Indiana continues age-based vaccination plan, looks to add Hoosiers at high risk for COVID illness

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INDIANAPOLIS — On Wednesday, Indiana State Health Commissioner Dr. Kristina Box and Governor Eric Holcomb discussed the state’s plans for opening up vaccine eligibility to more people.

Officials announced they would continue moving forward with the state’s age-based approach to vaccination prioritization but are looking to add Hoosiers with certain comorbidities to the list of people eligible.

The state released its initial plan for COVID-19 vaccine allocations in October. Included in the current phase (1-B) were Hoosiers with underlying health conditions that made them higher at risk for morbidity or mortality from coronavirus.

However, the most recent vaccine eligibility list published by the Indiana State Department of Health (ISDH) in Jan. does not clarify exactly when people with comorbidities from ages 16-64 will be eligible to receive a vaccine.

“The good news is, we’re getting it in arms. When we get it, we’re getting it in arms, and we’re getting it in our most vulnerable arms,” said Holcomb.

More than 637,000 Hoosiers have received their first dose of a COVID-19 vaccine and more than 178,000 are said to be fully vaccinated.

This week, Hoosiers 65 and up became eligible to receive their COVID-19 vaccine. Dr. Box said they will now look to add people with underlying health conditions but did not give an exact time frame on when that would happen.

Box explained the state’s reasoning for how Hoosiers have been prioritized so far.

“When we look at individual comorbidities what are the highest risks? It was clear from the data, from the evidence, from the research, it was age,” said Box. “That is why we started with the age and Indiana’s data has backed that up.”

“I think there is good rationale for looking at using the age-based approach,” said Dr. Shaun Grannis, Vice President for Data and Analytics at the Regenstrief Institute.

“It turns out the older you get, the more likely you are to have a comorbidity,” he said.

“So, if you look at comorbidities in the state of Indiana, it goes up, up, up with age,” said Grannis. “So, if you want to get the most people who have a diagnosis of cancer, start with the elderly.”

“A lot of things in life aren’t simple. I think this issue is fairly simple,” Grannis explained.

“Older people have more comorbidities and so starting with the oldest and working your way down is gonna treat those both with the age risk factor as well as other risk factors.”

Box said the state will take certain factors into consideration when deciding the comorbid conditions that would deem Hoosiers eligible for the vaccine.

“When the age risk starts to equal the risk of a particular comorbidity, that is how we are starting to add the comorbidities back in,” said Box.

The CDC’s list of increased risk medical conditions includes cancer, chronic kidney disease, COPD, immunocompromised state from solid organ transplant, obesity, serious heart conditions, sickle cell disease and Type 2 diabetes.

Box said they are working with experts to determine which high-risk groups should receive priority for vaccinations.

“All of those things go into making these decisions and they are evidence-based, research-based, academic decisions at a time when the resource is scarce,” she said.

Several Hoosiers who reached out to CBS4 News said the lack of clarity over when people with underlying conditions will be eligible is causing frustrations and anxiety.

Valerie Coulter, who has multiple chronic illnesses, including Type 1 diabetes and Selective IgA deficiency, an immune system condition that leaves her susceptible to respiratory illnesses, said she has been following the data and feels now is an appropriate to extend eligibility, including to Type 1 diabetics.

Coulter works in critical infrastructure as a controls engineer, working at schools, universities and other government buildings. She said she has had confirmed exposures and been lucky but worries what could happen if she does contracts COVID-19 before her chance to be vaccinated.

“Even without the severe complications of COVID, like Type 1 diabetes I’m at risk for ketoacidosis, which I could get with any infection,” she said.

Coulter said being able to get a COVID-19 vaccine would help alleviate the anxiety of worrying about what could happen if she contracted the virus, where she is already susceptible to severe respiratory illnesses.

“I have no doubt that there are lots of people that feel the same way,” she said.

Coulter said she has a scientific background and has been following the data in the state to track the groups facing most severe complications due to COVID-19.

“The data still seems, to me, to say that people like me should still be prioritized,” said Coulter. “Age certainly is a major risk factor and that’s why they vaccinated older people and that makes sense, but now they’ve gotten to the point that the mortality rates for those groups are similar to data published by other places for people with chronic illnesses.”

“It feels like it’s time. You know, they’ve gone through the older ages and it’s time for us to be eligible,” Coulter shared.

“It’s scary,” she said. “It’s something that I will get through and it will be fine. We’ll get there eventually. But certainly, getting a vaccine would make a lot of that feel a lot better.”

On Thursday the Diabetes Leadership Council called on Governor Holcomb to prioritize Type 1 diabetes in the at-risk populations.

In a letter to Holcomb, the council wrote in part, “While the Indiana State Department of Health prioritizes people with underlying medical conditions, the state continues to follow outdated vaccination guidance by the CDC that people with T2D “are” at increased risk, but people with T1D “might be.” We now know that is not the case. People with T1D need equal access to the COVID-19 vaccine.”

According to the American Diabetes Association, approximately 586,000 people, or 11.5 percent of the adult population in Indiana, have diagnosed diabetes.

Included in those numbers are an estimated 553,000 people with Type 2 diabetes and 33,000 with Type 1.

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