COVID-19 vaccines still in limbo at Cumberland County health department

“When can I get my COVID-19 vaccine?” 

It’s one of the most common questions people are asking Jennifer Green, director of the Cumberland County Department of Public Health.

Last year, Green would direct them to the department’s immunization clinic on Ramsey Street to get the shot. This year, the clinic has none to offer as the department is waiting for final federal and state vaccine recommendations before ordering any doses.

“We are in a wait-and-see mode,” Green said. “We want people to sort of lean into the confusion with us just a little bit. We don’t want people to delay or get frustrated with the process and not get their vaccine.”

On Friday, the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices recommended that anyone six months and older receive a COVID-19 vaccine after they consult with a physician, nurse or pharmacist, which they called “shared clinical decision-making.” 

The recommendation, which leaves it up to individuals to decide whether they want the vaccine, is a change from previous years when the committee broadly recommended the vaccine as part of its fall respiratory illness vaccine regimen.

Jim O’Neill, the acting director of the CDC and deputy secretary of the U.S. Department of Health and Human Services, still needs to approve the committee’s recommendations. Once approved, the North Carolina Department of Health and Human Services will officially pass them down to county health departments.

NCDHHS is waiting on CDC approval before providing details on this season’s COVID-19 vaccine, the department wrote on Monday in an email statement to CityView. 

Whether the vaccine is covered under the Vaccines for Children program is a particular sticking point for Cumberland County’s health department, Green said. The program, funded by the CDC and administered by the state, pays for the vaccines of children 18 years old and younger whose parents otherwise couldn’t afford them.

“I anticipate that we will not actually get the vaccine in hand until we get clarity on what’s actually covered or allowed under the VFC [Vaccines for Children] program,” Green said. She expects to receive state guidance and order the vaccines sometime in October.

The CDC committee’s recommendations state that the shots are covered “through all payment mechanisms,” including the Vaccines for Children program, Children’s Health Insurance Program, Medicaid and Medicare. The committee recommended that insurance plans available on the federal Health Insurance Marketplace — also known as the Affordable Care Act (ACA) Marketplace — cover the vaccines.

On Sept. 15, the Cumberland County Board of Commissioners said it would waive the cost of any COVID-19, flu and RSV vaccine for uninsured and underinsured residents. The commissioners’ decision allows those with a private health insurance plan that does not cover a shot to get it at the county health department for free, Green said.  

However, it may not be needed as insurance provided by most large employers in the country will cover the COVID-19 vaccine, James Gelfand, president and CEO of ERIC, a nonprofit that helps companies plan their employee benefits, told USA Today. AHIP, the national trade association representing the health insurance industry, announced on Sept. 16 that its over 100 members will cover the vaccine through the end of 2026 without any cost sharing.

Green also said her department is trying to decipher exactly what the committee means by “shared clinical decision-making” and what proof residents need to show that they’ve gone through it to receive a vaccine. She said the department’s vaccine clinic workers have always given residents information sheets for any vaccine, and discussed with them the risks, possible side effects and benefits the shots provide. 

With immunization clinics already scheduled for next month, Green said she is concerned residents won’t be able to get the COVID-19, flu and RSV shots during a single event. This could cause them to go without a COVID-19 vaccination this year, she said.

“It’s challenging to get people vaccinated in the first place,” Green said. “To get them to come back twice is a barrier to care.”

Until the CDC approves the latest recommendations, residents must follow the Federal Drug Administration’s recommendations for the COVID-19 vaccine, which state that they can get a shot from a pharmacy if they have a prescription and are:

• 65 or older.

• Between 18 and 64 years old and have at least one high-risk health condition listed on the CDC’s website, which include: pregnancy, cancer, asthma, diabetes, sickle cell disease, substance use disorders, mental health conditions and HIV. 

NCDHHS Secretary Devdutta Sangvai issued standing orders on Sept. 12 that act as a prescription for the COVID-19 vaccine. In its statement, NCDHHS recommended eligible residents get the shot and suggested calling a local pharmacy to check if they have them in stock.

“Vaccines are one of the most effective means available to prevent severe illness, hospitalization and death,” the department said. “They help protect the health of children and adults, their families, and the entire community from the spread of infectious diseases. Getting your vaccinations now for COVID-19, flu and RSV if you are eligible is important so you have the best protection during peak respiratory virus season through the winter months.”

COVID-19 is already spreading in North Carolina, according to wastewater monitoring data from NCDHHS, which helps the department determine the spread of COVID-19. The data shows very high virus activity across the state ahead of the respiratory illness season, which typically begins in November with peaks in January and February.

In Fayetteville, COVID-19 is also increasingly spreading in the community, according to data from NCDHHS’s monitoring station in the Rockfish area. Since the start of August, there’s been a twelve-fold increase in the number of virus particles detected per person in the city’s wastewater.

CityView Reporter Morgan Casey is a corps member with Report for America, a national service program that places journalists into local newsrooms. Morgan’s reporting focuses on health care issues in and around Cumberland County and can be supported through the News Foundation of Greater Fayetteville.