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Pharmacies canceling coronavirus vaccination appointments. Pediatricians reporting they can’t offer the federally recommended shots. Panicked parents scouring Facebook and X for success stories with a fervor not seen since the first vaccines were released.
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This is what care looks like in the Washington region as America enters the first winter sick season in years without the protections of a public health emergency, plunging providers and patients back into the complexities of the private market.
While demand for coronavirus vaccines has waned overall, interest has spiked in the weeks since the Centers for Disease Control recommended new shots targeting the latest omicron subvariant.
Some pediatricians report feeling squeezed by demand from families and foot-dragging from insurance companies about reimbursement, forcing practices to weigh the financial burden against providing immunizations — a cornerstone of public health.
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“It’s disappointing and frustrating because patients really rely on us to be able to provide these vaccines in a timely and efficient way,” said Jenna Vallejo, chief operating officer at Potomac Pediatrics, a large practice in Rockville, Md.
The only option her practice’s patients have is to pay for a vaccine at their sister company, a travel clinic that charges $150 per dose, although Vallejo said it’s not ideal for anyone to pay for a preventive vaccine themselves. “That’s ridiculous. But that’s the position we’ve been put in, all of us. And this has just never happened before,” she said.
Under federal law, coronavirus vaccines must be covered by public and private insurers. The federal Bridge Access Program provides vaccines for uninsured and underinsured adults. While nearly half of adults said that they plan to get the new coronavirus vaccine, most parents are less enthusiastic about getting their children vaccinated, according to a KFF survey released Wednesday.
The waiting game comes as public health experts warn of a cold weather uptick in cases combined with back-to-school germs running amok and a looming government shutdown. If federal agencies wind down, community health workers worry delays will further complicate access for patients who relay on government assistance — at the same time some could also lose their Medicaid coverage.
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“When it rains, it pours,” said Jessica Wilson, chief strategy officer at CCI Health Services, a federally qualified heath center serving about 35,000 medical patients and another 35,000 WIC participants in Montgomery and Prince George’s counties.
Kaley Beins, 31, of Rockville, recently considered paying out of pocket at the travel clinic to vaccinate her toddler daughter, then hit another roadblock: The clinic stocks a different vaccine brand than she used before, and since the guidance is to stick with the same vaccine brand for children under 5, only Moderna will do.
Beins, who said she knows how to navigate medical systems after working in public health for about a decade, has resorted to searching on Facebook and X for homemade Google spreadsheets.
“A lot of it is just scrolling,” she said. “It’s just really haphazard. We shouldn’t be on social media begging for a vaccine.”
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The transition to the commercial availability of the vaccine means state and local health departments will still distribute some vaccines — through the federally funded Vaccines for Children program, for example — but are no longer the go-to source for vaccines broadly.
Access was once the top priority of health departments, which opened pop-up clinics, deployed mobile vans and even made house calls to bring vaccines to people who needed it most.
But with vaccines to protect against severe disease, the public health emergency ended and health departments began to return their attention to concerns set aside at the height of the pandemic. In the spring, the District closed eight covid centers, which were highly visible one-stop shops for vaccines, tests and masks with evening and weekend hours.
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Spokespeople for the D.C. Department of Health did not respond to messages seeking comment about the current strategy for the new vaccines. In Maryland and Virginia, public health officials said they tracked a steady spike in cases at the end of July into early August, which began to wane last month, but they expect an uptick as the weather cools and people spend more time indoors.
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That’s cold comfort for Jessica Gehrke, a mother of five from Clifton in Fairfax County, who can’t find appointments for her older children, who range from 8 to 15, and who, until now, were all vaccinated within a week of their age group being eligible for shots. Her biggest concern is her 8-month-old son, who received two shots in the three-shot Pfizer series before clinicians were told to only give the new vaccine, which her pediatrician doesn’t have.
“I’m worried for everybody, but especially the baby. He doesn’t have the immunity,” Gehrke said.
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That’s why Mohammad Jarvandi, a longtime pediatrician with a new private practice in Fairfax, is working until 8 p.m. many nights to vaccinate children 6 months to 12 years old even if they are not regular patients. Within hours of appearing on a CDC list of providers offering no-cost vaccine, he said, his office began getting calls from across Virginia and as far away as New York and New Jersey.
“We just felt as a pediatric practice we could not send our little babies out there with no place to get vaccines. Being a pediatrician — vaccines are so important to us — we decided to do it and just hope for the best,” Jarvandi said.
He confirmed with Pfizer that supplies are robust, considered the 10-week shelf life of the vaccine and that most pharmacies won’t vaccinate children under 3, and assumes insurance companies will sort out coverage and reimburse him, eventually.
Capitol Medical Group, a large practice in Chevy Chase, Md., is making the coronavirus vaccine available for existing patients by appointment, knowing cases have been up and it’s been a long time since most people were vaccinated, pediatrician Dan Finkelstein said.
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“We’re just ordering blind because we know our patients are going to want the vaccine,” he said. At the first of the Saturday drive-up vaccine clinics the practice holds every fall, 800 people got the flu shot and about half also opted for the coronavirus shot, he said.
With all the uncertainty surrounding shots that cost $40 to $110, he said, patients worry they will get a bill from the practice, creating anxiety that flows back to doctors and nurses.
“This is the kind of thing that gives insurance companies a bad reputation with the public because everybody gets really annoyed and it doesn’t have to be that way,” Finkelstein said.
Parents unable to find vaccines for their children find themselves also navigating worries about what the school year will bring as masking and sickness reporting protocols fall away.
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The jump in cases ignited old fears in Sapna Pandya, a social justice consultant from Mount Pleasant, who sent her daughter, 5, to kindergarten with a mask for the first day. Dina Passman, a Columbia Heights mother of 9-year-old twins, said she would like to see more clear guidance and partnership on vaccine access from her school district.
“I don’t have to imagine what happens when someone at risk gets covid,” said Passman, an epidemiologist by training whose father’s legal partner died from covid early in the pandemic. “I know kids are a link in that chain. I know people hate a mask mandate, but I hate covid ripping through the community.”
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