The Department of Veterans Affairs on Tuesday released a preliminary look at its COVID-19 vaccine plans, including who is likely to receive the vaccine first.
VA has yet to release a comprehensive vaccine distribution plan, which has drawn criticism from some veterans and Capitol Hill lawmakers anxious to learn how the massive federal agency, the largest healthcare system in America, plans to dole out the vaccine to its nearly 400,000 employees and more than 9 million veteran patients.
In a nine-page frequently asked questions document released Tuesday, VA outlines why the COVID-19 vaccine is important, how it works, who is eligible and more.
Those most likely to receive the vaccine first include those VA determines are most at risk among its staff and veteran patients, along with particular geographic areas the department identified as those most likely to receive batches of the vaccine first.
VA says it submitted a draft plan to the Centers for Disease Control and Prevention in October 2020, "but the plan will not be finalized until" the Food and Drug Administration authorizes or approves at least one vaccine and the CDC Advisory Committee on Immunization Practices (ACIP) issues recommendations for how to deliver the vaccine.
VA is working with the CDC and other federal partners to develop a phased plan, especially for the early stages of vaccine distribution when supplies will likely be more limited.
Under that plan, VA said high-risk veterans and department staff will receive the vaccine first, based on CDC guidelines. Those guidelines include those most at risk of: becoming infected with the virus, severe illness and death from COVID-19, spreading the virus to others, harm to society if an essential worker is unable to work.
VA plans to offer the vaccine first to healthcare staff at highest risk, aiming to reduce the spread of the virus to veterans at higher risk as well as other employees, and to keep staff working.
Veterans will receive the vaccine based on risk of infection, including age, race and ethnicity, existing health conditions and other factors such as those living in nursing homes or other group living facilities.
In a nationwide study of more than a quarter of a million veterans released earlier this year, VA researchers found that Black and Hispanic veterans are twice as likely to test positive for the virus as white veterans. VA data showed that while Black and Hispanic veterans make up about 23% of VA patients, they account for nearly half of all VA COVID-19 cases.
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VA data shows that Native veterans also are disproportionately at risk for the virus. Similar trends among Black, Hispanic and Native populations is reflected among the overall American population as well.
Survival rates do not differ significantly by race or ethnicity, however, VA officials said.
Older veterans, or those with health conditions such as cancer, diabetes or heart disease, are also more at risk.
Experts previously warned that veterans exposed to burn pits or who have experienced Gulf War Illness from military toxic exposures may also be at elevated risk for the virus.
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Many veterans will have to wait to receive a vaccine, VA cautioned.
When the FDA first signs off on a vaccine, "we'll have a limited amount to start," the department said. VA will focus first on those most at risk before offering the vaccine "to all veterans enrolled in VA health care who want one."
Veterans will not likely have a choice of which vaccine they receive, if more than one is approved, according to VA.
"For the first several months we wouldn’t have enough vaccine to allow for this. We will reassess as more vaccines become available," VA said in the vaccine plan document.
The number of doses of the vaccine needed will vary depending on the vaccine, according to VA. The first two vaccines expected to receive FDA and CDC reviews each require at least two doses, given three to four weeks apart.
It's still unclear how long those vaccines may protect people from the virus.
VA officials said they expect the CDC to recommend against getting both the flu and COVID-19 vaccines at the same time, but added that the CDC will provide further guidance once a vaccine moves forward.
VA expects that the initial rollout of the vaccine will require special storage and handling, so only certain VA Medical Centers will provide them. Once more are available, VA said it will decide whether to distribute the vaccines through community providers as well as VA facilities.
Internal VA documents obtained by Connecting Vets showed that five initial VA sites have already been chosen: Bedford, Massachusetts; Orlando, Florida; New Orleans; Albuquerque, New Mexico; and Minneapolis. Some of those areas, such as New Orleans and Minneapolis, are among those hit hardest during different stages of the pandemic so far.
Those sites are likely to receive the vaccines "within 24 hours of approval but will not be authorized to administer until after ACIP meets," according to the documents. Additional sites will receive vaccines after that meeting. Not all VA sites will receive vaccines in the department's initial CDC allocation.
A Nov. 3 internal VA memo sent to health system directors asked that they identify COVID-19 vaccine teams to prepare for safe handling, storage, distribution and administering the vaccine itself.
Veterans enrolled in VA health care do not pay copays for vaccinations provided during health visits, and VA officials said there are no current plans to charge any fees for the COVID-19 vaccine.
The department does plan to monitor those who receive the vaccine for any reactions, side effects or "adverse events" and report those incidents in its vaccine monitoring and tracking system used for all vaccines at the department. VA said it will share the same information about patients receiving the COVID-19 vaccine with the CDC that it shares for all other vaccines, including demographics and negative reactions, but not patient names or addresses.
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Reach Abbie Bennett: abbie@connectingvets.com or @AbbieRBennett.
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