California moved from a risk-based to an age-based system for the COVID-19 vaccine in January. People with disabilities say that pivot cast them aside and they should have been prioritized.



With the approval of the Johnson & Johnson vaccine, California says all residents could be inoculated against COVID-19 by summer. But some people with disabilities that put them at high risk for COVID-19 say that even as vaccinations accelerate, they still feel left behind. Reporter Adwoa Gyimah-Brempong has the story.

ADWOA GYIMAH-BREMPONG, BYLINE: On March 6, 2020, Mimi Newman went into strict quarantine with her wife and two dogs.

MIMI NEWMAN: Want to go outside? Let's go. Come on. Let's - going to go outside.

GYIMAH-BREMPONG: That means outside is a relative term. More than a year later, she's only been past her front gate three times.

NEWMAN: It was clearly a virus that was going to spread fast. And it wasn't a difficult choice for me to make. I did not think that we would be where we are now.

GYIMAH-BREMPONG: Newman is severely immunocompromised. As of last December, that made her eligible for the vaccine in the state's tier 1C. But then on January 25, California joined states like Indiana and Rhode Island in pivoting from a risk-based priority system to an age-based one. That meant Newman, who's 31, now had to wait till mid-March.

NEWMAN: That decision to revoke the tier system in California and just go by age felt like just like somebody taking a pen and underlining the sentence, disabled people don't matter.

GYIMAH-BREMPONG: Age-based vaccine systems are the norm. Think of the shots needed for school. But things change in a pandemic when everyone needs a shot at the same time. The state's original system makes sense on paper - prioritize folks in health care and other essential workers. But those designations create some odd loopholes. For instance, landscapers and outdoor exercise instructors have been eligible for the vaccine since early February, while folks with heart failure or chronic pulmonary disease have had to wait.

PETER CHIN-HONG: The infrastructure limitations are huge in California.

GYIMAH-BREMPONG: Doctor Peter Chin-Hong specializes in infectious disease, and he says that given the size of the state, age-based allocation has the benefit of simplicity. It's easy to verify. Plus, California's definition of who's at high risk is messy.

CHIN-HONG: So diabetes Type 2 is recorded on the medical conditions list, but not diabetes Type 1. From a medical perspective, there's no real difference.

GYIMAH-BREMPONG: Chin-Hong says the difference is in the data. More people have diabetes Type 2. So there's more evidence showing that the condition puts you at higher risk of dying from COVID-19. But there's an ethical conversation that's separate from the science. Some people are more vulnerable, but vaccine scarcity sets up the question, who's more important? Bioethicist Jen James puts it like this.

JEN JAMES: Those questions of individual value who sort of quote-unquote "deserves" a vaccine or needs a vaccine more are directly butting heads with who do we need to be vaccinated for the good of our society to allow our economy to continue and to allow the greatest number of people access to essential services.

GYIMAH-BREMPONG: That's why health care and agricultural workers got the vaccine first. But for Mimi Newman, equating the economy with the good of our society is why she's still inside.

NEWMAN: My life isn't worthless. It might be financially worthless because somebody decided that it was, but I still feel the same things. If I'm having a hard pain day, I find it almost impossible to communicate verbally. But that doesn't mean that I'm not feeling.

GYIMAH-BREMPONG: On March 15, Newman will join millions of Californians who are newly eligible for the vaccine. In the meantime, she's entering the second year of the pandemic exactly where she started the first - stuck inside, waiting.

For NPR News, I'm Adwoa Gyimah-Brempong.