Smoking listed as high-risk condition for COVID, eligible for priority in Massachusetts vaccine timeline

Smokers in Massachusetts may be able to get the COVID-19 vaccine as soon as next month.

An adjustment of the state’s prioritization order moved residents with multiple health conditions considered high risk for COVID-19 to the first group eligible to receive the vaccine during Phase 2, which is scheduled to distribute more than a million vaccines. Smoking – along with obesity and Type 2 diabetes – among the dozen conditions considered at increased risk of severe illness from COVID.

Massachusetts is one of a half dozen states in the nation which prioritize smokers in vaccinations plans, including one state which made smokers immediately eligible this month.

In the coronavirus vaccine rollout plan announced by Massachusetts health officials in December, priority for the vaccine was given to residents at high risk due to their occupation, housing and health.

The first to receive the vaccine were health care workers offering direct care to COVID patients. This includes not only doctors and nurses in hospitals but other support staff within the health care system who come into direct contact with COVID patients.

Following frontline health care workers were residents and staff in long-term care facilities, rest homes and assisted living facilities where COVID claimed the lives of many.

Tens of thousands of emergency medical providers, police and firefighters were prioritized third to receive the vaccine, efforts which began in Massachusetts last week.

Residents and staff in group homes, substance use disorder treatment programs and emergency shelters, as well as prisoners, will receive the vaccine starting Monday.

Massachusetts is set to enter Phase 2 of the vaccine distribution plan in February. In Phase 2, residents with at least two health conditions which make them high risk for COVID-19 complications, seniors 75 and older and residents and staff of low income and affordable senior housing are prioritized to receive the vaccine first.

For the high-risk conditions, which qualify a resident for receiving the vaccine, state health officials include a list from the Centers for Disease Control and Prevention.

The CDC’s list includes a dozen conditions which puts adults of any age at increased risk for severe illness from COVID-19:

  • Cancer
  • Chronic kidney disease
  • COPD (chronic obstructive pulmonary disease)
  • Down Syndrome
  • Heart conditions, such as heart failure or coronary artery disease
  • Immunocompromised state from organ transplant
  • Obesity (body mass index [BMI] of 30 kg/m2 or higher but < 40 kg/m2)
  • Severe Obesity (BMI ≥ 40 kg/m2)
  • Pregnancy
  • Sickle cell disease
  • Smoking
  • Type 2 diabetes mellitus

This group will be followed by teachers, transit operators and grocery store workers, among other industries deemed essential during the pandemic.

“Being a current or former cigarette smoker increases your risk of severe illness from COVID-19,” the CDC states. Federal health officials do not distinguish between cigarettes and the increasingly popular in recent years e-cigarettes.

The list of underlying conditions has been updated throughout the pandemic to reflect recent studies suggesting which health concerns make an individual more at risk.

Such updates have led to some health officials changing their vaccine distribution plans.

New Jersey Gov. Phil Murphy announced Wednesday that an estimated 2 million smokers in the state would become immediately eligible for the vaccine, in addition to seniors and residents with a pre-existing condition.

Responding to criticism, Murphy called it a “cheap shot” on Friday that some claim smokers are jumping the line.

Other states include smokers in COVID vaccination plans. As in New Jersey, smokers in Mississippi can receive the vaccination earlier. In Alaska, Maine and North Carolina, smokers are included in later phases.

Smoking rates have dropped significantly in recent years. About 30 years ago, roughly 24% of Massachusetts residents reported they smoked daily or some days. In 2019, 12% identified as smokers – about 4% lower than the national average.

Gov. Charlie Baker was asked Wednesday about possible modifications to the state’s rollout following new guidance issued by federal health officials this week.

“I know this isn’t popular, but I really hope that early on we are able, with the vaccine that’s available, to hit the populations for whom life is most at risk, and for whom the health care system relies on and depends on to provide care,” Baker said.

Massachusetts is scheduled to enter Phase 3 of the vaccine rollout in April, when the general public is expected to be eligible. By summer 2021, the majority of residents should have access to the vaccine.

By then some 80% of the state population is expected to be vaccinated – with the remaining 20% including children under the age of 14, adults who cannot safety get vaccinated and those who choose not to get the vaccine.

“It is our explicit goal that everyone who is medically eligible receive the vaccine,” Dr. Paul Biddinger, the chief of emergency preparedness at Massachusetts General Hospital and the director of Mass. General’s Center for Disaster Medicine, said during a press conference announcing the three-phase plan. Biddinger serves as the chair for the Massachusetts COVID-19 Advisory Group which helped determine allocation and distribution plans for the vaccine.

COVID-19 vaccines are being offered free of charge to all by federal health officials. Insurance companies have committed to not charging out-of-pocket fees or co-payments related to the vaccine and vaccine clinics.

When it becomes more readily in coming months, public vaccine clinics will be listed on the CDC’s website vaccinefinder.org.

In addition to hospitals, the vaccine will be available at large-scale clinics. Baker announced Tuesday that Gillette Stadium will serve as the first large-scale facility in the state.

The clinic will open to first responders receiving the vaccine on Monday.

The facility is scheduled to start offering 300 vaccines per day, ramping up to provide 5,000 daily followed by “potentially much bigger numbers,” Baker said Tuesday.

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Janelle B. Smith

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