I’m hearing through the grapevine that the people who work in billing are remote.
But, the hospital wants everybody who worked physically onsite prior to covid lockdowns vaccinated. A friend of mine in billing will be vaccinated next week.
I suspect that this is because they want those guys back in the office, so they are bumping them to the front of the line.
Secondary to the ethical questions this raises (in that they are not in compliance with federal agreements on vaccine delivery protocols), we wonder this:
Should there be any concern in early vaccination if CDC hasn’t yet been released recommendations for high risk chronic illness grounds? One of the guys is HIV+ (early diagnosis in the 80s). But, CDC has not formally released recommendations for this group. They seem to suggest some risk and that people should be warned about risks associated with vacc.
I think HIV is much like T1 in that they don’t feel they have a large enough data sample to pass judgement on if we are “high risk” or not. Those guys are worried a bit about vaccine safety due to lack of testing on that subgroup. Does that apply to us, too?
I think we are so accustomed here to discussing diabetes and associated health concerns in so many different varying shades of grey (treatment, insulin type, insulin delivery device , bg tech, “severity”, diet, lo-carb vs militant lo-carb, how we were diagnosed, how we were misdiagnosed, etc.) day in and day out.
Then vaccination priorities are announced. And every fine distinction we make about our own disease, seems to be swept under the rug along with all the fine distinctions about hundreds of other chronic conditions.
There is a lot of interpretation left to - who knows? local health officials? - about the fine details of vaccination priority groups. I’m T1, I’m over 50, I’m an essential worker (I even have a letter in the glovebox since March, from the police chief, saying I’m a “critical infrastructure worker” and I’m allowed to drive whenever I want), but I’d be surprised if I get vaccinated before June.
I think that there are good and bad things about waiting.
That’s kinda what I’m trying to sort out.
I can’t really see the forest thru the trees anymore, so I wanna be cautious.
They are specifically waiting to vacc HIV because they a concerned that the vacc could hurt them in some way. They state it very explicitly.
Medical risks are sooo dependent of the individual. Everybody is different.
Vaccine priorities are still very much in flux among illness groups.
We do NOT know that T1’s will have any priority. T2’s will.
QUESTIONS
1.) Are they unprepared to vacc T1’s because they think we are more medically vulnerable? We are in the same vacc boat as HIV - both are in the category of not having a large enough data sample to proceed with early vacc. They have issued strong warnings about HIV & vacc, but not for us. That leads me to believe that for some individuals, they perceive risk.
2.) I assume that there is a reason that these vacc protocols have been established.
The agreements between the State and the Feds are to follow the CDC guidelines for delivery. They are currently supposed to be doing healthcare providers, not EVERY hospital employee that is working remote. That appears to me to be a violation of medical ethics. If we can’t trust the hospital to follow some standard of medical ethics in this very serious situation where everyone is watching, WTF?!?!? Why should we anticipate that anyone will follow protocol?
Does the non-adherence to protocol put people at undue risk? The hospital wants people back in the office. That’s their only justification for doing this. Are they putting my friend at risk by pushing him to the front of the line for vacc before CDC has issued hard and fast guidelines? It feels safer to vacc with your illness group, once risks are better established.
If the protocols are already slipping…maybe Tim12 is right to assume that no protocols for vaccine delivery will be adhered to and he might as well assume no priority for illness groups.
At the most most macro public health level, it doesn’t matter a lot which group you vaccinate first. You won’t stop the virus until 80-90% of everyone is vaccinated.
Figuring out the best order to vaccinate does have some possibility to vaccinate the highest risk/highest danger/smallest communities first. There are some opportunities to vaccinate in an order that decreases total deaths. But for the most part it’s like rearranging the deck chairs on the titanic.
RPhil seems to have a well thought out plan regarding methods of mitigating risk to himself surrounding vaccination. He is adjusting treatment plans with his Doc. I don’t see that being true for most people. People are asking me what the diabetics are doing in some effort to think through this. I have to tell them that there is no plan for T1 either. Everything feels very ‘up in the air’. We only have 2 months left…technically, by the current guidelines.
Most of the discussions, about like the fine points you and RPhil are having, are at the very much micro-individual-detail level.
At the macro level, delaying your own vaccination for whatever angels-dancing-on-a-head-of-a-pin that may be real or you might be imagining, it only slows us down in stopping the spread of the virus.
