Type 2s before Type 1s

I’m watching the evening news and see the next group of people eligible to be vaccinated for Covid includes people with Type 2 diabetes. Why would they not extend Type 1s the same eligibility?

Your asking about this as though everyone, everywhere uses the same rules. That’s not my understanding of how this works.

What’s your understanding of how it works?

In the United States every state decides which of the CDC’s recommendations to adopt and how to adopt them.

In particular, each state decides if/how it wants to prioritize diabetics by the type of diabetes a person is diagnosed with. If you live in the United States and want to know what vaccination group you are part of, you need to look up the rules your state uses.

I have no idea what Canada, the UK, Australia, et alia are doing to decide in what order people get vaccinated.

Okay, well why would any place specifically prioritize Type 2s over Type 1s?

Ok … I am not saying this is a good reason, just how it can arise …

Early publications, especially “preprints”, hypothesised that those with “diabetes” would be more vulnerable.

A few published reports on early experiences of patients with COVID-19 referred to patients with “diabetes” but did not, or barely, differentiated the type.

Early reports, published in journals (including “predatory” journals) and to FDA referred to a very few patients with diabetes but hardly described their pathology or their co-morbidities.

Come time to prioritise vaccine rollouts … “well, there are far more type 2s, and it is assumed many of them are obese (which correlates with more health problems), have hypertension or CVD, so let’s go with the easy numerical justification for prioritising them, since we simply just do not know”.

Also, in my country, there’s a particular group of Type 2s that have been given very high priority. This is on the statistical basis of their higher death rate overall and it would be political suicide not to prioritise them. I agree with the prioritisation on the statistical basis (and the absolute numbers are small, anyway), but it is going to be very hard to implement in practice with the vaccines that need very low temperature storage.

Mindful that government-driven prioritisation needs to be based on the practicalities of how to identify, schedule, contact and track groups in the context of huge logistics of rolling out different vaccines with their different dosing schedules, what would be the ideal basis for prioritisation?

It would be pure statistics on the severe complications and mortality.
This you would not know until after the severe illnesses and deaths, which is what the vaccines are designed to minimise.
(PS, though, the datasets on earlier pandemics of coronaviruses provide some basis for framing prioritsing categories for SARS-COV-2 vaccines.)

Mindful that the following is not medical advice, and is grossly generalised from a non-expert, I suggest that an ideal screening criteria would be a measure on an inflammation index.
That is, a type 2 with a high measure on a reliable index of inflammation ought to be prioritised over a type 1 with little or no measurable inflammation (absent other serious ailments).

In my hypothetical world in the future, there would be simple, reliable testing for a generalised index measure of inflammation. This would be tracked for general medical check-ups and for patients with conditions. it would be the trigger also for all flu vaccine rollouts.

Use this link and enter your state.

My state just added those over 65.

Enter your state, then click on the word website, which is link to your state.

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There are way more T2Ds than T1Ds so they’re going to show up in any statistical report.

I still think that T1D is risky in the face of Covid, particularly with many Covid T1Ds presenting with diabetic keto acidosis or DKA. I think this is just another inequity with vaccination priorities.

My advice is to just pay attention, persist, and try to keep a positive attitude. We need to be thankful that there are now several viable vaccines. Things will start to return to normal this year.

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Also, some localities are expanding the grouping differently than the states. Also, hospitals are expanding on what it deems best. You might have to check all possibilities to see what group you may fall into to get vaccinated as soon as possible.

FYI, current info on who qualifies as having a high-risk medical condition in the U.S. The variation among the states is off the map! (Pun intended)

Why all this speculation??? Why not go straight to what the CDC says, which is actually trying to save people with autoimmune diseases like Type 1 & LADA? FROM THEIR WEBSITE: Vaccine Considerations for People with Underlying Medical Conditions | CDC

People who have weakened immune systems

People with HIV and those with weakened immune systems due to other illnesses or medication might be at increased risk for severe COVID-19. They may receive a COVID-19 vaccine. However, they should be aware of the limited safety data:

  • Information about the safety of mRNA COVID-19 vaccines for people who have weakened immune systems in this group is not yet available.
  • People living with HIV were included in clinical trials, though safety data specific to this group are not yet available at this time.

People with weakened immune systems should also be aware of the potential for reduced immune responses to the vaccine, as well as the need to continue following all [current guidance].

People who have autoimmune conditions

People with autoimmune conditions may receive an mRNA COVID-19 vaccine. However, they should be aware that no data are currently available on the safety of mRNA COVID-19 vaccines for them. Individuals from this group were eligible for enrollment in clinical trials.

T2D is not an autoimmune disease - that’s why. T1Ds getting this vaccine are an experiment unto themselves bc the CDC nor the drug companies have enough data on how it’s going to affect us. See my post.

It may be suicide, political and otherwise, to prioritize anyone with an autoimmune disease if one is to believe the cautions listed by the CDC (see my post below). T1Ds and anyone with autoimmune disease (I have T1D & Hashimoto’s) who get this vaccine at this point in the game where there isn’t sufficient data on the effects for us, are playing Russian roulette with their health and possibly lives.

just guessing type 2 might have a longer life span than us type 1 why waste it on people like us?

In Utah, it’s diabetics with an A1c of over 9. Our health care people have really been on the governor to keep more people from being hospitalized, as the hospitals are getting close to full. Also people with other health care needs are avoiding the hospitals.

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I saw the same. I just can’t believe it, either. In Massachusetts, type 2s are on the list to get vaccinated right now, but not type 1s!!

Same in Pennsylvania.