Are you confused? You have lots of company. Here’s what is going on:
All people over 75 years are now vaccine eligible
Effective last Monday, the state authorized anyone over 75 years of age to receive a Covid-19 vaccine as the start of “Phase 2.” No other new groups (whether over 65, comorbid illness, or other) are yet eligible in Phase 2.
Available vaccines unchanged
Only Pfizer and Moderna vaccines are available right now. They are both highly efficacious with about the same side effect profile, including common local reactions (redness, tenderness at injection site) and also a strong minority who feel really badly (fatigue, muscle aches and joint pains, etc.) for 1-2 days. Two shots are required, 3 weeks apart for Pfizer and 4 weeks for Moderna. Second shot reactions may be slightly worse.
How do elders >75 get the vaccine?
Grandparents now have three options. Do it yourself by website, or wait for the Covid Fairy to call you, or the latest choice just announced Friday, call the Covid Fairy yourself. Our practice is not yet an option.
1. Make your own appointment by website
Anyone over 75 can try to get a vaccination appointment through state authorized websites that link to the many many vaccination centers that have been set up around the state. These include downtown at Fenway, at Gillette stadium and other cozy places. The state website is COVID-19 Vaccine | Mass.gov. The website is widely acknowledged to be exceedingly difficult and frustrating to use. Tears and curses are regularly reported. The poor website design is compounded by the short supply of vaccine and hence of appointments, regardless of location.
A dramatically better website to try is https://www.macovidvaccines.com/ which many members have recommended. Here they only show vaccination venues that actually have appointments available!
Should you use https://www.macovidvaccines.com/ to snag an appointment in Pittsfield or other distant location, please be aware you will need to return there for your second shot. That is standard practice at all sites. Consider this in your decision, although I might agree that a jaunt to the Berkshires could be a pleasant diversion.
2. Wait for the Covid Fairy to call or email
A good number of our members have received calls or emails this week inviting them to make an appointment for a Covid vaccination at either a Mass General Brigham (formerly Partners Healthcare) or BILH (Beth Israel Lahey Healthcare) facility. Additional organizations calling now include pharmacy chains CVS and Walgreens. There may be others.
Essentially, the state has now supplied vaccine to larger health care organizations that have databases of people over 75 and charged them to reach out (email, phones by Covid Fairy) to those people and offer vaccination appointments. Medical practices, who normally provide most people their vaccines, are still largely excluded.
This process appears to be starting well and perhaps picking up speed. We can all be grateful. The reach-outs are being done randomly by all the organizations. Everyone of you will be on at least one organization’s database. If you get a call soon, you are lucky. Answer it. Unless they want your credit card, they are legit. Take the appointment and go.
3. Call the Covid Fairy at 211 (a new state hotline)
Governor Baker announced Friday that anyone 75+ can call 211 for assistance booking a Covid-19 vaccine appointment weekdays from 8 a.m. to 5 p.m. He said 500 representatives will be available to make appointments using the same access at the state’s website mass.gov/covid-19-vaccine. This should be good news. Let us know if it really works.
All adult >75 shots should be underway this month
With the options now available (websites, you are called, you call), all people 75 and over should be able to get at least their first vaccination in February. The state should have enough vaccine in inventory and arriving to do so. (I plan to review the arithmetic in another post.) Similarly, over-75 vaccination should be done by the end of March.
So no elder needs to panic. Please keep yourselves safe, listen to the phone or call 211 yourself, or try the https://www.macovidvaccines.com/.
Keep us at OHC informed
Please let us know by email to firstname.lastname@example.org or email@example.com or phone to our office when you are scheduled for your shots or, more importantly, when you have gotten your first one and which vaccine it was.
If we are getting late into February and you are still having difficulty getting scheduled, let us know.
Finally, if we are unexpectedly given an allocation of vaccine this month, we will let everyone know the same day.
What about everyone else? Group 2?
The next group to be eligible for vaccination will be everyone over 65 and younger people who have at least two of a short list of specific complicating medical conditions that are thought to raise the risk of bad outcomes from Covid-19.
