Black Veterans, like Retired Army veteran Joe L. Knight, 87, shown here, are opting to receive the ... [+]
Earlier this month, President Biden visited the vaccine clinic at the Washington D.C. Veterans Affairs Medical Center. He was justifiably proud of VA’s success in vaccinating veterans against COVID-19.
As Deputy Executive Director of the VA’s National Center for Ethics in Health Care (NCEHC) Anita Tarzian points out, many state governments have struggled to get COVID-19 vaccines into the arms of their residents.
VA was able to mobilize early to identify vaccine allocation guidelines and proactively prepare facilities to vaccinate VA staff and veterans as soon as vaccines were authorized under the Emergency Use Authorizations by the U.S. Food and Drug Administration.
And this is no mean feat, especially considering the ethical conflicts inherent in deciding to whom and when a potentially life-saving vaccine is offered when there is limited supply.
In August of 2020, VA formed a COVID-19 Vaccine Integrated Project Team, comprised of six subgroups: communications, distribution, education, measurement, policy, prioritization, and vaccine safety.
The NCEHC weighed in on the ethical justification for VA’s risk stratification framework to help determine who received vaccines during the limited supply period. This risk stratification framework was based on, but not identical to, that recommended by the Centers for Disease Control and Prevention Advisory Committee on Immunization Practices.
With these preparatory efforts, VA began rolling out the vaccine in December through their Veterans Health Administration (VHA). As of March 20, 2021, over 3 million doses have been given to over 2 million veterans, VA employees, health care workers and support personnel.
According to Dr. Richard Stone, Acting Under Secretary for Health, this is out of about 9 million veterans enrolled in the VA health care programs and about 400,000 employees at the agency.
This has been good news to places like Montana where 11% of adults are veterans. VHA has even flown private planes into rural Montana to bring the vaccine to veterans there.
“They’re taking care of us,” said Vietnam War veteran Russell Miller, 77. “It’s above and beyond.”
VHA is also helping to administer vaccinations to federal partners such as the Department of Homeland Security personnel, and through what the VA calls their 4th Mission – supporting state and local health care systems.
The number of doses administered to veterans by each facility is being updated on the VA COVID-19 Summary website, and the program is summarized in the figures below, from their website.
U.S. Department of Veterans Affairs COVID-19 Pandemic Response Plan, part one.
One of the powerful aspects the Veterans Health Administration brings to this issue stems from being the largest integrated health care system in the United States, providing care at 1,255 health care facilities, including 170 VA Medical Centers and 1,074 outpatient sites providing care of varying complexity.
This allows them to cross-reference tons of critical information on the veterans getting vaccinated. The VA has a new tool that identifies veterans based on age or underlying conditions and co-morbidities. It also shows current disease treatments, including chemotherapy or dialysis, and other risk factors for severe cases of COVID-19, such as smoking or obesity.
U.S. Department of Veterans Affairs COVID-19 Pandemic Response Plan, part one.
The department can then provide its medical facilities with a prioritized list of who will receive the vaccine - where and when – and also helps to schedule and track the second dose.
With this database, the individual does not have to contact the agency to find out if they can get a dose or where to get it. The agency will contact Veterans directly when a coronavirus vaccine is available for them, based on their individual risk factors and their location.
VHA is also able to address societal problems better than many commercial medical centers and programs. Black veterans 75 years and older, like Retired Army veteran Joe L. Knight, 87, shown above, are opting to receive the COVID-19 vaccine at a higher rate than White and Latino(a) veterans in the same age group, opposite to society at large.
This is a direct result of early outreach efforts. VHA began outreach efforts to minority veterans to build trust in the vaccine last summer and clinics are reporting only a 2% rate of refusal much better than the rate for active duty members of the military.
According to VHA, 34% of Black veterans age 75 and older who use the VA health system have received the vaccine, higher than the 29% of White veterans and 31% of Latino(a) veterans in that age category.
Well before the vaccine was available, VA held listening sessions with minority veterans to get their views on how to build trust in the COVID vaccine. One big issue was addressing the past health practices that left minorities behind, sometimes even exploiting them.
VHA has correctly determined that good communication is essential to succeeding in the fight against the SARS CoV-2 pandemic, starting with websites like their Coronavirus FAQs: What Veterans Need To Know and COVID-19 Vaccines at VA with interactive chatbots and lots of links.
VA Patient receiving vaccine at the Charlie Norwood VA Medical Center.
VHA’s approach is a good roadmap for other agencies and for any future pandemics or epidemics – which there certainly will be.
