New Covid Shots May Be Hard to Come by for Uninsured Georgians
Georgia has a low vaccination rate for COVID-19, with 17.4% of adults having received an updated shot last year, according to U.S. Centers for Disease Control and Prevention data.
By Rebecca Grapevine, Georgia Public Broadcasting
Updated COVID vaccines, slated to hit shelves this week, could come with serious sticker shock for more than a million Georgians who don’t have health insurance.
The shots will cost around $201.99 for uninsured patients paying out of pocket at CVS, spokesperson Amy Thibault said.
The newly approved COVID vaccines should provide “great coverage” for current versions of the virus and will be effective in preventing serious hospitalizations and death, Emory University epidemiologist Jodie Guest said.
But doctors and public health practitioners are concerned about vaccine access and equity as Georgia is seeing “very high” rates of COVID and the federal Bridge Access Program, which provided vaccines to uninsured adults, ends this month.
With about one million uninsured adults under age 65, Georgia has one of the highest uninsured rates in the country. It also has a low vaccination rate, with only around 17% of adults having received last year’s COVID vaccine as of May this year, according to U.S. Centers for Disease Control and Prevention data.
“This season is going to be a very difficult COVID and flu season,” said Dr. Cecil Bennett, a family medicine doctor and fellow at Morehouse School of Medicine.
He warned that the ending of the federal vaccine access program could contribute to lost productivity and more deaths. COVID caused 2.4% of all deaths in Georgia in the week leading up to August 10, according to the CDC.
“This is not the time that I would say the federal government should be penny wise and pound foolish,” Bennett said.
For comparison, New York state also has about one million uninsured people. But NYC Health + Hospitals, the city’s public health system, continues to offer COVID-19 vaccines at no cost to patients, said Dr. Jonathan Jimenez, a primary care doctor and executive director of NYC Care, which connects uninsured New Yorkers to services.
Nationwide, the vaccines will still be free for Marketplace and Medicare enrollees. Uninsured, underinsured and Medicaid-eligible kids should be able to get the vaccines for free under the Vaccines for Children program. And CVS said the shots should be free under most insurance plans at in-network pharmacies.
The CDC last week announced a tranche of $62 million that states across the country can use to buy vaccines for uninsured people as the Bridge Access Program ends.
Georgia already planned to purchase 4,600 updated COVID shots for underinsured and uninsured people, and last week applied to the CDC for funds to cover an additional 33,540 shots, Department of Public Health spokesperson Nancy Nydam said.
That would bring the state’s supply to 38,140 vaccines for uninsured and underinsured adults. Those would be distributed to county health departments and around 30 external providers through the state’s Adult Vaccine Program.
While that’s “still not enough to cover every uninsured and underinsured adult in Georgia,” Nydam said, “this still puts us in a better position to serve adults who seek service through our [Adult Vaccine Program] provider sites.”
Campaign to take on vaccine hesitancy
Beyond that program, the state health department plans to roll out its annual multi-platform campaign in the fall encouraging people to be vaccinated for COVID and flu, Nydam said. The campaign will include billboards, radio/TV, digital, web and social media.
Vaccine events are typically held at the district level. Events and clinic hours and appointments are listed on district websites and social media. DPH also works with the Community Organized Relief Effort (CORE) to provide vaccines through local organizations and faith-based groups.
Dr. Harry Heiman, a clinical professor at Georgia State University’s School of Public Health, said he would love to see how the state might work to boost federal efforts and fill any gaps.
“Those are the kinds of state level plans that even in the absence of guidance from the federal government you would hope are being put into place,” Heiman said.
For many local Georgia health departments, uptake remains a challenge.
For example, in DeKalb County, with a population of about 760,000, fewer than 200 people got COVID vaccines from the board of health between January and April, spokesperson Eric Nickens said.
In neighboring Fulton County, with a population just over one million, spokesperson Darryl Carver said the board of health has “actively continued promoting” vaccines as part of its #VaccineWorks campaign. But the agency has administered just 375 COVID vaccines so far this year.
Charity clinics lack funds for COVID shots
The end of the free federal vaccine program also means that nonprofit and charity clinics must now cobble together funds to provide vaccines, and some clinics are not able to provide them at all.
Georgia’s 35 federally funded nonprofit health centers will be able to continue providing vaccines, said Dr. Theresa Jacobs, medical director for the Georgia Primary Care Association, which represents the clinics.
The clinics serve around 650,000 patients a year, about a third of whom are uninsured. The clinics will rely on partnerships with public health departments and other groups as well as “small grants” to fill in the gaps for uninsured adults.
“They’re not going to miss a beat,” Jacobs said. “They’re going to still be able to offer them either free or at a very low discounted price for those that are uninsured.”
But some charity clinics are not able to offer COVID vaccines. For example, Clarkston Community Health Center, a free health clinic that serves uninsured people, including many refugees, is no longer able to provide any vaccines, said executive director Jeremy Cole, because of “funding shortages.”
“Funding for a charitable clinic is always a challenge, and we have not had grants or funding in the past few years that would allow us to relaunch a vaccine program,” Cole said. “But we are working on it.”
Many large metro Atlanta health systems like Wellstar, Emory and Children’s Healthcare of Atlanta do not offer the vaccine onsite, instead referring patients to other providers. Grady Health System provides COVID vaccines at its primary care clinic and neighborhood health centers, spokesperson Danielle Hackett said.
Representatives of another large health system, Piedmont Healthcare, did not respond to questions about whether they provide the vaccine.
Uninsured left vulnerable to COVID risks
Some vaccine advocates say that given Georgia’s low uptake rates, healthcare providers and policymakers should focus on removing as many barriers to access as possible.
“The way that I think about this is that the second someone decides they’re ready to get a vaccine, there should be no additional barriers to that,” said Marquisha Johns, associate director for public health policy at the Center for American Progress, a left-leaning think tank.
“We should make it as easy as possible for them to take the very next step into actually getting the shot in their arm, because there are already so many barriers to getting the person to the first step,” Johns said.
The end of the program puts a burden on uninsured Georgians who need key preventive care like the COVID-19 vaccines, said Laura Colbert, executive director of Georgians for a Healthy Future, a health advocacy group in Atlanta.
Uninsured Georgians may have to cover their own vaccine costs, Colbert said, which “unfairly leaves them vulnerable to illnesses and health conditions that other Georgians are better protected from.”
Johns pointed out that Georgia policymakers could find a way to increase funding for vaccines in the state, especially since the state has a large uninsured population.
“If they wanted to make that a priority, they definitely, absolutely could say, like, ‘Us as the state of Georgia will guarantee that all of our uninsured people will have access to these. Every uninsured person will have access to these five vaccines,’” Johns said.
“The vaccine should be available for everyone,” said Christopher Pride, the director of clinical care at Positive Impact Health Centers, which provides comprehensive sexual health care in Atlanta. “Cost can make people, you know, determine whether they’re going to put food on their table or get a vaccine.”
Pride said he ensures the Positive Impact clinics always have vaccines available to patients. With the ending of the Bridge Access Program, the clinic has turned to other funding streams to ensure it can continue to offer the shots at low or no cost to patients.
“People who are hesitant are more likely to accept the vaccine from someone they trust, and that’s why the doctor’s office is key,” Pride said. “We will ensure that we always have it, regardless [of whether] you’re insured or uninsured.”