By S. Mitra Kalita
This 78-year-old Woodside, Queens man wanted a vaccine. We cut and paste below what he received from the Walgreens site upon registration:
Walgreens
Dose 1:
164 KENT AVE
BROOKLYN, NY 11249
718-302-1549
Appointment Date & Time
Monday, March 1, 2021 at 09:45 am
Dose 2:
45-02 43RD AVENUE
SUNNYSIDE, NY 11104
718-433-0941
Appointment Date & Time
March 29, 2021 at 05:30 pm
He canceled because he does not have a car and could not get to Brooklyn. (We helped him find another appointment, closer to home.)
On March 21, a man with a comorbidity reported being denied a vaccine because the pharmacy said it was only serving those 60+ or in childcare or education.
Another said she was asked for insurance, even though neither insurance nor immigration status is required for a vaccine.
There also have been multiple reports of doctors’ notes requested at pharmacies even though New York State has repeatedly said self-attestation for an underlying illness is enough. At a pop-up at an independent pharmacy in Brooklyn on Sunday, four people were denied vaccines because they did not have required paperwork; two returned home to Queens and two waited till the end of the day and received leftover doses. A Queens restaurant worker was denied his vaccine today at a pop-up clinic in Long Island City, despite having an IDNYC card, because the site wanted a license or other proof of New York State residency; he also had proof of employment.
Epicenter, which has registered thousands of people for vaccine appointments, has encountered these complaints regularly. In response, our volunteers created a public folder of documentation examples. This week, we asked the public relations departments of Walgreens and CVS to explain their protocols in New York State. The complete q-and-a follows this article. But some key takeaways, starting with a really really big one:
Walgreens said it is wrong if New York pharmacies are asking for doctors’ notes. A spokesperson said: “We do not require any documentation related to medical conditions unless required by the state/jurisdiction, and it is not required in the state of New York or New York City.”
The pharmacy chain, the second largest based of number of stores (CVS is first), also said it will offer second dose appointments, based on supply and appointment availability, regardless of where a person received the first shot. Walgreens also said it is trying to work with scheduling Pfizer shots at the 21-day mark instead of the 28-day mark as it currently does (another issue that has confused vaccine recipients).
Both New York State and New York City have said that self-attestations are sufficient as proof of qualifying medical condition.
The NYC guidance is here: (Relevant portion: “You do not need documentation from your personal health care provider or any other proof of your condition to get a vaccine in NYC. It is only necessary for you to self-certify you have an underlying condition that makes you eligible.”)
The NYC self-attestation form is here.
The NYS guidance is here: (Relevant portion: “For individuals with certain comorbidities or underlying conditions, at state-operated mass vaccination sites, any of the following proof is acceptable to prove eligibility: • Doctor’s Letter, or • Medical Information Evidencing Comorbidity, or • Signed Certification…The mandatory New York State COVID-19 Vaccine Form includes a self-attestation regarding eligibility for vaccination and New York residence or employment in New York, which must be completed prior to vaccination.”)
The New York State general attestation form is here.
Other edited excerpts:
Epicenter: Why are first and second doses scheduled in different locations sometimes? Seniors are confused, say they cannot travel, etc.
Walgreens: Our online scheduler (Walgreens.com/ScheduleVaccine) now defaults to automatically schedule patients for their first and second doses at the same location to ensure a seamless experience and provide a clearer view of available vaccine inventory. We are committed to continuing to enhance our scheduling experience to achieve the shared goal of vaccinating our most vulnerable populations as quickly as possible.
Patients may update the time/date/location of their second dose appointment via the online scheduler, by calling 1-800-Walgreens, in-store or by calling their local Walgreens. Patients may elect to schedule their second dose appointments at any Walgreens location that has available appointments and inventory.
CVS: Our digital vaccine scheduling system on CVS.com searches for available nearby appointments based on the zip code entered by the customer. Patients are able to see which CVS Pharmacy location has which vaccine and appointment availability on CVS.com before scheduling, and they are given a choice of where they’d like to schedule their two appointments (if required).
In most cases, first and second doses are scheduled in the same store location. Due to the select number of CVS Pharmacy locations offering the vaccine and the limited supply we received from the federal government, there are rare instances when two locations are necessary and may be a longer distance to ensure the corresponding second dose is administered within the recommended timeframe to ensure best protection against Covid-19.
Epicenter: If a pharmacy gives out extra, unused doses at the end of the day, does it account for the recipient’s second dose? How so?
Walgreens: Walgreens is committed to ensuring every dose of COVID-19 vaccine is used. At this time, demand for vaccines outweighs supply, so excess doses are rare. If there are available doses at the end of the day that are due to expire, our pharmacists are embedded in their communities and proactively reach out to eligible customers to offer the vaccine. The CDC provided guidance on excess doses with the FRPP [Federal Retail Pharmacy Program] announcement, which can be found here.
In the event that an excess dose is distributed to an eligible patient who was not scheduled in advance to receive it, the patient would be able to schedule their second dose at that time in-store. Additionally, second doses may be scheduled via the online scheduler or by calling 1-800-Walgreens.
We are committed to honoring all appointments and providing second doses to all patients, regardless of where their first dose was administered.
CVS: In the event a patient receives a first dose of a COVID-19 vaccine without a prescheduled appointment for the corresponding second dose, our pharmacy teams will work with the patient to assist them with scheduling their second dose within the recommended timeframe for the vaccine they received.
Epicenter: Why are you doing 28 days of waiting for the second dose of Pfizer too? This is a question we are getting from seniors. Again, they are confused.
