Older individuals who need an early Covid-19 vaccine could not get one as quickly as they'd like

Older Americans who want to get vaccinated against Covid-19 may need to be patient.

While Medicare – which insures a large proportion of the 65-year-olds and older – has recently changed its rules to fully cover a rapid vaccine, the availability of doses will initially be limited. And individual states have the responsibility of actually distributing the vaccine and identifying priority populations to be vaccinated.

"I think there are still major problems with vaccine distribution, which is primarily left to states," said Juliette Cubanski, associate director of the Kaiser Family Foundation's Medicare Policy Program.

"That includes which populations are prioritized when it comes to getting the starting doses once they're approved or approved," said Cubanski.

The details of each state's preliminary plans for who to vaccinate first differ slightly, although they generally target the same broad categories for Phase 1 distribution, according to the Foundation. That is, healthcare workers, key workers, and people at high risk.

As the US coronavirus crisis deepens, there is optimism that at least one, if not two, vaccine could be available in limited quantities as early as next month. In the United States, the number of coronavirus cases is over 11.5 million with more than 250,000 deaths, representing about 20% of the 56.3 million cases worldwide and the estimated 1.3 million Covid-19 deaths worldwide.

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On Wednesday, Pfizer and German biotech partner BioNTech announced that they would be seeking emergency approval from the Food and Drug Administration for their vaccine within a few days. The companies also reported that their vaccine was 95% effective overall – up from their previous estimate of 90% – and that those 65 and older were at least 94% effective.

The news came two days after Moderna said its preliminary data also show 94.5% effectiveness. Between the two, the US should have enough doses by the end of the year to vaccinate 20 million people, Minister of Health and Human Services Alex Azar told CNBC on Monday.

Public health officials have announced that the vaccine will be released gradually. States are making plans based on the guidelines from the Centers for Disease Control and Prevention and the guidelines published by the National Academies of Science, Engineering, and Medicine in early October.

This group recommends a four-phase approach, with Phase 1A aimed at healthcare workers and first responders, and 1B focusing on those with underlying health conditions that are at significant risk for serious illness, as well as older adults living in a community or live in a crowded environment (that would include nursing homes and the like).

All older adults who were not included in phase 1 would belong to the populations affected in phase 2. The group finds that adults aged 65 and over account for approximately 80% of reported deaths related to Covid-19. Recent CDC data shows that of nearly 224,000 Covid-19 deaths in the US, more than 177,000 were in the 65-year cohort.

The groups addressed in phase 3 include young adults and children; Phase 4 would cover any that were not previously included. Exactly how long each phase would last is uncertain, as part of the timing depends on distribution logistics and vaccine availability.

According to Kaiser, states are also early in increasing the number of providers and locations for administering the vaccine. Most of them also realize that there may not be enough vaccine doses initially available to cover everyone affected in phase 1.

For example, according to the CDC, there are an estimated 17 to 20 million healthcare workers. The estimated population of the over 65s is 53 million.

Even so, older people can generally expect to be vaccinated in front of, for example, healthy young adults.

"But when that will happen is … still very unknown," said Cubanski.

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