By Shawn Mulcahy, Elvia Limón and Yasmeen Khalifa | Texas Tribune
Doses of the COVID-19 vaccine began arriving in Texas in mid-December, marking a significant milestone in the battle against the virus. But it will be months before vaccine doses are widely available, and the rollout is leaving eligible Texans with more questions than answers.
For now, the limited supply is prioritized for front-line health care workers, certain high-risk populations, and teachers and child-care workers.
As of Feb. 22, 3.1 million Texans had received at least one dose of the Pfizer or Moderna vaccine, both of which require two shots up to six weeks apart, and 1.4 million Texans had been fully inoculated. Texas could initially receive more than 200,000 doses of the newly approved Johnson & Johnson vaccine, according to the Texas Department of State Health Services. As of Feb. 27, the agency had not received a timeline for when they would arrive.
Who is eligible for the COVID-19 vaccine in Texas?
Front-line health care workers and long-term care facility residents and staff are the prioritized groups to receive doses of the vaccine as part of Phase 1A of distribution.
Phase 1B prioritizes Texans who are 65 years and older, and people who are at least 16 and have qualifying health conditions that put them at an increased risk for severe illness from COVID-19. According to the Texas Department of State Health Services, some of these conditions are:
>> Cancer
>> Chronic kidney disease
>> Chronic obstructive pulmonary disease
>> Heart conditions, such as heart failure, coronary artery disease or cardiomyopathy
>> Solid organ transplantation
>> Obesity and severe obesity
>> Pregnancy
>> Sickle cell disease
>> Type 2 diabetes mellitus
As of March 3, all school staff, Head Start program staff, and child care staff can receive a vaccine in Texas. The notice came after the Biden administration urged all states to prioritize vaccinating teachers and school staff.
I meet the Phase 1B eligibility. Can I get the COVID-19 vaccine?
Texans in group 1B were eligible to receive doses of the vaccine starting Dec. 21. But supplies are in short order and likely will be for weeks. This issue isn’t unique to Texas, as several others states have reported issues — short supplies, system crashes and unanswered questions — when distributing vaccine doses to senior citizens and others.
There are about 1.9 million eligible Texans in Phase 1A. Phase 1B has an estimated 8 million people, although state officials said an undetermined number of people fall under both groups. A shipment of vaccine doses in January was expected to bring the state’s total allotment to 1.7 million since mid-December.
What kind of documentation is needed to qualify for Phase 1B?
The Texas Department of State Health Services is leaving documentation requirements up to providers and has not provided guidance on how they should check for qualifying conditions. If you believe you qualify for Phase 1B, contact your health care provider or doctor to ask what documentation is needed to receive a vaccine.
As for identification, the state has said there are no residency requirements for the vaccine, and providers should not require proof of residency, according to KERA. However, some counties have been issuing their own requirements.
Who else is eligible to get the vaccine?
As of March 3, all school staff, Head Start program staff, and child care staff in Texas are eligible to get the COVID-19 vaccine. This new group comes after the Biden administration Tuesday urged all states to prioritize vaccinating teachers and school staff. Texas had not previously prioritized teachers. Texas received a letter from the U.S. Department of Health and Human Services Tuesday night directing it to expand eligibility, according to a DSHS news release.
Those eligible are “those who work in pre-primary, primary, and secondary schools, as well as Head Start and Early Head Start programs (including teachers, staff, and bus drivers) and those who work as or for licensed child care providers, including center-based and family care providers,” according to the federal directive.
What happens to me if they open it up for the next section, and I am still not vaccinated?
You can still get vaccinated in the next phase if you did not do so in your designated group, according to the DSHS plan.
The state estimates that the vaccine will be available for the general public this spring, but that may change depending on the speed of vaccine production. The Expert Vaccine Allocation Panel is still considering what criteria will be used for later stages of vaccine distribution. This webpage will be updated when those decisions have been made.
Where can I get the COVID-19 vaccine?
Check with your health care provider.
The vaccine will be available at a range of health care providers — like health clinics and hospitals — but most people will likely get vaccinated at their doctor’s office or a pharmacy. Some providers are also requiring Texans to register for an appointment to get the vaccine to minimize traffic flow.
