While helpful to some, websites and apps have only compounded the frustration for many people seeking vaccines.

This article was published on Thursday, February 11, 2021 in Kaiser Health News.

By Miranda Green

On Jan. 14 at 8:43 p.m., Patrick McKenzie tweeted a plea for tech engineers to help him set up a website to track covid-19 vaccine availability in California. McKenzie, who heads a Bay Area financial services tech company, issued the call to "anyone in California [who] wants to do a civtech project which matters."

The response was swift and resounding. In less than an hour, someone had set up a chat group for brainstorming the effort. By 12:24 a.m. the next day, 70 people had joined. By noon, the tracker was live. Now, just over two weeks later, the site, called VaccinateCA, involves about 300 volunteers. They operate what is essentially a call bank, dialing pharmacies and hospitals for updates about covid vaccine supplies and posting the results on the site.

The quick and ardent response to McKenzie's pitch highlights just how desperate Californians have become amid a chaotic vaccine rollout that has overwhelmed public health departments. Similar crowdsourced websites have gone up in Georgia, New Jersey, Michigan, Texas and other states.

While helpful to some, however, the websites and apps have only compounded the frustration for many people seeking vaccines for themselves or loved ones but can't secure an appointment no matter how hard they try because supply is limited. Critics say that, at best, they simply enable the tech-savvy and people with time on their hands — two groups that don't necessarily overlap with those most in need of covid vaccination — while leaving poor and minority communities behind.

"If you have an hourly job, you're not going to be on your phone every minute," said Jeffrey Klausner, a professor of preventive medicine at the University of Southern California's Keck School of Medicine, who likened the process of securing a vaccination to "The Hunger Games."

"We need call centers. We need people going out into the community door to door, registering people as if there were a census. You need to somewhat structure the system to allow and prioritize access for the most disadvantaged — reversing structural racism, or factors that exclude certain groups."

Rhonda Smith, executive director of California Black Health Network, said it's vital to reach out to communities where vaccine hesitancy is strong. While technology can help centralize information, building trust and relationships is what's needed to convince skeptical communities of the vaccines' importance.

"They aren't going to just respond to a text message or a random app," she said.

Platforms like VaccinateCA acknowledge their limitations. "We recognize that this isn't our core strength today," said Zoelle Egner, a volunteer with the site. But the app could be a resource for organizations that work with disenfranchised communities, she said.

California is also working with an online platform called My Turn, developed by Salesforce, that will alert residents when they are eligible for vaccination and facilitate sign-ups. The state announced last week that it had hired insurance company Blue Shield of California to create and manage a statewide vaccination network.

While some platforms offer a central place to search for pharmacies and links to sign up for updates from hospital systems or local governments, they can't provide more vaccine-filled needles. With limited supply, a thousand allocation snafus and conflicting information about who is eligible, consumers find themselves signing up for wait lists and spending hours trying to snag appointments, only to be told there's no vaccine for them or their loved ones. The apps can't do anything about that.

Many users have found success. Melissa Reyes, who lives in Sacramento, was able to get her 76-year-old mother vaccinated after checking VaccinateCA. She called four pharmacies listed on the site before she hit the jackpot with her local Save Mart. She tweeted to VaccinateCA to thank the group.

For many others, success rests on luck: clicking through to the right pharmacy or supermarket website at the right time before all appointments are gone. For every exuberant user, there are often multiple frustrated people unable to land an appointment.

Misa Ahmad, whose 83-year-old father lives in Oakland, said VaccinateCA didn't work for her. She ended up deciding to wait for her father's healthcare provider, Kaiser Permanente, to contact him with an opening. (KHN, which produces California Healthline, is not affiliated with Kaiser Permanente.)

Her VaccinateCA search involved "going through trying to look at all of the places and figure out what they are, where they are, if they would be optimal for him, and then locating some and then trying to see if I can get an appointment. That is a very time-consuming process. And, unfortunately, my father has limited technological ability."

Other users have found that the information provided is sometimes inaccurate, a product of ever-changing state and county regulations. Many Californians are still finding that, while Gov. Gavin Newsom announced that residents age 65 and older are eligible for the vaccines, their counties are still allowing only those 75 and older to sign up. Who is eligible for vaccination differs by county.