Walgreens: In many states, our stores carry COVID-19 vaccines from multiple manufacturers simultaneously, as determined by federal and state allocation. The CDC states that second doses of Pfizer-BioNTech and Moderna COVID-19 vaccines may be administered up to 42 days after the first dose, but no earlier than the recommended interval of 21 and 28 days respectively. We are automatically scheduling patients’ second doses to occur a minimum of 28 days following their first dose to ensure that no dose is administered earlier than the authorized intervals and patients are able to complete the series vaccination. Walgreens is currently working on system enhancements to our scheduler to account for multiple manufacturers with different dose 2 schedules to automatically schedule patients’ second dose either at day 21 or day 28.
At this time, our pharmacists have been instructed to proactively educate patients receiving dose 1 of the Pfizer-BioNTech COVID-19 vaccine that the 28-day interval is appropriate based on CDC guidelines. After day 20, patients have the option reschedule their second dose appointment on Walgreens.com or can work with directly with their local store to reschedule based on appointment availability.
CVS: When patients make an appointment for their initial shot online or through the CVS app, they are prompted to schedule an appointment for their second dose at the same time (if receiving Moderna or Pfizer). The second dose is scheduled within the appropriate timeframe, allowing enough time for a potential reschedule of the appointment, if needed. CVS Health has implemented a detailed tracking system to make sure we know who received which vaccine and to help ensure they get the second dose of the same vaccine, if needed. Upon receiving their first dose, patients are provided with a vaccine card with all relevant vaccination information. Detailed reporting will be shared with state, local or territorial public health authorities.
Epicenter: Now that pharmacies can give vaccines to comorbidity cases, we have heard from a few people that the self-attestation form that NYS allows was rejected and they need doctor’s notes or MyChart proof. I am wondering if there’s a reason pharmacies want this paperwork versus the state and city sites?
Walgreens: Customers must attest to meeting jurisdiction eligibility requirements when making an appointment through Walgreens.com/ScheduleVaccine or by calling 1-800-Walgreens, which is available in English and Spanish. Patients are also required to attest a second time to their eligibility when they arrive to their appointment. The relevant jurisdiction eligibility requirements are provided to customers in advance of each attestation. We do not require any documentation related to medical conditions unless required by the state/jurisdiction, and it is not required in the state of New York or New York City.
CVS: As part of our online scheduling process, individuals must affirm that they meet the eligibility requirements in the state they want to be vaccinated in before an appointment can be booked. We reserve the right to cancel a vaccination appointment if it is determined that an individual does not meet any of the state eligibility requirements to be vaccinated in a pharmacy.
Epicenter: What is your guidance on vaccinating undocumented populations?
Walgreens: The intent for asking for ID at the time of appointment is to confirm the person receiving a vaccine matches the individual who made the appointment online and attested to meeting the eligibility requirements outlined by the state or jurisdiction. In New York, state guidelines require our team members to validate government-issued IDs to confirm that the patient is 50 years old or older.
CVS: Per our recent announcement, we are committed to addressing potential inequities related to COVID-19 vaccine access in underserved communities, with a particular focus on Black and Hispanic populations.
In addition, the COVID-19 vaccine is covered through a federal program for the uninsured. If a patient does not have insurance, we are required by the Health Resources and Services Administration to ask the patient to provide either a social security number or valid driver’s license/ state ID #. However, uninsured patients are not required to provide this information in order to receive a vaccine from us.
Epicenter: The spillover effect of all this on your pharmacy and nursing staffs… What do we want people to know/understand? Also, is there a way to help those incoming folks in a different way than turning to the store?
Walgreens: While Walgreens is ready to administer COVID-19 vaccinations at scale through our 9,000+ store locations by May 1, it’s important to remember that appointment availability will still be dependent upon vaccine supply. At this time, eligible individuals can receive the vaccine at Walgreens store locations according to state and local eligibility guidelines. Covid-19 vaccination appointments can be made by visiting Walgreens.com/ScheduleVaccine, through local department of health websites, by calling 1-800-Walgreens or by calling a local Walgreens pharmacy. Eligible patients can also sign up to receive alerts for when appointments open up in their area. We continue to work hand in hand with the state of New York to vaccinate vulnerable patients as quickly as possible.
We would also encourage customers with questions about COVID-19 vaccinations – including appointment scheduling, current eligibility guidelines, and in-store vaccine availability in their area – to call 1-800-Walgreens. Our Customer Care team members are available and happy to address any questions or concerns they may have.
CVS: While we have had the occasional patient seeking a walk-up vaccine appointment, we have not experienced people demanding doses or yelling at our pharmacy staff.
We have created a fully digital end-to-end experience for COVID-19 testing and flu vaccinations, and we are putting these same tools to work to schedule COVID-19 vaccinations, including—importantly—the required second dose.
Vaccines at participating CVS Pharmacy locations will be available to individuals meeting state criteria, as well as well as K-12 teachers and staff and childcare workers. Individuals must register in advance at CVS.com or through the CVS Pharmacy app, and people without online access can contact CVS Customer Service: (800) 746-7287.
Walk-in vaccinations without an appointment will not be provided.
We are also reaching out to patients in vulnerable communities to help them make appointments and to answer questions or concerns they may have about being vaccinated as part of our recently announced commitment to addressing potential inequities related to COVID-19 vaccine access in underserved communities, with a particular focus on Black and Hispanic populations.
Have you run into the problem of a pharmacy denying you vaccine access because you provided self-attestation for an underlying illness and not a doctors’ note? Our volunteers created this template for you to provide to the pharmacy.
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