We’ve heard from a number of Texans who have been unable to make an appointment to get a vaccine in their areas. Keep trying in the weeks to come — the state is expected to get more vaccines over the next few months and more and more people will be eligible.
CVS, Walgreens and PharmScript are working with the federal government directly to deliver vaccinations to long-term care facilities. Administration of those doses was scheduled to start Dec. 28. H-E-B has launched a registration portal and is offering COVID-19 vaccinations at select locations.
Gov. Greg Abbott said in December that more than 7,200 providers across the state had enrolled to administer vaccine doses as they become available. Among these are state designated “vaccination hubs” capable of vaccinating up to 100,000 people — helping streamline distribution as the number of eligible Texans grows. Contact information for the hubs can be found here.
The Federal Emergency Management Agency (FEMA) and state emergency management officials have also begun running mass vaccination sites aimed at underserved communities in Houston and Dallas-Fort Worth. The sites are NRG Stadium in Houston, AT&T Stadium in Arlington and Fair Park in Dallas. Residents need a reservation before showing up to these sites. FEMA is getting the names of Texans eligible to receive their vaccinations at these sites from those already signed up with the counties, according to NBC DFW.
The governor has also said some 1,100 members of the Texas National Guard will administer vaccines to older people in their homes in rural and isolated areas of the state. The renewed effort to reach older Texans who are unable to leave or have difficulty leaving their homes, an effort dubbed Save Our Seniors, launched Feb. 22. The state will work with organizations like Meals On Wheels and nursing groups to identify homebound older Texans who have volunteer to be vaccinated.
It is an expansion of a mobile vaccination program run for several weeks by the Texas Division of Emergency Management and is modeled after local programs that partner with nonprofit organizations to identify homebound older people in need of the vaccines, state leaders said.
Why is my provider saying they don’t have a vaccine available?
As thousands of Texans have come to discover in recent weeks, doses of the coronavirus vaccine have remained in short supply.
Shipments of the vaccine first began arriving at Texas hospitals on Dec. 14. Under Phase 1A of the state’s rollout, the limited supply was reserved for front-line health care workers, as well as residents and staff members of nursing homes and other long-term care facilities, which have been decimated by the virus. The second group authorized to get a vaccine in Texas, referred to as 1B, consists of Texans 65 and older, and people who are at least 16 with certain medical conditions.
State data initially suggested there would be an ample supply of vaccine doses — enough to expand eligibility to the 1B group weeks ahead of time. But the state has dealt with with a short supply of doses, poor messaging from state officials, technical errors and logistical delays. The winter storm in February also caused vaccination delays.
The newly approved Johnson & Johnson vaccine, which requires only one dose, began being administered in Texas in early March. But even with this new vaccine, the supply falls far short of both the demand and the number of people eligible to get it.
How much will the COVID-19 vaccine cost?
The U.S. Centers for Disease Control and Prevention requires that vaccine doses purchased with taxpayer dollars be given at no cost. But providers are allowed to charge an administration fee, which can be reimbursed through insurance. People without insurance will not be charged, according to DSHS.
For people covered under Medicare or Medicaid, the federal government will cover the cost of the vaccine and any fees.
Texas’ COVID-19 vaccination plan requires providers to administer the vaccine “regardless of the vaccine recipient’s ability to pay COVID-19 vaccine administration fees.”
I’m a veteran. What do I need to know about getting the vaccine?
The United States Department of Veterans Affairs is working with the CDC and other federal partners to develop a phased plan. It is currently offering vaccine doses to two groups: veterans living in the VA’s long-term care facilities and VA health care personnel. If you’re eligible to get the vaccine through the VA, you do not need to reserve a dose or go to a facility to request one — your VA health care team should contact you.
When more doses are available, the VA will determine when it can provide them through its community provider network. After the first two groups, it will begin to offer vaccine doses to more veterans who are at high risk of severe illness from COVID-19. The VA plans to offer a free COVID-19 dose to all veterans receiving VA health care who want one once there are enough doses available.