"What's really frustrating is I keep getting texts and emails from the Department of Public Health saying, 'You're eligible for the shot; call your healthcare providers,' and you call and no one is giving it to your age yet," said Leanna Dawydak, a 66-year-old San Franciscan. She estimates she's spent an average of four hours a day since Jan. 13 trying to find an appointment, only to be told she's too young, lives in the wrong county or gets her care from the wrong healthcare system.

Some localities have purchased or set up their own apps, with mixed results. Orange County reportedly paid $1.2 million to tech company CuraPatient to create an app for organizing the vaccination of county residents. County public health officials had registered 493,000 people as of Jan. 29, with about 81,320 having received a vaccine.

But the app, Othena, has gotten bad reviews. Residents say its interface is unfriendly, with bugs that have resulted in people being improperly scheduled for appointments.

"It's a disaster. It's a total mess," said Suzanne Haggerty, 60.

Haggerty, who has severe asthma, scheduled a vaccination through Othena, drove 45 minutes from her home to the vaccination site at Disneyland and spent two hours standing in line with her appointment and barcode in hand. She was turned away once she got to the front. A glitch in the app had cleared her for an appointment available only to those 65 and older. Staffers told her that about 50 people a day were being turned away for the same reason.

Still, some tech companies are confident they can ameliorate the scheduling fiasco.

Zocdoc, a web platform founded in 2007 to bring patients in for last-minute appointments with doctors, built a pilot program with New York's Mount Sinai Hospital late last year for scheduling covid vaccinations for hospital staffers. Now the company has begun a partnership with the Chicago city government to offer its vaccine scheduler tool — free — to care organizations and public health agencies, said Zocdoc founder and CEO Oliver Kharraz. His company's years of experience with scheduling software is a huge advantage, he said.

Zocdoc is the main platform for Chicago residents to make vaccination appointments free of charge, aggregating real-time appointment openings from various vaccination sites and care organizations. But vaccine supplies and shipments are out of his control, Kharraz said.

"I want to make the following disclaimer," he said. "The vaccines, per se, are in short supply. So, I think Chicagoans should expect limited availability."

Miranda Green: mirandac.green@gmail.com, @mirandacgreen

The concerns arising in western North Carolina, a region tucked between Asheville to the east and the Appalachian Mountains to the west, provide a window into the challenges facing health workers across the country.

This article was published on Wednesday, February 10, 2021 in Kaiser Health News. This story also ran on The Charlotte Observer. It can be republished for free.

By Aneri Pattani

Kim Wagenaar has been preparing to bring covid-19 vaccines to western North Carolina for months.

She’s signed up the community health center she operates in Asheville to receive and distribute the doses. She’s ordered a subzero freezer to store the Pfizer-BioNTech vaccine and transport it to rural counties. She’s also allocated her staff between covid testing sites and vaccine clinics.

But those logistics make up only half the equation, said Wagenaar, CEO of Western North Carolina Community Health Services.

Because the vaccines have a limited shelf life, “you want to make sure you’re ordering what you think you’ll be able to give,” she said. “That’s where messaging comes in.”

While many of the health center’s patients are eager to get their shots, Wagenaar said, she’s worried about other populations in the region — from communities of color to migrant farmworkers and people who live on the street — who may be reluctant to be vaccinated, even though they are more likely to contract the virus.

“It’s so important in this time to go beyond our normal education to reach more communities,” she said.

The concerns arising in western North Carolina, a region tucked between Asheville to the east and the Appalachian Mountains to the west, provide a window into the challenges facing health workers across the country. Not only do they have to transport the vaccine to vulnerable populations, but they also must address those individuals’ concerns and encourage them to take the shots.

Polls show Black and Hispanic Americans, as well as residents of rural areas, have expressed greater reluctance about the vaccine. And disparities in vaccination rates are already emerging.

Now, a host of grassroots organizations in western North Carolina are taking to the streets, to WhatsApp chats and to Zoom lunches to close that gap.

‘You Can Be a Community Hero’

When Adrienne Sigmon talks to people living on the street in Asheville about covid vaccines, she doesn’t suggest the medical system is trying to help them.

As someone who was unsheltered for two years, she knows mistrust of health workers runs deep. Many people who are homeless receive poor care or no care at all.

Instead, Sigmon frames the vaccine as an opportunity to help society. “By getting vaccinated, you can be a community hero,” she tells them.

“Giving people that ownership and sense that they can help in this small way is empowering,” she said.

