Florida and Texas have started vaccinating people 65 and older against the coronavirus, breaking with CDC guidelines

pfizer vaccine covid 19 nursing homes
Vera Leip, 88, receives a COVID-19 vaccine at the John Knox Village Continuing Care Retirement Community in Pompano Beach, Florida, on December 16, 2020.
  • Florida and Texas residents age 65 and older are now able to get coronavirus vaccines.
  • The decision bucks CDC recommendations that say essential workers and people older than 75 should be next.
  • "The problem is people that are 73, 74 would be in the back of the line for a young 21-year-old worker who's considered 'essential,'" Florida Gov. Ron DeSantis said.
  • Visit Business Insider's homepage for more stories.

Florida and Texas have started to distribute coronavirus vaccines to residents over age 65.

Last week, Florida Gov. Ron DeSantis issued an executive order allocating vaccines to nursing-home residents and staff, people 65 and older, medical workers, and anyone deemed "extremely vulnerable to COVID-19." Texas did the same a few days prior, giving the green light for people 65 and older, along with those who have certain preexisting conditions, to start getting vaccinated.

"The focus on people who are age 65 and older or who have comorbidities will protect the most vulnerable populations," Imelda Garcia, chair of Texas' expert vaccine allocation panel, said in a statement.

These decisions go against guidelines set by an advisory group at the Centers for Disease Control and Prevention. The CDC recommended that healthcare workers and nursing-home residents and staff should be first in line, followed by frontline essential workers and people over 75. These recommendations, the group wrote, are meant to "preserve functioning of society" and "decrease death and serious disease as much as possible."

But in Florida and Texas, essential workers have been bumped out of the next phase of vaccinations.

"The problem is people that are 73, 74 would be in the back of the line for a young 21-year-old worker who's considered 'essential.' That doesn't, I think, make sense,'' DeSantis said at a press conference on Wednesday.

Neither state has finished vaccinating everyone in the first priority group.

Literal vaccine lines have formed

The few places in Florida and Texas that have started administering vaccinations to people older than 65 quickly exhausted supply.

Coronavirus vaccine US
The CEO of the The New Jewish Home long-term care facility in New York receives a COVID-19 vaccine on December 21, 2020.

The Department of Health in Lee County, which includes Fort Myers, started vaccinating people aged 65 and older on Monday. County staff reported that they expected have 300 doses available at one site on Monday, three sites on Tuesday, and three sites on Wednesday.

Photos from local outlet The News-Press showed Fort Myers residents lined up at the Estero Park and Rec Center on Sunday evening, 19 hours before the clinic site was set to open.

By the next morning, the line stretched around the building. The clinic ran out of doses by noon.

 

Similarly, the Wise Health System in Decatur, Texas, began giving shots to residents in the 65-plus age group on a first-come, first-served basis on Wednesday. People lined up more than two hours before the clinic opened, and doses ran out by 8:30 a.m.

"We know that the 65+ clinic did not go as smoothly as we would have liked," the Wise Health System wrote on its Facebook page on Wednesday. "The decision was made to provide the vaccine to this critical age group on Tuesday morning and it was implemented in less than 24 hours."

Each state decides how to distribute its vaccine supply

Vaccine sticker, US, Kentucky
Dr. Jason Smith showed off his bandage after getting vaccinated at the University of Louisville Hospital in Kentucky.

The CDC guidelines for distributing the Moderna and Pfizer vaccines say that after healthcare workers and nursing-home residents and personnel (priority group 1a), the next doses should go to people over 75 and essential workers - like teachers, agriculture workers, grocery store employees, and public transportation workers (group 1b). Then should come Americans ages 65 to 74, along with people under 64 who have high-risk medical conditions, and any other essential workers.

In total, the US has 24 million healthcare workers and nursing-home residents and staff. As of Saturday, 9.5 million vaccine doses had been distributed. Florida, specifically, is expected to receive 970,000 doses by the end of the year, but the state has 1.1 million healthcare workers and 270,000 nursing home residents, according to the Washington Post. Texas has about 1.4 million healthcare workers and 300,000 people in nursing homes, but Gov. Greg Abbott said the state will get 1.2 million doses this month. 

"There is no need to ensure all of your 1a group has been vaccinated before starting 1b vaccinations," John Hellerstedt, commissioner of Texas' Department of State Health Services, wrote in a letter to healthcare facilities on Wednesday.

The CDC instructions are just guidelines - it's up to states to prioritize their shots. A recent Kaiser Family Foundation report found that 45 states are following the CDC recommendations. Massachusetts, Nevada, New Hampshire, and Wyoming deviated slightly by including law enforcement in their first round of vaccinations. Massachusetts is also including incarcerated people and those in homeless shelters in its first group.

Texas, meanwhile, decided residents' occupations won't be the deciding factor, at least not yet.

"Texas has clearly come down on the side of, 'we're going to focus on those who are at greatest risk of illness and death,'" Jen Kates, senior vice president at the Kaiser Family Foundation, told CNBC.

'Our priority is the elderly'

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A Publix supermarket cashier bags groceries in Miami, Florida, on May 27, 2020.

In Florida, approximately 4.4 million residents are older than 65, and more than 3 million are above 70. Between May and August, 78% of coronavirus deaths in the US were people age 65 or older.

"Our priority is the elderly population," DeSantis said during the Wednesday press conference.

Brett Giroir, assistant secretary for health at the Department of Health and Human Services, said the decision makes sense.

"Because those are the people who go to the hospitals. It's not the frontline 24-year-old worker who is at low risk of getting the infection and at very, very low risk of getting serious results from that," Giroir told Fox News Sunday, adding, "as the hospitals fill up, the first priority really needs to be to save lives and reduce the burden on hospitals."

Essential workers, however, face an increased risk of exposure to the coronavirus, and a disproportionate share are poor and non-white.

"Black and Hispanic workers in Florida are disproportionately dying of COVID," Dr. Terry Adirim, a pediatric emergency medicine physician at Florida Atlantic University, told the Palm-Beach Post, adding, "these are the people working in the grocery stores, delivering the grocery, driving the buses, putting their lives at risk so those of us who can work from home can work from home."

COVID-19 has also killed many young people. One study found that from April through June, more than 3,300 Americans between 18 and 34 were hospitalized with COVID-19, and 21% required intensive care. About 3% died.

Between July and August, people between 20 and 29 accounted for the largest proportion of coronavirus cases in the US - more than 20%

Aria Bendix and Hilary Brueck contributed reporting.

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