'There's a balance'

Some vaccine providers' no-ID rule might allow some to ‘skip in line.’ But Chatham providers say it’s worth it.

Posted 2/17/21

Many Chatham vaccine providers don’t require ID to ensure that it’s not a barrier to vaccination — a decision which could allow some to misrepresent their eligibility and “jump the …

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'There's a balance'

Some vaccine providers' no-ID rule might allow some to ‘skip in line.’ But Chatham providers say it’s worth it.

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Many Chatham vaccine providers don’t require ID to ensure that it’s not a barrier to vaccination — a decision that could allow some to misrepresent their eligibility and “jump the line.”

Even so, several Chatham providers and community organizations say they think it’s worth the risk.

“There’s a balance,” said Mike Zelek, Chatham County’s Public Health Director. “In an effort to catch a few potential cases of misrepresentation, we don’t want to cause a barrier to access, especially to our historically marginalized communities.”

The CCPHD and Chatham Hospital — which together administer over half of the Chatham providers' allotted doses — don’t require ID to give shots, a decision based both in equity concerns and the state’s own recommendations for providers. North Carolina does not require residents to present government-issued ID or any other form of documentation to get vaccinated, spokesperson SarahLewis Peel of the N.C. Dept. of Health and Human Services told the News + Record.

“Some vaccine providers may ask for a way to confirm your identity (name, date of birth) to make sure they are vaccinating the right person, so it is important to bring an item with your name on it (utility bill, faith ID, passport, matrícula consular, credit union member card, etc.),” she said. “Vaccine providers should not withhold vaccinations or appointments for vaccinations because you cannot not present identification.”

But not requiring ID may have some unwanted consequences, the N.C. Watchdog Reporting Network found last week. Some vaccine providers in North Carolina, they reported, have been vaccinating people who aren’t yet eligible under current guidelines, including New Hanover county commissioners. Reporters also found that many providers rely on people to provide accurate information about their vaccine eligibility since they don’t require ID.

“In short, the vaccine distribution system operates largely on the honor system,” the Network concluded, “and a few have taken advantage of it, risking the health of other North Carolinians.”

Has this happened in Chatham?

Not that we’re aware of, said the CCPHD’s Zelek and Chatham Hospital’s chief medical officer, Andrew Hannapel.

“I can’t tell you that it hasn’t been an issue at all,” Zelek said, “but I don’t anticipate that we’ve had hundreds of people come through our clinics that have not fit the profile, because we do have that process for data entry and then scheduling.”

In Chatham, the CCPHD and Chatham Hospital determine and verify eligibility based on the information residents provide themselves via online registration tools and call centers. To get vaccinated through the CCPHD, residents call the department’s COVID-19 call center or register online in English or Spanish via its online Vaccination Information Tool. Among other things, this form asks people to provide their contact information, name, date of birth, address and type of employment.

“(For) those 65 and older, we’re asking for their date of birth, and that would be our process to validate,” he said. “We don’t require documentation. We don’t want that to be a barrier to folks.”

The form doesn’t require people to fill out everything, though; among required items — items “starred” on the form — are residents’ names, contact information and date of birth, but not employment information.

“It is helpful that we have complete information,” Zelek said, “as this is used to determine eligibility and the information is required by NC DHHS during the vaccination process, so it speeds up the registration process.”

According to Hannapel, Chatham Hospital likewise asks for a resident’s name, date of birth, race and ethnicity.

“We are required to input required information of your name and date of birth,” he told the News + Record in early February. “Optionally, the state asks that you provide gender, race and ethnicity and we input it into the Coronavirus Vaccine Management System (CVMS) to track your immunization and make sure that you receive your second shot.”

If they have extra doses, he added that they reach out to “eligible recipients” nearby, such as their health care workers who’ve yet to be vaccinated, so that they don’t waste any doses.

“Is it possible that some have slipped through the cracks and misrepresented their information? Yes, it’s possible,” Zelek said. “But the Chatham community, I think, is a very understanding and honest community in my experience, and it’s important that the folks out there understand that there’s a reason for the prioritization of vaccines.”

If the health department finds “strong evidence” that someone registered for an appointment wasn’t eligible, Zelek said they’d then follow prioritization guidance. But if the health department were to find out after the vaccination appointment, he said they currently have no mechanism to penalize people for misrepresenting themselves and touting guidelines.

Though not requiring ID may present problems in enforcing the state’s prioritization guidelines, Zelek said it’s an important piece of the state’s — and providers’ — efforts to equitably distribute the vaccine, especially to minority communities who may not have government-issued ID and may choose not to get vaccinated if they had to present it.

“If somebody doesn’t have a driver’s license, for whatever reason, should that be the barrier to get a vaccine?” Zelek asked. “I think most of us would agree that it shouldn’t.”

Chatham County Council on Aging’s executive director, Dennis Streets, agrees with Zelek.

The COA has devoted a lot of effort to ensuring vaccine equity and access for Chatham’s seniors. They’ve been collecting information from seniors without smartphones or laptops and passing it on to the CCPHD. They also partnered with Chatham Transit and the CCPHD to provide homebound seniors with transportation to vaccination clinics.

Streets said he’s heard stories nationwide about people “skipping in line,” but he hasn’t heard any in Chatham — and he hopes that continues. Seniors are at greater risk of dying from COVID-19, he said; any dose given to people ineligible for the vaccine under current guidelines is one less dose for the people he and his organization serve.

“Certainly, the intent here — and I think the practice — has been to give the real strong priority to those eligible,” he said. “I’m 68 ... I’m here every day, there was no effort on the part of anybody else or public health to say, ‘Well, we can work you in.’ When I’m talking 75 plus, I waited my turn as well. I was on the list. It’s the right thing to do.”

Streets said he thinks the benefits of not requiring ID outweigh the costs. He said he could see how an ID requirement might scare certain communities away from getting vaccinated.

“I could see for some people, mentally, they’d say, ‘Gosh, I don’t know,’” he said. “We want people to be vaccinated in our community; it’s important for them, and it’s important to the larger community. So anything like that could be seen as a deterrent, I think if at all possible we’d want to avoid (it).”

The Hispanic Liaison’s executive director, Ilana Dubester, also said she thinks the costs outweigh the benefits. Her organization serves Hispanic residents in Chatham County, including undocumented immigrants who may not have government-issued IDs.

“I can’t imagine the majority of people trying to cheat the system to get a vaccine,” she said, “and everyone needs the vaccine in the end of it all anyway. ... Of all our troubles, that’s not one of them.”

Reporter Victoria Johnson can be reached at victoria@chathamnr.com.


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