That’s how Sigmon felt four years ago when she joined the street medic team at BeLoved Asheville, a nonprofit that tackles issues like homelessness and hunger. The team trains people who are currently or formerly unsheltered in basic medical skills, from first aid to wound care and overdose prevention.

“Instead of other people coming in to say, ‘I’m going to fix you and serve you,’ we learn to take care of ourselves and the community,” said Sigmon, who is now a lead street medic.

On Mondays and Thursdays, Sigmon and her team travel through downtown Asheville and the rural corners of Buncombe County to hand out lifesaving supplies like insulated tents, sleeping bags, thermal socks, face masks and hand sanitizer to those living outdoors. Now they also pass out flyers about the vaccines and ask people if they’ll pledge to get their shots.

Some refuse, Sigmon said. They may suffer from mental illness, not believe covid is real or not care if they get sick.

But more often, people have questions: Will I get sick if I get a vaccine? Is it safe, since it came out so quickly?

Sigmon assures them that the vaccines don’t contain the coronavirus and that, although the development process was quick, it built on a decade of research.

Of the hundreds of people Sigmon and her team have spoken with, about 75% have agreed to be vaccinated.

‘Think About Your Older Roommates’

Migrant farmworkers begin arriving in western North Carolina in February, when they work in greenhouses, and stay through the fall or early winter, harvesting crops and Christmas trees.

This past year, conversations about covid vaccines began in July, said Jessica Rodriguez, outreach coordinator for Vecinos Farmworker Health Program, which provides medical services to about 500 migrant workers in the region.

At the time, covid outbreaks across two farms sickened nearly 100 men. “When will this be over?” the workers asked her.

Since then, Rodriguez and her team have been updating the farmworkers about the vaccines.

Men in their 50s and 60s have generally been eager, Rodriguez said. But the younger workers, some just 18 years old, have been hesitant. They’ve received conflicting messages about the seriousness of the virus from family back home, and sometimes from their home countries’ governments.

“Think about your older roommates,” Rodriguez tells them in Spanish. The workers live in tight quarters, often old converted hotels tucked behind a main road or cabins perched on the side of a mountain, with anywhere from five to 50 men together.

“You could get covid and feel nothing at all,” Rodriguez said, “but if you pass it to someone who is older or has diabetes, he could end up in the hospital.”

Rodriguez also posts fact sheets in Spanish on her WhatsApp story, where anyone with her phone number can view them. That’s been particularly popular, she said. Since the workers’ schedules rarely allow them to check for health advisories from the White House or watch the state health secretary’s afternoon telecasts, updates from Rodriguez and her team have been crucial. Even workers she met a few years ago who now live in other countries have messaged her to say thanks for the information on WhatsApp.

Her team also provides in-person education at the camps, where they often bring food and medical supplies.

“As soon as we’d arrive, the whole crew would come out,” she said. “Some of our covid education sessions went up to an hour because the guys had so many questions.”

‘You All Are My Ambassadors’

Kathey Avery, a community health nurse, has been hosting monthly lunch-and-learn meetings for a group of 14 women for nearly a decade.

The youngest attendee is in her 50s, and the oldest is 94. Most are Black women who go to church, volunteer in the community and are in regular contact with their extended families, said Avery, who also co-chairs the Institute for Prevention and Healthcare Advocacy, a grassroots organization that addresses health disparities in Buncombe County.

“Whenever I need to get information out, I tell them, ‘You all are my ambassadors,’” said Avery, who is Black too. “That always makes them smile.”

In the past, Avery talked to them about topics like chronic disease and nutrition. During the pandemic, she’s moved the lunch-and-learns to Zoom and talks about covid symptoms, testing and, now, vaccines.

Black people’s history of mistreatment in the U.S. makes the vaccines a tough sell, Avery said. Many worry about a repeat of the infamous Tuskegee trial, in which Black patients with syphilis were purposely left untreated. Others point to the brutal response to Black Lives Matter protests and efforts to suppress Black votes.

That’s why education about the vaccines has to come from a place they trust, Avery said.

She tries to keep it simple, using a one-page document she created with answers to questions like “What is the definition of ‘vaccine’?” and “What is the definition of ‘virus’?”

It’s a matter of homing in on a couple of points and relating it to “something you know they already know,” Avery said.

Then you build on that knowledge in a second conversation, and a third and fourth.

“If you’re not talking to people and building trust over time,” Avery said, “they won’t listen.”

