Will People with Disabilities Have Priority for a COVID-19 Vaccine?

The COVID-19 pandemic has been particularly devasting to people with disabilities. Recent studies indicate that they are three times as likely to die from the virus as the general population.

But as the pharmaceutical industry moves closer to obtaining approval for one or more COVID-19 vaccines, questions continue about whether the vaccines will be allocated in a way that does not discriminate against people with disabilities, and how affordable they will be.

Vaccines developed by Pfizer and Moderna were both more than 90 percent effective in large clinical trials.  Both companies are now gathering safety data necessary for emergency approval by the Food and Drug Administration. Numerous other vaccines are in various stages of development.

Even if a vaccine is approved, however, there will not be sufficient doses immediately to provide to every American. As a result, government agencies and health care providers will have to make difficult decisions about whom to prioritize when administering the vaccine.  

At the request of the Centers for Disease Control and Prevention, in September 2020 the National Academies of Science, Engineering and Medicine issued a preliminary framework for the distribution of a COVID-19 vaccine. The framework prioritizes essential and front-line health care workers, as well as people living in group homes and other congregate settings.

Echoing concerns earlier in the COVID-19 pandemic about ventilator rationing, disability advocates have pointed out the absence of any express mention of people with developmental disabilities, who they fear will receive lower priority based on outdated assumptions and stereotypes about their ability to survive COVID-19.

In a September 9 letter to the Office of Civil Rights in the Department of Health and Human Services, the Consortium for Citizens with Disabilities (CCD) implored the Department to ensure that the distribution of any COVID-19 vaccine complies with federal anti-discrimination laws.

“Disability status and age should not be used to deny or deprioritize people for a vaccine, such as categorically excluding people with certain disabilities or functional impairments or prioritizing people based on projections of long-term survivability,” the CCD wrote.

The National Council on Disability and the Autistic Self Advocacy Network also submitted comments to the National Academies, expressing similar fears about its framework.  

In addition to distribution concerns, there are questions about whether health insurers will provide vaccine coverage, and if it will be affordable.

As part of the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) , Congress mandated in March 2020 that Medicare cover the full cost of any COVID-19 vaccine for Medicare beneficiaries. However, Medicare regulations currently only permit the federal government to cover the costs of vaccines approved through the standard approval process, as opposed to through an emergency use authorization (EUA), which appears to be how the Trump Administration anticipates approving vaccines in the next two months.

On October 28, the Centers for Medicare and Medicaid Services (CMS) released interim final regulations requiring Medicare to cover the full cost to patients of any COVID-19 vaccine, regardless of whether it is approved through an EUA. Coverage will also be free for Medicaid recipients, under the announced policy.

CMS also announced a partnership on October 16 with retail pharmacies CVS and Walgreens to provide vaccines at no cost to seniors and staff in long-term facilities