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Medical assistant Monica Magana prepares a syringe with the Moderna COVID-19 vaccine at Ravenswood Family Health Center in East Palo Alto on Jan. 30. (Photo by Magali Gauthier)

Beginning March 15, anyone ages 16 to 64 with a developmental disability, cancer or other conditions that would put them at risk of death and complications from COVID-19 will be eligible for the vaccine, California Department of Public Health officials said during a press briefing on Friday.

The department sent the directive to vaccinators and local health departments in a Feb. 12 memo announcing the change, which will allow health care providers to “use their clinical judgement” to vaccinate certain people who are deemed to be at the “very highest risk” for severe illness and death.

Starting March 15, people ages 16-64 with the following conditions will be eligible: current cancer, with a debilitated or immunocompromised state; chronic kidney disease, stage 4 or above; oxygen-dependent chronic pulmonary disease; Down syndrome; immunocompromised state (weakened immune system) from a solid organ transplant; pregnancy; sickle cell disease; heart conditions such as heart failure, coronary artery disease or cardiomyopathies (but not hypertension); severe obesity (body mass index equal or greater than 40 and Type 2 diabetes mellitus with a hemoglobin A1c level greater than 7.5%.

People with a developmental or other severe, high-risk disability are also eligible if one or more of the following applies: the person is likely to develop severe, life-threatening illness or death from COVID-19 infection; acquiring COVID-19 will limit the person’s ability to receive ongoing care or services that are vital to their well-being and survival; and if providing adequate and timely COVID-19 care will be particularly challenging as a result of the person’s disability.

Dr. Mark Ghaly, California’s secretary of the Health and Human Services Agency, said the guidelines are consistent with the state’s goals to protect those who are most vulnerable to the coronavirus as quickly as possible. The decision to open vaccine administration to these groups comes after weeks of work with stakeholder groups.

“There are 4 to 6 million people in these groups,” he said. Altogether, the number of eligible people from existing groups approved for the vaccines and this new number would equal 17 million to 19 million, Ghaly said.

In the coming weeks, the state will continue to build up its infrastructure to accommodate the increasing numbers of people who will become eligible. How people will be asked to prove they fall into one of these categories still hasn’t been worked out, he said.

The main concern continues to be the scarcity of vaccines, he added. The state does have supplies for the next three weeks. Ghaly said he anticipates that some of the increased dose supply will come from additional doses that can be pulled from vials. That number could go considerably higher.

The Food and Drug Administration on Friday agreed to allow drug manufacturer Moderna to increase its COVID-19 vaccine doses by up to 40% in each vial, or from 10 to 14 doses, according to The New York Times. The Pfizer-BioNTech vaccine doses will increase from five to six doses per vial.

State health officials are still operating under its phased-eligibility protocols, currently in its Phase 1A and Phase 1B Tier 1. The state plans to switch to age-based eligibility but it hasn’t worked out the details yet, Ghaly said.

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