Biden proposes hiring 100,000 people nationwide as part of a new public health jobs corps. They would help with contact tracing and facilitate vaccination.

This article was published on Wednesday, February 10, 2021 in Kaiser Health News.

By Steven Findlay

Contact tracing, a critical part of efforts to slow the spread of the coronavirus, has fallen behind in recent months as covid-19 cases have soared. President Joe Biden had pledged to change that.

Biden proposes hiring 100,000 people nationwide as part of a new public health jobs corps. They would help with contact tracing and facilitate vaccination. Experts said it's not clear that would be enough tracers to keep up with another surge in covid cases, even if the vaccination rate increases at the same time.

As with everything covid right now — testing, vaccinations and hospital capacity — ramping up contact tracing has become a race against time as new, more contagious variants of the virus threaten to accelerate transmission of the disease.

In addition, as testing has steadily increased to around 2 million per day, so has the need for tracing. The two go hand in hand. Also, even conservative estimates put the number of people with undetected infection at two to three times the number with reported positive test results.

Such estimates translate to 75 million to 100 million infections in the U.S. Officials in California's Los Angeles County reported Jan. 14 that an estimated third of the population of the county, the nation's largest, was likely infected.

I have experienced the urgency of the pandemic up close. With a leap of faith, I became a foot soldier in the covid fight last June as a contact tracer in Maryland. Talking by phone to dozens of infected and exposed people every week, I hear about the impact of the virus on families in often sobering detail.

We tracers, for example, are often the first to reach people with their positive test results since labs and health systems frequently get backed up. For people already experiencing symptoms, our calls usually confirm what they suspected. For people without symptoms, though, we are the bearers of unwelcome news. That's not an easy part of the job.

Still, almost everyone we interview takes it in stride. They agree to isolate and provide us with the names of people they've come into "close contact" with — generally, within 6 feet for more than 15 minutes — in the previous week or two. Those contacts then get a call, too. The aim is to reach as many people as possible within 24 hours, to break the chain of transmission by urging them to stay home and quarantine.

Of course, not everyone cooperates. Some decline to quarantine or give the names of close contacts. Most states do not report the number of uncooperative people. But a Pew survey of adults conducted last July found that 93% said they would quarantine if told they had the virus. A third, however, said it would not be easy to do so — usually because of work — and a quarter said they would not be comfortable telling tracers about places they had been or people they'd been in close contact with.

As such, contact tracing has inherent limitations, and quarantining isn't enforced in the U.S. Tracing also becomes far less effective as the number of cases grows.

An analysis by researchers at Johns Hopkins University in Baltimore concluded that contact tracing in the U.S. can be fully effective in mitigating spread of the virus only when new cases are at or below 10 a day for every 100,000 people. The case count now exceeds that in most states. The national seven-day average as of Monday was 35 cases per 100,000.

"Tracing programs nationwide are overwhelmed right now," said Crystal Watson, a senior scholar at Hopkins' Center for Health Security. "States just don't have enough people to keep up."

Even so, Watson added, "every contact traced still means lives potentially saved. We can't let up."

Every state has a tracing program, but they vary widely. The Centers for Disease Control and Prevention has comprehensive covid tracing guidelines, but the Trump administration had neither data nor performance requirements for states to meet. 

A White House spokesperson told KHN that the administration views contact tracing as "critical to efforts to reduce spread of the virus." 

Staffing is the most significant challenge. Researchers at George Washington University in Washington, D.C., evaluated contact tracing needs and how states and counties performed.

Their bottom line, based on the most recent surge in cases: The nation would need 928,000 contact tracers to keep up with the current number of cases — or 281 per 100,000 people.

But that projection, which takes many factors into account, is widely viewed as unrealistic. The current number of tracers, according to data from Johns Hopkins, is 70,500. 

"If we could get close to half the ideal number, it would help greatly," said Dr. Amanda D. Castel, a professor of epidemiology at George Washington University. "With luck the vaccine will begin to reduce the need."

Most states aren't even close to 140 tracers per 100,000 people. With 530 active tracers, the District of Columbia has 75 per 100,000 people, more than any state. Fifteen states have 12 or fewer per 100,000. And the number of people who have received two doses of the vaccine is not yet large enough to appreciably reduce the rate of infection.

