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Vaccinations for Older Adults in CA: What We Know Now

As older adults and other across the country get vaccinated, Justice in Aging continues to monitor vaccine distribution closely, especially in California. Details continue to change, and some information may differ depending on the county. Here is an update:

Who is eligible for a COVID-19 vaccine?

In January 2021, Governor Newsom announced the state was opening up COVID-19 vaccinations to those age 65 and over in addition to health care workers and residents of long-term care facilities. In March, counties started vaccinating certain industries of essential workers, and beginning on March 15, Californians aged 16-64 who are high-risk are also eligible to be vaccinated.

Can an older adult who is not yet 65 get the vaccine?

Older adults who are not yet 65 but who are high-risk are eligible for the vaccine beginning March 15, 2021. The state has defined high-risk as individuals who are diagnosed with cancer, chronic kidney disease, chronic pulmonary disease, Down syndrome, solid organ transplant, pregnancy, sickle cell disease, heart conditions, severe obesity or Type 2 diabetes mellitus. This also includes individuals who, as a result of a developmental or other severe high-risk disability, is more likely to develop severe life-threatening illness or death from COVID-19, COVID-19 would limit the individual’s ability to receive care, or that providing care for COVID-19 would be challenging as a result of the individual’s disability. As supply remains limited, eligible individuals may still need to wait for an available appointment.

What about older adults on Medi-Cal Home and Community-Based Services programs?

As part of the eligibility expansion on March 15, individuals who are 16-64 and enrolled in Medi-Cal Home and Community-Based Services (HCBS) programs are eligible to receive the vaccine. These include individuals enrolled in In-Home Supportive Services, the Medi-Cal Home and Community-Based Alternative waiver, the Medi-Cal Assisted Living Waiver, Community-Based Adult Services, Program of All-Inclusive Care for the Elderly (PACE), and others. Regional Center clients are also eligible. Individuals enrolled in these programs will receive notices from the state informing them of their eligibility. Note that individuals who are 65 years old or older and enrolled in one of these programs should have already been eligible prior to March 15.

What vaccines are approved?

As of March 15, 2021, the federal government has granted emergency use authorization of three vaccines, manufactured by Pfizer, Moderna and Johnson & Johnson to adults. Both the Pfizer and Moderna vaccines require two doses, 21 and 28 days apart respectively, while the Johnson & Johnson vaccine requires only one dose.

How much does the vaccine cost? 

These vaccines should be provided at no cost to all, regardless of insurance or immigration status. If the individual has insurance, providers administering the vaccine are allowed to bill a fee to insurance for administering the vaccine including Medicare and Medi-Cal. If the individual does not have insurance, providers can request reimbursement for administration of the vaccine through the federal government’s provider relief fund. Advocates should advise older adults to be on alert for potential scams, like paying to get a vaccine earlier.

Is the vaccine safe? 

The three vaccines currently being distributed have gone through a rigorous FDA approval process, and California, along with several other states, empaneled a group of scientists to conduct an independent review. The clinical trials included a diverse mix of races and ages, and all vaccines have shown a high efficacy rate against becoming ill with, being hospitalized or dying from COVID-19.

When can older adults get vaccinated?  

Every local health department is operating on its own timeline, and large health systems like Kaiser may have their own timeline too. Advocates should check with their health system or local health department on the status of the vaccine rollout in their county or system and for instructions on how to obtain the vaccine. 

In addition to checking with the local health departments and individual health care systems, California has a system to let people know if they are eligible to receive a vaccine, and if not yet eligible, to register for a notification via email or text when they are eligible. That system is called MyTurn. It is currently available in English, Spanish, Chinese, Korean, Arabic, Tagalog, and Vietnamese. People who prefer to sign up over the telephone or are seeking more information about COVID-19, including vaccinations, can also call the state’s COVID-19 hotline at 1-833-422-4255.

Where can older adults get vaccinated?

Similar to the annual flu shot, most older Californians who live in the community will be vaccinated at health providers like hospitals, clinics, doctor’s offices, or pharmacies. Counties are also ramping temporary mass community vaccination sites. For residents of long-term care facilities, facilities had the option to sign up with a federal partnership program with CVS and Walgreens to administer the vaccine at facilities through on-site vaccination clinics or coordinate with their local health department. 

How can an older adult get to a vaccination site?  

For older adults who do not have the ability to get to a vaccination site, their health insurance plan may offer transportation to and from the site, including pharmacies. Individuals should check with their Medicare Advantage or Medi-Cal plans for specific details on what type of transportation is offered and how to make an appointment. 

Why do some older adults have to wait a long time to get the vaccine?  

Although the state has recognized that many older adults, especially older adults of color and in disadvantaged communities, are at greater risk of COVID-19 infection and death and prioritized them in vaccine distribution, right now demand far outweighs supply. California is still receiving a relatively low number of vaccines every week. Older adults may have to wait several weeks or longer to get an appointment for the vaccine. 

What are some of an older adult’s rights during the vaccine process? 

All civil rights laws, including those specific to healthcare and entities receiving federal and state funding, apply. For example, older adults with limited English proficiency should be given meaningful access to language assistance services when getting a vaccine, including interpretation services and translated materials when appropriate. In addition, vaccination sites should comply with federal and state accessibility requirements, and no older adult should be denied a vaccine because of assumptions of their life expectancy or quality of life. Finally, California law strictly limits what personal information can be shared, and only de-identified information will be shared with federal authorities. 

If you want more information about COVID-19 vaccinations in California, please visit California’s Vaccinate All 58 website. Information and materials will be updated on an ongoing basis.

Justice in Aging serves on California’s Community Vaccine Advisory Committee, a group tasked with providing input and feedback to the vaccine planning efforts and resolving barriers to equitable vaccine implementation and decision making. We will continue to work with the state to champion a vaccine allocation plan that centers on equity by focusing on those older adults most at risk of COVID-19 and ensure the state implements innovative outreach and education efforts to reach all older Californians.

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