'intellectual and developmental disabilities' or better yet, 'severe Developmental Disabilities' or 'severe IDD', 'Medicaid funded Home and Community Based Services', 'Home healthcare for a person with DD', 'Caregiver of person with severe DD, '…and related severe medical conditions'…anything to get their attention that we are talking about severe disabilities with related medical fragility and health conditions putting even younger people with DD at increased risk from COVID.”

Another parent suggested, “… I'll add to it that if your loved one has any physical ailments that might put them at greater risk (asthma, COPD, diabetes, etc.), it might help to spell it out in the email. If you include your phone number in your email, you may get a call from the County nurse to ask additional questions and potentially schedule your home visit. They really are swamped and using the 'magic words' can help get your loved one appropriately prioritized.”

Another parent came up with a sample email to send:

Hello,
My adult child, ______, receives Medicaid funded Home and Community Based Services through Community Mental Health. He /she has significant developmental disabilities and other underlying medical issues. He/she cannot tolerate wearing a mask for any length of time. I/we provide full time care for _______ in our home. My child has been sheltering at home all these months because he/she is medically fragile and thus more vulnerable to the Covid 19 virus. I am wondering what the procedure would be to schedule vaccination for my child in the home or at a drive through location, rather than at a large vaccination site.
Thanks so much,_______________

Another parent added that her son’s lack of expressed language and his seizure disorder qualified him as high risk and that because he couldn’t effectively communicate how he was feeling or whether he was feeling pain, was also helpful in identifying him as high risk.

JUC heard back from a number of families who were delighted to have a visiting nurse scheduled to come to their home to administer the vaccines, once their need for special accommodations was heard. 

I hope this helps with the frustrations of trying to get vaccinations for people with complex disabilities and needs.

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Information from the AARP on "The COVID-19 Vaccine Distribution Plan in Michigan" by Catherine Maddux , February 03, 2021

 

Beyond free speech: Anti-vaccine protesters temporarily shut down vaccine site in Los Angeles

From The Washington Post, “Anti-vaccine protesters temporarily shut down major coronavirus vaccine site at Dodger Stadium in Los Angeles” by Meryl Kornfield, 1/30/21:

“One of the largest vaccination sites in the country briefly shut down Saturday afternoon because maskless, anti-vaccine protesters blocked the entrance, officials said.

“For nearly an hour, thousands of motorists in line to get a coronavirus vaccine shot at Dodger Stadium were stalled as about 50 people demonstrating against immunization efforts caused officials to temporarily close the site’s gates, Los Angeles Fire Department spokesman David Ortiz told The Washington Post. The protest had no impact on the number of shots given Saturday at the site, which can vaccinate 8,000 people a day, Ortiz said.”

The temporary shutdown complicated the already stressful process of getting vaccinated with vaccines in limited supply and in high demand.

According to The L.A. Times, “Confirmed coronavirus cases in California have surpassed 3.2 million. More than 40,000 people — one in every 1,000 Californians — have died from complications of COVID-19. The Los Angeles County Department of Public Health’s official death toll stands at 16,647 after 316 fatalities were confirmed Saturday [emphasis added], along with more than 6,900 new cases.” Variants of the coronavirus that make the virus more transmissible continue to spread in L.A. County.

The protests were organized on social media and "...advised participants to 'please refrain from wearing Trump/MAGA attire as we want our statement to resonate with the sheeple. No flags but informational signs only.'"  The protest, however, was not only about the COVID vaccine, but had the purposeful effect of spreading disinformation about a wide-range of conspiracies - “This is a sharing information protest and march against everything COVID, Vaccine, PCR Tests, Lockdowns, Masks, Fauci, Gates, Newsom, China, digital tracking, etc.”

Meanwhile, “Following demonstrations by anti-mask groups at shopping malls, grocery stores and homeless encampments, the Los Angeles City Council earlier this month bolstered restrictions and subjected some violators to financial penalties.”

I trust the will of the "sheeple", more than I trust the politically motivated exploitation of people with unfounded fear and disinformation.

If you don’t want to wear a mask, don’t wear one, but then don’t go into places such as private businesses that require masks to protect their customers and employees. If you don’t want a vaccine, don’t get one, but don’t get in the way of people who want to get vaccinated to prevent themselves from getting sick or worse from COVID and to prevent the spread of the virus that has caused the worst pandemic in 100 years.  

The Barker boys, Danny and Ian, live in a group home with four other severely and profoundly disabled residents, all of whom are medically vulnerable to the worst effects of this virus. They all received their second Pfizer vaccine last week without adverse side effects. It is troubling, however, that many of the staff chose not to get vaccinated because of fears that it might hurt them in some way more than the virus. The demand for vaccines is generally high and eventually I expect that many of the staff will change their minds.

