Like nearly everyone concerned about catching the novel coronavirus, Dr. Kelly Avila wonders when her turn will come to be vaccinated for COVID-19. As a veterinarian in private practice, Avila has found that the answer is not at all clear, and rumors are rampant.
Governments are in general agreement that veterinarians are essential workers. But while they're health care professionals, veterinarians are far from the front lines of COVID-19 patient care. Consequently, their wait for the vaccine varies greatly. In some U.S. states, they're with the top-priority group. In at least one state, they're categorized with the general public. And in most states, they've yet to receive direction one way or another.
On Dec. 14, an intensive care nurse in New York City was the first person in the country to receive a coronavirus vaccination. In the month since, 10.8 million doses have been given in the U.S., and at least 762,601 people have completed the two-dose regimen, according to tracking by Bloomberg.
Recommendations by the U.S. Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices put health care personnel and long-term care facility residents first in line for vaccinations, followed by people age 75 years and older, and non-health-care front-line essential workers. Next come people age 65 to 74 years, people age 16 to 64 with high-risk medical conditions, and essential workers not previously vaccinated.
It's up to states to determine exactly how vaccines are rolled out in their jurisdictions, and many have delegated some decision-making to counties.
Avila, a mobile veterinarian in Texas with a rehabilitation and acupuncture practice, said she checked the CDC and her state's Department of Health and Human Services websites for guidance on her occupation. Still unsure where she stood, she kept a watchful eye on a listserv for Texas veterinarians.
Two weeks or so ago, Avila told the VIN News Service, someone posted that local health departments with excess vaccine might soon call individual veterinarians with an invitation to be vaccinated. Shortly after, she reported, someone else posted, "They called me and I went right in."
Other veterinarians posted that they'd called the pharmacy of a supermarket chain handling vaccinations in Texas, and were told words to the effect of, "Come, and if there are any doses left over, you can have [one]."
Each vial of either of the two COVID-19 vaccines currently in use — made by Pfizer-BioNTech and Moderna — contains multiple doses. With either product, once a vial is punctured, the contents must be used within six hours.
Still, Avila was unsettled by what sounded like a bit of a free-for-all. Her confusion was compounded by a story from a client who works as an accountant. The client told Avila that her orthopedic surgeon is administering vaccinations and offered to vaccinate her.
As Avila understood it, "He was being nice; he just had extra. So he's going to be doing his whole staff, himself and then, I guess, select people that he chooses," she said, calling the apparent favoritism "ugly."
That the COVID-19 vaccine rollout is happening in a less-than-systematic fashion is well-documented. In the past week, for example, The New York Times reported that wealthy people are trying to get the vaccine first; and that at elite medical centers, workers who don't qualify as front-line staff were being vaccinated, too.
But highlighting the importance of flexibility, The Times also reported that the governor of New York loosened the rules after unused vaccines were thrown away.
Many veterinary advocacy groups are pressing to have veterinarians and support staff prioritized for vaccination. The American Veterinary Medical Association maintains that:
- Veterinary teams contribute directly to supporting the food and agriculture industries and also help ensure the health of household pets, which support their owners' physical and mental well-being.
- Veterinary teams are at risk of exposure to members of the public while providing care to patients.
- Veterinary professionals protect public and animal health through surveillance for SARS-CoV-2 in animals and surveillance of other zoonotic diseases.
Many state veterinary medical associations are urging their state governments to include veterinary teams among the earliest vaccine recipients. Some have been successful.
In California, the state Community Vaccine Advisory Committee amended its "essential workforce" listing last week to include "workers supporting veterinary hospitals and clinics," according to Dan Baxter, executive director of the California Veterinary Medical Association. As a result, he told VIN News by email, "[W]e now believe veterinarians will be included in Phase 1a."
Similarly, in Oregon, veterinary workers are in phase 1a with other health care professionals. Those in phase 1a are further subdivided into priority categories; workers providing veterinary care are in group 4, according to a letter sent to licensees last week by Dr. Emilio DeBess, state public health veterinarian.
"Groups 1-4 are considered eligible for vaccine at this time," he wrote. "The speed of vaccinating people will depend on vaccine availability and the assistance of health care systems to provide vaccines and care for those with adverse reactions. Logistics behind how this will be communicated and implemented are in the works."