How many shots of the vaccine do I need?
Two of the coronavirus vaccines — Moderna and Pfizer — authorized in the United States need two shots to be effective, according to the CDC. A third, the recently approved Johnson & Johnson vaccine, only requires one dose.
Once you’ve received all of the required doses of the vaccine you were given, health experts still recommend wearing a mask to cover your nose and mouth when you’re outside of your home.
Will I be notified when to receive the second dose? Will I be required to schedule an appointment?
According to DSHS, when you get the vaccine, you will receive information about what kind of vaccine you got and if you need to go back for a second dose. You can also register for the V-safe After Vaccination Health Checker to receive health check-ins after you receive a COVID-19 vaccine, along with reminders to get your second dose if you need one. Only two of the current three vaccines authorized in the United States require two doses. The Johnson & Johnson vaccine requires one dose.
How long after the second shot does it take before the vaccine reaches maximum immunity?
For the vaccines that require two doses, you will usually develop full protection one to two weeks after getting your second dose. At this time, experts do not know how long that protection will last or whether a booster shot will be necessary after the initial recommended vaccine dose(s). The CDC says it won’t know how long immunity lasts after vaccination until it has more data on how well COVID-19 vaccines work in real-world conditions. The CDC and DSHS will keep the public informed as they learn more.
Can I gather with other people once I get both doses of the vaccine?
People who have been fully vaccinated against COVID-19 can gather with other vaccinated people indoors without wearing a mask or social distancing, according to the CDC. But they recommend to keep those gatherings small. Officials also say that fully vaccinated people can gather in the same way with people considered at low-risk for severe disease, such as vaccinated grandparents visiting visiting healthy children and grandchildren, as long as the unvaccinated people are from the same low-risk household.
Health officials say a person is considered fully vaccinated two weeks after receiving the last required dose of vaccine. The new guidance does not mention anything related to travel, and visiting restaurants or other places, even as several states have begun loosening COVID-19 restrictions on businesses. The guidance also doesn’t mention anything about people who’ve gained some level of immunity from having been infected and recovered from the virus.
Fully vaccinated people should still follow steps to protect themselves and others — like wearing a mask and social distance — when out in public, gathering with unvaccinated people from more than one other household and visiting with an high-risk unvaccinated people or people who live with them.
How is Texas keeping track of who’s gotten the first dose?
The Texas Department of State Health Services has a map that tracks where doses of the coronavirus vaccines are going and how many people are receiving them. The state’s dashboard has so far separated the numbers by the phase — either 1A or 1B.
But the state’s numbers could lag up to two days behind what’s happening on the ground. Providers have 24 hours to report their vaccination statistics to the agency, which updates its numbers each afternoon with data reported by midnight the day before.
How will I know when to get my second dose of the vaccine?
Texans should receive a COVID-19 Vaccination Record Card when they get their first dose of the vaccine. This card will include: the date of their first dose; the dose manufacturer’s name and the lot number of the vaccine; the health care professional or clinic site; and the date to return for their second dose, according to the Texas Department of State Health Services.
Texans who receive a Moderna or Pfizer vaccine can also book their second dose during their appointment for the first one. If they don’t, they can make the appointment later. The provider may also contact them proactively to schedule the follow-up dose. The health department recommends people get their second dose at the same location they got their first so “each provider has an opportunity to order a matching number of second doses to arrive at the appropriate time.” The Johnson & Johnson vaccine requires one dose.
Are there different reactions to the vaccine depending on the manufacturer?
There are three manufacturers whose vaccines are currently approved for use in the US: Pfizer, Moderna and Johnson & Johnson. According to the Texas Department of State Health Services, the most common side effect reported for both the Pfizer and Moderna vaccines is a headache. Fatigue or chills were the next most frequent symptoms reported by people who’ve received the vaccine.
Texas has seen similar symptoms reported compared to the national symptoms reported by the manufacturers.
Side effects related to the Johnson & Johnson vaccine include pain at injection site, headache, feeling very tired, muscle aches, nausea and fever, according to the manufacturer.
