When Louisiana expanded vaccine eligibility earlier this week to anyone over 16 with a long list of medical conditions, the state shifted overnight to one of the most open states in the U.S. when it comes to who can get a shot.
Nearly three in four adults in Louisiana are estimated to meet the broad category of "overweight" or "obese" that would allow them to receive a coronavirus vaccine, and potentially many more would be eligible due to other medical conditions like cancer and "smoking" under new rules released Tuesday.
Dr. Shantel Hebert-Magee, the newly appointed Region 1 medical director for the Louisiana Department of Health, estimated that along with earlier eligibility rules that allowed all people above 65 and some other groups to get a shot, "we are pretty much blanketing 80% to 90% of our population."
“A significant portion of our population has comorbidities,” she said.
The approach is more far-reaching than that of many states, which have put more red tape around eligibility by limiting the types of conditions or requiring people to be a certain age to qualify.
The push to get Louisianans vaccinated against the coronavirus aims to get people vaccinated as quickly as possible while prioritizing the eld…
For instance, Louisiana is one of just three states in the country to open to people as young as 16 with one of nearly two dozen conditions.
The state allows for conditions the Centers for Disease Control and Prevention has deemed to put people at an increased risk for severe illness, such as obesity and cancer, but also pulls from a second, broader list. That list includes conditions such as asthma, having a body-mass index over 25 or having Type 1 diabetes.
Many states pick and choose illnesses from both lists but don't include all of them. Texas, for example, includes 11 of the 12 most at-risk conditions but omits smoking. Ohio does not allow for heart conditions or cancer, but does allow people with Down syndrome and sickle cell disease to be vaccinated. Some states require two or more conditions for vaccination or limit condition qualifications to older people.
And while a handful of states allow providers to decide whether a patient should be vaccinated, many others are much more restrictive. In New York, people over 60 just became eligible this week, lowered from 65, though there is a carve-out for public-facing nonprofit and government workers.
“Louisiana is casting a wider net than a lot of states,” said Jennifer Kates, a health policy analyst and researcher at the Henry J. Kaiser Family Foundation.
At the back of a room roughly the size of two football fields, Mary Francis was sitting in a wheelchair, her daughter by her side. Ahead, a gi…
Gov. John Bel Edwards said Tuesday that the decision to expand eligibility came after a “slack” in appointments over the weekend and was made with the goal of preventing hospitalizations and deaths as more transmissible variants gain ground.
“Our primary goal in establishing priorities for vaccination would be to preserve hospital capacity and to save lives. That is why we are working with individuals with co-morbid health conditions that predispose them to a poor outcome,” he said.
Gov. John Bel Edwards speaks at a press conference updating the state's COVID-19 response, Tuesday, March 9, 2021 at the State Capitol in Baton Rouge. Edwards said Tuesday people age 16 and older with certain health conditions are now eligible to receive the coronavirus vaccine, a dramatic expansion in Louisiana's effort to overcome the pandemic. Sign language interpreter Sylvie Sullivan is in background.
The new qualifications were developed with essential workers in mind, with the thinking that the many conditions would qualify them. That is broadly true, said Kates, but it’s not true for everyone.
And some essential workers say they feel like they have been left behind.
Marjeta Wolfe is a 21-year-old restaurant greeter in Jefferson Parish and a college student, where she is exposed to large groups of people indoors. She has a vocal cord condition and has been on a daily inhaler for eight years.
“My mother and I have Googled the ingredients,” she said, trying to see if her inhaler counts as a corticosteroid. But she doesn’t make the cut.
Helen Woo, 49, is a registered dietician nutritionist who works at a food pantry in New Orleans. She doesn’t qualify under the expanded guidelines, either.
“I know people who have lied or traveled to another state to get a vaccine,” said Woo. “I don't want to do that. I'm not going to pretend I have an illness or dress up like an old lady so I can get my shot.”
When people 70 or older became eligible in Louisiana for the coronavirus vaccine in January, New Orleans resident Phil Costa started calling a…
Both Woo and Wolfe say they don't want to bend the rules or lie and are instead trying their hand at finding “leftover” vaccines, but they’re frustrated to not be included as essential workers.
“I feel like people like us who provide essential services and interact with the public should be given some kind of priority over people who are safely working from home and interacting with no one,” said Woo.
The lack of focus on essential workers is something epidemiologist Susan Hassig has watched play out all over the country.
“I would argue you should be doing workplace oriented vaccinations, that we should have mobile units that are setting up in the French Quarter where there is a high density of restaurant workers,” said Hassig. “They don't have a lot of control over how they might be exposed.”
Balancing vaccine distribution between risk of illness and risk of exposure is difficult, said Mike Springborn, a health resource economist at the University of California, Davis.
“There are trade offs all over the place,” he said, adding that in some instances the best method is to vaccinate vulnerable people directly, but under other conditions it's more important to simply reduce the spread in the broader community.
In early February 2020, doctors and scientists filed into an auditorium at LSU’s medical school in New Orleans. Sitting shoulder to shoulder, …
One problem with that is there is not good data on how well the vaccines prevent transmission. Another problem is that some people may not realize they have one of the qualifications.
Brenda Rainbolt's family urged her to mark the smoking box to qualify, since she smoked 20 years ago, but the 64-year-old felt that was a lie — plus she had to enter her insurance information and didn’t want that to affect her coverage.
“I’m not comfortable marking that block when it says smoking,” said Rainbolt, who works in a public library and lives in Shreveport with her son, a high school history teacher and football coach, and daughter-in-law, an ICU nurse on the COVID floor. “My health insurance has me as a non-smoker. And the rest don’t fit at all.”
It wasn’t until she spoke with a reporter and tapped her weight and height into a BMI calculator that she realized she had a BMI of 25.6, above the threshold.
“If an individual does not define themselves that way, or they are not diagnosed or are uncomfortable coming forward, they're not likely to put themselves in that group,” said Kates.
Being a few decimal points off of the required BMI or having an unlisted medical condition isn't something people should fret over, Hassig said.
"I would tell them to check a box and get vaccinated," said Hassig.
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