This is a much larger group. I think it unlikely that appointments will open up for this group before the end of March when the over 75 group should be completed. How quickly this group can be immunized will be heavily dependent on whether additional vaccine stocks become available to allow a high daily rate of immunizations. Think Johnson and Johnson, for example. But two months (April-May) for these Group 2 vaccinations seems a reasonable guess at this time, hoping for some additional vaccine.
Healthier and younger people?
The start time for younger and healthier people now seems unlikely before June, but it is really too uncertain to try to predict at this time because of the constantly evolving development and approval of new vaccines.
How are we doing now?
Lots of good news. The viral prevalence in Massachusetts is diminishing. Daily new cases in Massachusetts are now about 3,000, down from about 4,500 in December. We are making real progress. But we can’t succumb to Covid fatigue and let our guard down. Getting vaccinated is not yet a get-out-of-jail card. Remember, in the summer, daily cases were 200-300, ten times less. Indoor gatherings (like SuperBowl parties, which I hope you are not having) remain sizeable risks. Don’t.
In closing, let’s underscore some extraordinary good results
In the Phase 3 trials of all major SARS-CoV-2 vaccines to date (Pfizer, Moderna, Johnson & Johnson, Novavax, and likely still AstraZeneca), there were no reported cases of hospitalization or death in vaccinated volunteers. These trials added up to around 100,000 people. These results appear to be holding up with the variant strains, at least so far.
Regardless of the efficacy (94-95% for midlife adults for the first two, somewhat lower for the others), any Covid-19 cases that did arise were milder and treated as outpatients. I think that is extraordinary, since ICU care and death is what has from the beginning differentiated this terrible disease from what some people last year dismissively called just “a bad flu.”
While we have a long way to go to get everyone immunized, or to relax our guard on masks, social distancing and avoidance of prolonged indoor congregating, I believe we can realistically expect to be safe by sometime this fall. I find that thought truly uplifting in the dead of our winter with another heavy snow falling. I hope you do, too.
Postscript: Some extras for the data-driven
If I reprise the same risk analysis from my early January post, when I calculated the likelihood of having an unknown and asymptomatic but infectious person in group gatherings of different sizes, the February numbers are more favorable, but still not good. With daily new cases in Massachusetts now about 3,000 (resulting in a prevalence of asymptomatic infectious people of 0.0033), down from about 4,500 (prevalence 0.0050) in December, we can see a reduction in the risk in group gatherings.
Unfortunately, I think (and believe most of you would find) that risk to be unacceptable. For example, in a group of 10, the risk is 3.3% (down from 4.9%). Do you think that is safe enough? In a larger group of 20 (think house party for the SuperBowl), the risk is 6.4% down from 9.5%. That doesn’t make me feel safe. That’s breeding ground for a superspreader event.
|Group Size=N and likelihood of at least one person with Covid-19 in group who is asymptomatic but infectious
And to lay on a bit of crepe, there is literally just-breaking not-good news this evening that the AstraZeneca-Oxford vaccine appeared to fail to limit infections in South Africa with the B.1.351 variant of SARS-CoV-2 prevalent there. That is clearly troubling, although it is possible that there will be benefit shown in limiting severe cases and deaths, as has been shown for other vaccines. That variant is just showing up in the U.S. So we clearly have uncertainty and challenges yet to come. Lots to be thankful for. Lots still to be concerned about.
Postpostscript: Covid Fairy and Tooth Fairy
When some older members last week gleefully reported the unsolicited calls from hospitals or pharmacies offering them prompt appointments for Covid-19 vaccine, the unexpected external happy intervention they described struck me, perhaps idiosyncratically, as a child might respond to the divine and secretive intervention and reward of the Tooth Fairy upon loss of an incisor. I thought those agents of vaccine access mercy should not remain anonymous, even though they were. The moniker Covid Fairy immediately struck me as a way to personalize them. We all do know they are real people, of course.