If my first dose is by one manufacturer, can I receive a dose from the other for the second?
The second dose of the COVID-19 vaccine should be from the same manufacturer. This is why the Texas Department of State Health Services recommends returning to the same location as the first dose for the second one.
Who decides who is eligible to receive doses of the vaccine?
Decisions on how doses of the vaccine are allocated are made by a state panel of advisers — including lawmakers, state and local health officials, and medical experts and researchers. The group, known as the Expert Vaccine Advisory Panel, provides recommendations for final approval by Hellerstedt.
Is the COVID-19 vaccine safe?
Yes. Health experts and public officials widely agree that the vaccine is safe. The three currently approved vaccine manufacturers — Pfizer, Moderna and Johnson & Johnson — reported their vaccines are 95%, 94% and 72% effective, respectively, at protecting people from serious illness. While no vaccine is without side effects, clinical trials for Pfizer, Moderna and Johnson & Johnson show serious reactions are rare.
Abbott received his first dose of the vaccine last month, telling reporters, “I will never ask a Texan to do something I’m not willing to do myself.”
Should I still get the vaccine if I’ve had COVID-19?
Yes. Medical experts recommend that people who have had COVID-19 should still get the vaccine. Research has shown that people can be reinfected with the virus, and the vaccine adds an extra layer of protection, according to the Centers for Disease Control and Prevention.
If someone’s treatment included monoclonal antibodies or convalescent plasma, they should talk to their doctor before scheduling a vaccine appointment. The CDC recommends that people who received those treatments should wait 90 days before getting the vaccine.
Should I still wear a mask after I get the vaccine?
Yes. Texans should continue to engage in safer practices like social distancing, wearing a mask whenever they’re around people outside of their immediate household and washing their hands frequently, according to the Texas Department of State Health Services. Wearing a mask lessens the chances of contracting the virus. Health experts estimate 75% to 90% of Texans would need to achieve immunity to COVID-19 for the state to reach herd immunity. It’s also currently unknown if getting a COVID-19 vaccine prevents people from spreading the virus, according to the CDC.
When will Texas get more COVID-19 vaccine doses?
New doses of the vaccine will continue to arrive in Texas over the coming months. Public health experts estimate it will take between six and nine months for the vaccine to be widely available to everyone who wants it.
Health officials have also said more vaccination hubs capable of helping thousands of Texans will be announced as weekly shipments get bigger. The Texas Department of State Health Services said the hubs will be required to set up registration phone numbers and websites and to focus on the most vulnerable communities in their regions. Contact information for the hubs can be found here.
The Federal Emergency Management Agency and state emergency management officials have also begun running mass vaccination sites aimed at underserved communities in Houston and Dallas-Fort Worth. The sites are NRG Stadium in Houston, AT&T Stadium in Arlington and Fair Park in Dallas. Residents need a reservation before showing up to these sites.
How will Texans in rural areas without reliable transportation get the vaccine?
For older Texans who need help accessing the vaccine, there are several initiatives happening at both the state and local levels, says Douglas Loveday, a spokesman for the Texas Department of State Health Services. Local chapters of the National Association of Area Agencies on Aging have helped identify and set appointments for locals to be vaccinated.
Loveday also said several councils of governments across the state have been helping people in more rural areas by pairing older Texans with smaller, local providers including pharmacies to help ease the vaccine process for them. These services are also available to people of any age who qualify for the vaccine because of other conditions.
For example, the Rio Grande Council of Governments is contacting Texans in those seven counties and the The Ysleta del Sur Pueblo who are part of phase 1B to help them schedule appointments or provide them with information to get them vaccinated. Texans can find useful contacts for their council in this directory.
Loveday also said some local health departments will move older Texans or those who cannot stand for long time to the front of the queue at vaccine sites. And some parts of the state have opened drive-thru vaccine sites, including Dallas, Fort Bend and Brazoria.
I’ve tried everything to get a vaccine. I can’t get one or get my question answered. Who do I contact at the state level?
If you have questions or concerns, or you would like more information about COVID-19 vaccine distribution, you can email [email protected] or call 211 and choose Option 6.