State and county health departments are keenly aware of the deficit and have moved to hire more tracers or deploy existing state or county employees to the task. Maryland, for example, has hired several hundred tracers in the past three months and is up to 1,550, said Katherine Feldman, director of contact tracing for the state. That's still just 26 tracers per 100,000 people.

Nationally, states have hired about 17,500 tracers since October, according to Johns Hopkins data.

Biden recommended hiring contact tracers and other public health workers as part of his proposal for a $1.9 trillion covid relief and stimulus package.

Those hired would keep their jobs once the pandemic eases, to enhance the nation's permanent public health corps and readiness. The president's proposal does not stipulate, however, how many of those hired would be initially deployed to contact tracing. Administration officials did not respond to requests for comment on this point.

Last week, a group of Republican senators proposed a scaled-back $618 billion covid relief package that includes resources for vaccine distribution, testing and tracing but makes no mention of a public health service corps.

David Cotton, vice president for public health research at NORC, the University of Chicago  survey and research organization that assists Maryland with its program, said that while tracers don't need medical or public health experience, hiring and training the right people and nurturing their skills is not something to be taken lightly.

"The success of tracing depends on having people in that job who can gain people's trust," he said. "Plus, the work can be quite emotionally draining."

States are also adjusting programs.

In Maryland, we have shortened the questionnaire and prioritized geographic areas with high positivity rates. People are also being texted to prompt them to answer our initial calls. These steps have sharply reduced a backlog of cases, said Feldman.

Nationally, traditional tracing programs successfully reach about 65% to 75% of people who test positive and 55% to 60% of contacts. Those numbers are likely trending lower over the past six weeks after the recent surge in cases, experts and state officials said.

But no one knows for sure. That's because there is no national reporting requirement or strategy for tracing metrics, and only 14 states make full data on their tracing programs public.

Scalise said it is Biden's policy that "people who came here illegally can jump ahead of other Americans who have been waiting to get the vaccine."

This article was published on Tuesday, February 9, 2021 in Kaiser Health News.

By Victoria Knight

During a Feb. 2 interview on Fox News, Rep. Steve Scalise (R-La.) claimed President Joe Biden was allowing unauthorized immigrants to move ahead of American citizens to get their covid-19 vaccines.

"Now [Biden's] saying that people who came here illegally can jump ahead of other Americans who have been waiting to get the vaccine," said Scalise, who is also the No. 2 Republican leader in the House.

Lauren Fine, a spokesperson for Scalise, said the representative was referring to a Feb. 1 statement from the Department of Homeland Security, which said the agency "encourages all individuals, regardless of immigration status, to receive the COVID-19 vaccine once eligible under local distribution guidelines."

Since supply is limited, wrote Fine in an emailed statement, "for every vaccine an illegal immigrant gets, that's one an American citizen waiting in line is not getting. If you're an American citizen that's currently in a group that can't get the vaccine yet, you're now behind in the line to an illegal immigrant in a group that can get one."

Considering the DHS statement, other press statements and executive plans, the Biden administration has certainly been vocal about its position that all immigrants should be able to get this shot.

But, we wondered, does allowing this population access to the vaccine mean — as Scalise suggested — they are being invited to step in front of American citizens in the queue?

We asked the experts.

The Gist of Biden's Policies

The Biden administration released a national covid-19 strategy plan during the president's first week in office. The administration, according to the document, is "committed to ensuring that safe, effective, cost-free vaccines are available to the entire U.S. public — regardless of their immigration status."

The plan directs federal agencies to take action to ensure everyone living in the U.S. can access the vaccine free of charge and without cost sharing.

During a Jan. 28 press briefing, White House press secretary Jen Psaki said the administration feels "that ensuring that all people in the United States — undocumented immigrants, as well, of course — receive access to a vaccine, because that, one, is morally right, but also ensures that people in the country are also safe."

The DHS statement also specified that the U.S. Immigration and Customs Enforcement agency wouldn't conduct enforcement operations at or near vaccination sites or clinics.

The Biden administration didn't respond to a request to clarify its position on unauthorized immigrants' access to vaccines in relation to Scalise's claim. But, based on publicly available information, it is clear the administration wants immigrants to have access to the vaccine. However, no statement or provision in the administration's policies indicates they should "jump" ahead of other Americans.

Public health experts across the board criticized Scalise for his statement, in effect saying he was missing the point.

"The line is not drawn by your immigration or legal status," said Dr. Ranit Mishori, senior medical adviser for Physicians for Human Rights, a nonprofit that investigates the health consequences of human rights violations. "It's drawn by your vulnerability, your potential for exposure and your risk."

