The 71-year-old raised his arms above his head in triumph after receiving a shot of the COVID-19 vaccine at the downtown Cashman Center on Tuesday morning.
“Yay!” yelled the man who gave only his first name, Mike.
On Monday, which started at 3:30 a.m., he had searched the Southern Nevada Health District’s online appointment portal every hour for available appointments, to no avail.
“And so I just got here and they didn’t even look for appointments,” he said.
Others shared similar stories about being vaccinated on Tuesday without an appointment after receiving a tip from a friend or relative. Many said they were not asked to provide identification to check their age or occupation. And some did not meet the current requirements of who is eligible to receive the vaccine.
According to state and county guidelines, health care workers and long-term care workers and residents were the top priority groups for receiving the vaccine, followed by those aged 70 and over. On Friday, without announcing the change, the health district updated its appointment portal so that the next priority group, known as “front-line community support,” can make appointments.
This broad workforce includes elected officials and their staff, childcare workers, and the rest of public health workers. Different vaccination agreements are made for teachers who also fall into this group.
Meanwhile, elderly residents eligible for the vaccine have complained in Force that while they are eligible for the vaccine, they were able to get appointments not just from Cashman but at a vaccination site.
Don’t solve the problem
Medical ethicist Arthur Caplan said it was a mistake not to get the vaccine to those who need it most first.
“The whole point of current vaccination policies, from the Trump administration to the Biden administration, is to provide vaccines to those most at risk of disease or death,” wrote Caplan, professor of bioethics at the Grossman School of Medicine New York University a 2017 book on vaccine ethics and policy. “Every government, every county, every state has an obligation … to try to do this because it is ethical.”
But there aren’t enough vaccines yet to vaccinate everyone over 70, and there are logistical problems reaching an older population, too, said Caplan, who criticizes the use of online appointment portals for a group that is generally less technical is – get it. But instead of solving the problem, officials are giving the vaccine to other groups.
He criticized the hardest that no identification was required at a vaccination site.
“How do we ration life-saving vaccines without asking for ID? That is incomprehensible, ”he said. In doing so, you really gave up following the high risk guidelines. If you don’t ask for ID, you’re just saying … “I can’t find out, so I don’t want to know.”
A representative from the Clark County government, which manages the site, said the majority of people served at Cashman had an appointment and that those who arrive without one could be turned away.
“We are further adapting our processes at the Cashman Center location to make them as efficient as possible based on the available daily vaccine supply,” said spokeswoman Stacey Welling in an email. “Appointments are required, and those who arrive on site should be willing to show ID and verify employment.”
When asked about guidelines for walk-ins at Cashman on Monday, Health District spokeswoman Jennifer Sizemore said that appointments are required to get the vaccine. On Tuesday, she said the district does not maintain the website and moved the comment to Clark County. Appointments and ID are required at health district locations, she said.
Are practices different from politics?
There was example after example Tuesday of practices that deviate from the guidelines stated at Cashman.
A 65-year-old retired man who was vaccinated without an appointment said he was previously unaware that he did not meet the current age criteria of 70 and over.
“The criteria are changing across the country,” said the Henderson man, who only called his first name Bob.
Bob, who said he had health issues that put him at higher risk for COVID-19, said a construction supervisor made an exception in his case.
A couple who identified themselves as Tim and Connie were given the vaccine without an appointment, and Tim is only 69 years old. Adding to the confusion was a sign on the website that people aged 65 and over are eligible, she and other respondents said.
A middle-aged man and woman, both of whom work in assisted care facilities, said they received the vaccine without an appointment and without ID. Under the priority system, employees in long-term care facilities are currently eligible for the vaccine.
A 25-year-old man, the youngest person spotted leaving the vaccination site, said he was a public health volunteer, a group eligible for the vaccine. However, he said he did not need to show any ID confirming his status.
Of the 15 people interviewed Tuesday, the only ones who gave a reporter their full name were those over 70 who had appointments.
Neat, efficient process
Respondents said the on-site process was orderly and efficient, and some defended the lack of strict enforcement of appointment and identification requirements. They said they got through the line in an hour and that the requirement of identification slowed the process down.
“You can do it,” said Mike. “Don’t criticize her for it.”
But while the ultimate goal may be getting the vaccine into as many arms as possible, there are other considerations, said a UNLV medical ethicist.
“In the long run I would say we want to encourage vaccine uptake and vaccinate as many people as possible,” said Johan Bester, assistant professor and director of bioethics at the UNLV School of Medicine.
“In the early stages, it’s important that we prioritize those who need to be prioritized, those who are vulnerable, those who are on the front lines. And so we have to find that balance.
“If it is indeed the case that those who need to be prioritized are being pushed out, then we need to think again,” he continued. “But I do agree with some kind of slow but deliberate relaxation of pre-vaccination restrictions and barriers, as long as this is communicated well and deliberately.”
Caplan said the fault did not lie with those vaccinated outside of the stated rules as they were only using the existing system. Instead, he blamed those responsible.
“If you’re going to say, ‘We can’t handle the age or status of health workers’ … admit it. Don’t just sneak around and say, “If you’re smart enough and lucky enough to find out, come down. And we’ll make it easy for ourselves too because we won’t worry about who you are. ‘I mean, this just gives up. “
Bester said a lack of transparency creates a credibility problem.
“I think transparency and honesty are important public health values,” he said. “And we damage credibility when we do one thing and say another. So I need to be clear that … I am not aware that this is the case.
“But when it happens that people can get on without appointments and the official line is that they are appointments, it undermines the credibility of your public health messages,” he said.
Contact Mary Hynes at [email protected] or 702-383-0336. Follow @ MaryHynes1 on Twitter.