If say 20% of the population is worried about some chronic health condition they have and the lack of testing of that particular vaccine against that particular condition or treatment, and doesn’t get vaccinated, then we may never reach the 90% vaccination level needed for stopping spread of the virus at the macro-public-health level.
I don’t think that we are ever reaching this. Or, at least it will take a VERY long time.
You gotta remember that its in animal populations too. Foreign countries are expecting to take 4 years to complete vaccination.
I think that events like this (the MN State Fair) will be risky for a very long time to come.
I’ve always liked painting crowds of people because I think that the behavior of people in a collective is interesting. This is a painting of that event. People always says it creeps them out. I think those paintings take on a different light, now. Crowds are gonna be creepier and represent a different type of risk than they ever have before. Its interesting.
I am forming my plans on what has not been said. No one has said that Type 2s should not get the vaccination but rather the Tennessee state vaccination plan says that type 2 is a comorbidity and should be given high priority, same with many other comorbidities like kidney disease, heart/arterial disease, lung disease, sickle cell disease and obesity, this is not a complete list. On this plan Type 1 is on the next priority level, making a difference in timing of about a month.
Tennessee’s plan is based on CDC guidelines. I have to believe that the safety of the vaccines for diabetic populations has been considered, why else would we be on the priority lists.
@Rphil2’s approach is very prudent, individual circumstances do trump every other consideration.
One other possibility is that with the surge-on-surge, hospital workers (for example in billing) might be “called to duty” for the surge, and thus should be vaccinated. This is happening with my spouse, who is in hospital administration but may need to deliver food/perform other tasks.
Just a point, each individual state is free to allow the vaccination plan they choose to proceed. So for instance FL opened vaccination to all people over 65 even before it has been offered to all health care workers. The rational is that over 30% of the population is over 65.
So where we live may be more important than who we are when getting the vaccine.
T2’s made the grade, Gary. They are all systems go for moving ahead with priority vaccination, according to CDC. I think that because there are fewer T1’s, CDC has inadequate data to say, for sure, that they are high priority.
Are you saying TN has a concrete plan to vacc T1’s? That’s the first I’ve heard of that.
Unless something has popped up since I last looked…TN is prioritizing differently than the Feds.
Ahhh, ok. That makes sense. I was wondering about that and felt a little apprehensive…as if they might be readying for some bad, bad things to come. Concerning thought. I don’t think they know for sure how this is going to go down.
So, your saying States DO have flexibility? That’s how I thought it was going to work, at first - to account for some of those geographic differences. But, then I heard one of the guys from the Feds say there were strict agreements that in order to receive shipments, states had to adhere to cdc guidelines. So, then I thought the Feds were the ultimate dictators of vaccination rules and I quit even looking at State plans.
You know, the thought occurs to me that whoever has the vaccine is in charge of the rules, previous agreements be damned.
Britain had agreements with India about how to distribute the Oxford vaccine once they released it to India for production. India initially agreed, and then India was like, “F that. We will release you your vaccine in 2 months, once some of us are vaccinated.” (maybe they will, maybe they wont).
The Feds said they wanted the States to adhere to certain rules.
Some States did. Some States didn’t.
The States told the Hospitals that they wanted that stuff administered in a certain way.
Some hospitals adhered to those agreements, some didn’t.
It seems that Yee who haveth the vaccine maketh the rules.
Previous schedules & priorities be damned.
Regardless of any agreements, states definitely have the authority to set priorities. I understood that the CDC guidelines were in fact just that, guidelines. The states retain the ability to set their own priorities. The lines in FL certainly show that.
There’s a group including public health professionals and doctors who are working to get the CDC to change the at-risk guidelines to include Type 1 because it is just as much a risk as type 2 for complications, hospitalizations, and mortality in several observational studies that have recently been released. I got hooked in with the group and hope to do some PR advocacy on the equal risks for both types!
Each state health department is making its own guidelines, hopefully with guidance from the CDC guidelines. Some are not rolling it out exactly as the CDC suggested though. Oklahoma and Florida opened the schedule up to 65 plus and people with chronic conditions. Some states are doing prison populations before essential workers. Some states have type 1 but not type 2 prioritized and some are opposite. It’s a HOT mess.
Idaho has me a 70 yr old type 1 diabetic with heart disease and high blood pressure plus two other serious diseases not getting the vaccination until April along with healthy 65 and older seniors and younger people with comorbidities. I have emailed the governor, but doubt that I will get a response. Everything is a mess at this point.