Jeffrey Levi, a professor of health policy and management at the George Washington University, said Scalise's claim misrepresents what Biden is trying to do.

"They are simply saying that if an immigrant falls within a category that is currently prioritized (e.g., a healthcare worker or someone over a certain age), they should not be excluded from getting the vaccine," Levi wrote in an email. "It does not put an immigrant ahead of a prioritized category."

Samantha Artiga, director of racial equity and health policy at KFF, a nonpartisan health policy organization, had a similar take. (KHN is an editorially independent program of KFF.)

"The policies clarify that all people in the U.S. are eligible for vaccinations regardless of their immigration status and encourage immigrants to get vaccinated when they become eligible based on their local guidelines," she wrote in an email. "They do not prioritize immigrants."

Dr. Jeffrey Singer, a senior fellow in health policy with the Cato Institute, a D.C.-based free-market think tank, said the Biden plan is just following standard public health policy and epidemiological principles.

"Trying to place an emphasis on immigration status might be a good way to press people's buttons to get a sound bite on television," said Singer. "But immigration status is really irrelevant when we're prioritizing people. It doesn't matter where you come from. If you're here in the U.S., you should get vaccinated."

Part of the Essential Workforce

The Centers for Disease Control and Prevention's independent Advisory Committee on Immunization Practices recommended in December that states should first prioritize vaccinating healthcare workers and residents and staff members of long-term care facilities. The next priority group, according to ACIP, should be people ages 75 and older and other front-line essential workers who are not in healthcare. The Biden administration also recently recommended the age category be lowered to include all seniors, age 65 and older. However, states are free to create their own vaccine distribution plans and decide what groups will get vaccinated first.

Unauthorized immigrants make up significant percentages of the workforces deemed "essential" by ACIP. For example, KFF reports that noncitizens (a broad group that could include immigrants in the country lawfully) constitute 22% of all food production workers, 8% of workers in long-term care facilities and 5% of healthcare workers who have direct patient contact.

The Migration Policy Institute estimated in a February report the number of unauthorized immigrants who qualify as essential workers ranges from 1.1 million to 5.6 million, depending on how essential workers are defined. The institute also reported that about 49% of the estimated 2.4 million farmworkers in the United States were unauthorized immigrants as of 2016.

And it's important those groups get vaccinated regardless of immigration status, not just as a good public health practice, but also from an ethical and humane perspective, said Dr. Georges Benjamin, executive director of the American Public Health Association.

"It has obviously been a long-standing public health principle that infection anywhere affects the health of everyone," said Benjamin. "It is also of the highest ethical standards to make sure everybody gets vaccinated and gets treated for infectious disease."

Benjamin added that many unauthorized immigrants who work in essential roles are the foundation keeping society functioning during the pandemic, such as restaurant workers and caretakers.

"They're at higher risk because they're out and about and they can't shelter at home," said Benjamin. "At the end of the day, if we did not vaccinate them and they could not go to work, our economy would totally collapse."

Plus, 70% to 90% of the population needs to be vaccinated to reach herd immunity in the U.S.

"As long as this doesn't happen, it doesn't matter who is vaccinated," said Mishori. "To reach herd immunity in the U.S., everyone, regardless of their immigration status, needs to get vaccinated."

"Viruses don't know the legal status of their victims," Mishori added.

One other note is that the population in question is small compared with the total U.S. population. About 11 million unauthorized immigrants live in the U.S., making up around 3% of about 330 million people in the country.

Our Ruling

Scalise said it is Biden's policy that "people who came here illegally can jump ahead of other Americans who have been waiting to get the vaccine."

The Biden administration has made it clear that unauthorized immigrants are eligible to receive the vaccine if they are part of a priority group, such as healthcare workers or seniors. That does mean some unauthorized immigrants who meet specific vaccination criteria for job duties or age could receive a shot before American citizens who do not meet those requirements. This is in keeping with long-standing public health practices.

But Scalise was misrepresenting Biden's policy when he suggested that unauthorized immigrants are being prioritized over American citizens or can jump the vaccination line.

Eligibility for the vaccine is based on job and age categories — period. Under the Biden approach, immigration status is not a qualifying or disqualifying factor.

His statement contains an element of truth but ignores critical facts that would give a different impression. We rate this claim Mostly False.