Weighing the risks and benefits of newly available Covid-19 vaccines

A Federal Food and Drug Administration (FDA) Advisory Panel has recommended an Emergency Use Authorization (EUA) for the Pfizer Covid-19 vaccine. Final approval by the FDA could come within days. [See “F.D.A. Advisory Panel Gives Green Light to Pfizer Vaccine” by Katie Thomas, Noah Welland, and Sharon LaFraniere, New York Times, 12/10/10]: 

“The initial shipment of 6.4 million doses will leave warehouses within 24 hours of being cleared by the F.D.A., according to federal officials. About half of those doses will be sent across the country, and the other half will be reserved for the initial recipients to receive their second dose about three weeks later. “

The Michigan Department of Health and Human Services (MDHHS) has a Website for “COVID-19 Vaccine Provider Guidance and Educational Resources” with the following statement:

“This webpage will house materials to support COVID-19 Vaccine Providers in successful implementation of the COVID-19 Vaccination Program. Be sure to ‘bookmark’ this page and check back frequently for updates!”

This document, “COVID-19 Vaccine Information for Providers,” gives details for how the vaccine program will be administered including billing codes and other requirements that may not be of general interest, but it does have some relevant information for people needing a vaccine.

According to the MDHHS vaccine provider document, 

“The EUA [Emergency Use Authorization] authority allows the U.S. Food and Drug Administration (FDA) to authorize either (a) the use of an unapproved medical product (e.g., drug, vaccine, or diagnostic device) or (b) the unapproved use of an approved medical product during an emergency based on certain criteria. The EUA will outline how the COVID-19 vaccine should be used and any conditions that must be met as requirements of authorized use. FDA will coordinate with CDC [Centers for Disease Control and Prevention] to confirm these ‘conditions of authorization.’ Additional information on EUAs, including guidance and frequently asked questions, is located on the FDA website.”

There is more information on the CDC Communications Website: 

“Looking for information on ensuring safety of COVID-19 vaccine, how CDC is making recommendations, FAQs and more? Visit CDC’s new website featuring information on COVID-19 vaccine..."

PRIORITY GROUPS for Vaccination from the MDHHS Website

The phases distributing the vaccine are outlined below, according to the CDC Playbook and most recent ACIP meeting (11/23/2020).

PHASE 1: Potentially limited supply of COVID-19 vaccine doses available - Concentrate efforts on reaching the initial populations of focus for COVID-19 vaccination. The interim subsets for phase 1 are as follows: 

Phase 1-A:

• Healthcare personnel: Paid and unpaid persons serving in healthcare settings who have the potential for direct or indirect exposure to patients or infectious materials…
• Long-Term Care Facility Residents: Residents of skilled nursing facilities and/or assisted living facilities, homes for the aged, adult foster care, etc

Phase 1-B: 

Essential Workers: People who play a key role in keeping essential functions of society running and cannot socially distance in the workplace (e.g., Education Sector, Food & Agriculture, Utilities, Police, Firefighters, Corrections Officers, Transportation)…

Phase 1-C:

High-Risk Adults: Adults with high-risk medical conditions who possess risk factors for severe COVID-19 illness

Adults 65 years of age or older

PHASE 2: Large number of vaccine doses available: Focus on ensuring access to vaccine for all critical populations who were not vaccinated in Phase 1, as well as for the general population; expand provider network.

PHASE 3: Sufficient supply of vaccine doses for entire population (surplus of doses): Focus on ensuring equitable vaccination access across the entire population. Monitor vaccine uptake and coverage; reassess strategy to increase uptake in populations or communities with low coverage.

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There is also information in the MDHHS document referring to the Moderna vaccine that may be available soon. Keep in mind that different versions of a vaccine will be available and there may be different recommendations for who should take these vaccines and varying side effects.

We are looking at over 3,000 deaths per day nationally from Covid-19 and a persistent resistance by a significant minority of the population to even acknowledge that the virus exists. I have friends who have had the virus and have survived, but say it is one of the worst experiences they have had. They continue to have lingering effects. I also know others who are critically ill during this current surge of cases. My husband’s second cousin recently died of the disease. Most cases of Covid are asymptomatic or relatively mild. That, along with how contagious the disease is and the fact that it can be transmitted before an infected person even knows they have it, make it especially difficult to contain its spread.

A vaccine is crucial to achieving control over the virus, but there is no federal mandate for anyone to take it. Private businesses, schools, hospitals, etc., may eventually require vaccination for employment or participation, but it is highly unlikely that this will happen with vaccines approved under an emergency authorization. [See "Yes, some Americans may be required to get a COVID-19 vaccine but not by the federal government" by Grace Hauck, USA Today, 12/06/20]

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See also:

"Are there side effects to a COVID-19 vaccine? What are the 'ingredients'? The cost? Answers to your vaccine questions" by Adrianna Rodriguez and Grace Hauck, USA TODAY,12/02/20

"Side effects from the COVID-19 vaccine means 'your body responded the way it's supposed to,' experts say" by Adrianna Rodriguez, USA TODAY, 12/07/20

"Pfizer and Moderna use mRNA in their COVID-19 vaccines. This never-before-used technology could transform how science fights diseases." by Karen Weintraub,USA TODAY, 11/23/20

"Britain warns against Pfizer vaccine for people with history of ‘significant’ allergic reactions" by William Booth and Erin Cunningham, The Washington Post, 12/09/20