Health Alert
Expanding Vaccine Eligibility to Persons with High and Moderate-Risk Health Conditions

This Division of Public Health (DPH) is issuing this Health Alert to advise the medical community to prepare to vaccinate individuals with high and moderate-risk medical conditions for COVID-19. The State’s official announcement will occur Tuesday to share the below information and additional highlights regarding its plans moving forward.  On Wednesday March 17, the following guidance from the state and DPH will be in effect. 

Background

In moving to vaccinate more eligible persons, the state and DPH advise clinicians to expand vaccine delivery to their patients aged 16-64 with conditions that increase the risk for severe illness from SARS-CoV-2. The conditions reviewed by the CDC Advisory Committee on Immunization Practices (ACIP) and the State's Ethics Advisory Group include the following (but not all inclusive):

Increased (high) risk of severe illness from SARS-CoV-2:

• Cancer
• Chronic Kidney Disease
• COPD (Chronic Obstructive Pulmonary Disease)
• Diabetes Mellitus
• Down Syndrome
• Serious Heart Conditions, such as heart failure, coronary artery disease, or cardiomyopathies
• Immunocompromised state from solid organ transplant
• Obesity (body mass index of 30 kg/m or higher)
• Sickle Cell Disease
• Current or Former Cigarette Smoker
• Intellectual or Developmental Disability
• Severe and Persistent Mental/Behavioral Health Condition
• Pregnancy

Suspected increased (moderate) risk of severe illness from SARS-CoV-2:

• Asthma (moderate-to-severe)
• Cerebrovascular disease
• Cystic fibrosis
• Hypertension or high blood pressure
• Immunocompromised state from blood or bone marrow transplant, immune deficiencies, HIV, use of corticosteroids, or use of other immune weakening medicines
• Neurologic conditions, such as dementia
• Liver disease
• Overweight (BMI > 25 kg/m2, but < 30 kg/m2)
• Pulmonary fibrosis
• Thalassemia

Summary 

No further guidance as to prioritization of these conditions will be forthcoming. Clinicians are advised to use clinical judgment and patient histories to make those determinations and deploy vaccine accordingly using the list above as guidance.

Non-paid caregivers who care for persons with high-risk health conditions, especially those who require assistance with activities of daily living (such as meal preparation, dressing, grooming, medication monitoring, transportation and housekeeping), will also be eligible and identified using clinical judgment or guidance from the list above. Clinicians may vaccinate caregivers of their patients to decrease risk of serious illness for their high-risk patients.

Vaccine partners (e.g., pharmacies, urgent care centers or other walk-in clinics) that are unable to assess individual medical conditions to determine those at highest risk for COVID-19 disease burden, are being asked to vaccinate persons aged 50 years and older, regardless of medical, occupational, or other, factors.

Recommendations

Medical providers who are not enrolled in DelVAX to provide COVID-19 Vaccination are asked to refer eligible patients to a Delaware health system. Provider offices should bear the responsibility for collecting eligible patient names, and contact information (phone number and email if available) and sending referral requests by email to the health care system POCs. Providers who did not receive a list of health system contacts can reach out to Vaccine Planning at VaccinePlanning@delaware.gov.

Additional Information

• COVID-19 Vaccines for People at Increased Risk for Severe Illness from COVID-19: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/specific-groups/high-risk.html

• Vaccination Strategies For High-Risk Adults: https://www.cdc.gov/vaccines/hcp/adults/for-practice/highrisk-strat.html