Deborah Lakamp, executive director of the Illinois Veterinary Medical Association, said veterinarians there have been categorized as "agricultural essential workers" and placed in tier 1b, which comprises 1.3 million people.
In South Carolina, veterinarians and their team members are assigned to phase 1c, according to Marie Queen at the South Carolina Association of Veterinarians. Queen said the state is still vaccinating those in phase 1a.
New Mexico is another state where veterinary workers are in phase 1c, according Tamara Spooner, executive director of the New Mexico Veterinary Medical Association.
At the other end of the range is Massachusetts, where veterinarians are not prioritized to receive the vaccine. "Currently the placement of veterinarians in the state's COVID vaccination distribution plan is in Phase 3," according to the state VMA website. "We understand that many are frustrated and disappointed." Phase 3 is when the vaccine is available to the general public.
Jamie Falzone, executive director of the MVMA, said the organization is not resigned to that position. "We're continuing to push for reconsideration so that veterinarians can receive the vaccine before the current projection of April 2021," she said by email.
Veterinary teams are pushing in other ways, too. An online petition is underway to ask the governor and Massachusetts Vaccine Advisory Group to include veterinarians and their support staff in phase 2.
More commonly — judging from information collected by VIN News within the past week — state veterinary organizations are awaiting clarification from officials on exactly where veterinarians and/or their support staffs stand.
"I wish I had more of a handle on it," said Chris Copeland, executive director of the Texas Veterinary Medical Association. "We've been working for weeks trying to get more information."
Copeland said the organization tried to make a case for including veterinarians in phase 1b, but the 1b group ended up being defined not by potential occupational exposure but by individual medical risk. It encompasses people 65 and older, and people 16 and older with a chronic medical condition. Now state officials are deciding who will be in phase 1c.
Like Avila, the mobile veterinarian in Texas, Copeland said he's heard anecdotes about individuals not in the prioritized groups managing to get vaccinated at local pharmacies. "We've told our members to keep an eye on what's happening at the local level [because] there may be opportunities that arise," he said.
"I would much rather see people that aren't necessarily on the current list get vaccinated, as opposed to the vaccine be thrown away because it's spoiled," Copeland reasoned.
In Kentucky, vaccine rollout is handled county-by-county, according to Debra Hamelback, executive director of the Kentucky Veterinary Medical Association. The group received confirmation from the state public health veterinarian that veterinarians are in phase 1b, but officials in at least two counties initially questioned that, she said. "It's just [requiring] a little bit of back and forth" to straighten things out, Hamelback said.
She noted that some localities have completed 1a vaccinations and are starting to contact individual veterinary practices to invite them to receive the shots. "I know of four different veterinary clinics throughout the state that have actually gotten calls from the health department," Hamelback said.
Heather Vaughn has two states to figure out — she's executive director of both the Alabama and Tennessee veterinary medical associations.
Until this week, the eligibility of veterinary workers in both states appeared to be left to interpretation by counties. "We are trying to figure out where veterinarians fit in the plan," Vaughn said last week, musing: " 'Critical infrastructure' — is that us? 'Agriculture and food' — is that us? 'Other health care workers'? "
But on Wednesday, Vaughn told VIN News she just received official word that Alabama veterinarians are in phase 1b. The state health officer, Dr. Scott Harris, has issued a letter stipulating the veterinarians' spot in line. Veterinary workers can contact ALVMA to obtain a copy of the letter.
Questions still remain about where veterinarians fall in Tennessee's vaccination plan. One possibility is that agricultural and non-agricultural veterinarians will be in separate categories. "We do believe it is possible that veterinarians in different regions of our state may be eligible for vaccination at different times due to differing regional allocations of the vaccines, population and the rate of decline of the vaccine from earlier phases," Vaughn wrote in an email to VIN News.
TVMA officials want information; they're not asking to be first in line.
“To be clear, we are not advocating for a position ahead of any front line health care workers or the highly susceptible population segments of our society who should receive vaccination at the earliest possible date," Dr. Matt Polovich, president of TVMA, wrote to association members. "We are requesting this information so that we can inform our membership when they and their employees can expect to be appropriately and timely vaccinated if they so choose.”
Anna Lewis contributed to this report.