How Will Indiana Distribute COVID-19 Vaccines? What You Need To Know As Age Eligibility Drops To 55

Mar 3, 2021

Appointments for COVID-19 vaccinations opened to Hoosiers 80 and older on Jan. 8.
Credit (Provided by Indiana Department of Health)

Indiana opened registration beyond first responders and health care workers on Jan. 8, allowing Hoosiers 80 and older to schedule appointments for vaccines. On March 2, the state expanded that to Hoosiers 55 and older.

When will others be able to receive the vaccine? What about people over the age of 65, but not living in long-term care facilities?

The state extended vaccine appointments to Hoosiers 65 and older on Feb. 1. Originally, health officials had anticipated opening appointments to Hoosiers 60 and older, but decided to split that group in half in response to the federal allocation of vaccines. State health officials anticipate moving in those kinds of increments, because of both the federal allocation of vaccines and the population of each age group.

Those who qualify may schedule vaccination appointments at OurShot.in.gov or by calling 211. About 70 public libraries, AARP and Indiana’s Area Agencies on Aging may also be able to help with registration.

Vaccination appointments were opened to first responders, law enforcement and similar groups earlier in January. Long-term care facility residents and health care workers were prioritized as the state received its first doses.

Who is next in line?

State health officials announced Feb. 10 they are continuing by age group, Hoosiers 50 and older as well as those with five specific comorbidities.

Dr. Lindsey Weaver, Indiana Department of Health chief medical officer, said Hoosiers in their 50s are 30 times more likely to die from COVID-19 than Hoosiers in their 20s. 

The prioritized comorbidities are: 

  • active dialysis patients, 
  • Down syndrome
  • post-solid organ transplant recipients
  • sickle cell disease patients
  • people in treatment for cancers now or in the last three months, or with active primary lung cancer or active hematologic cancers, like lymphoma, leukemia or multiple myeloma.

Those comorbidities were prioritized based on Indiana’s population and the recommendations from the Centers for Disease Control and Prevention.

State officials said, depending on the vaccine supply, the state will continue opening eligibility in five-year increments by age group. For Hoosiers with comorbidities, state officials have asked them to reach out to their primary care providers – there will be a separate registration link provided to that group.

More than 850,000 Hoosiers are over the age of 50. And the comorbidities add 51,000 to that group. Until more vaccines are available, state health officials are asking for patience as they continue to prioritize based on risk of death or severe illness.

When will teachers get the vaccine? Will essential workers be prioritized?

Short answer: not so far. 

State health officials said Jan. 6, the reason they were prioritizing based on age is to combat hospitalizations and deaths. Hoosiers 80-years-old and older represent only about 4 percent of the population, but 19 percent of hospitalizations and more than half of deaths. 

When extending that to Hoosiers 60 and older, that’s more than 93 percent of deaths. 

Vaccine distribution is left up to states. Some counties previously wait-listed education staff, allowing them to receive vaccinations earlier than state recommendations. But health officials announced Feb. 24 the state would be cracking down on eligibility requirements for waitlists.

If I qualify to receive the vaccine, how do I sign up? 

There are two main ways to do so: go to OurShot.in.gov or call 211. 

If you’re registering online, at the top of the page, there is a muted red bar that reads “Click here to find a vaccination site and register.” 

That will redirect you to a map, which lists vaccination sites by county. Select the one closest to you (or your loved one). And then select “Click here to register.” 

Select what group best describes you, and then register for your vaccine.

Can I sign up through Kroger, Meijer or Walmart?

Yes. Walmart will use the state’s registration system at OurShot.in.gov. 

But Kroger and Meijer will be using their own sign up system. Hoosiers who are eligible for vaccine appointments may schedule them through the stores’ websites – clinic.meijer.com or kroger.com/rx/guest/get-vaccinated

On Meijer’s website, you’ll fill out a brief questionnaire and then provide your zip code to select a store pharmacy providing vaccines. 

On Kroger’s website, you’ll provide a zip code to see your nearest stores. If the COVID-19 vaccine is available at that store’s pharmacy, it should be at the top of the list. But there isn’t a way to filter out stores that don’t have COVID-19 vaccines.

How long does the vaccine take to be effective? How effective are the vaccines?

According to the CDC, a week or two.

After the first dose, the Pfizer-BioNTech vaccine only measured 50 percent efficacy against COVID-19. But both available vaccines measured more than 94 percent efficacy against COVID-19 after the second dose in clinical trials. 

For the Johnson & Johnson vaccine, you only need one shot, but the measured efficacy is a little lower than the mRNA vaccines at 66.1 percent. 

Join the conversation and sign up for the Indiana Two-Way. Text "Indiana" to 73224. Your comments and questions in response to our weekly text help us find the answers you need on COVID-19 and other statewide issues.

It is important to remember: flu vaccines with about 40 to 60 percent efficacy are still pretty good.

Are the new strains of COVID-19 resistant to vaccines?

Not so far. 

Indiana officials announced on Jan. 11 the United Kingdom variant of COVID-19 was confirmed in the state. There are several newly identified strains including ones in California, South Africa and Brazil. 

The vaccines still protect against the new strains, and vaccine manufacturers may make adjustments or add additional doses of vaccines to protect against future strains. 

How does Indiana’s vaccine distribution compare to neighboring states?

States receive vaccines from the federal government based on population. Both Ohio and Michigan have distributed initial vaccines to more than 800,000 of their residents.

Indiana’s population is about 6.7 million Hoosiers. Ohio has 11.7 million, Michigan has just shy of 10 million people, and Kentucky has about 4.5 million. 

The state remains on par with its Midwest neighbors. As of March 1, nearly 15 percent of Hoosiers have received at least one COVID-19 vaccine dose compared to 15.9 percent in Kentucky, 14.4 percent in Ohio, and 14 percent in Michigan.

How many people need to get vaccinated to achieve herd immunity?

Brian Dixon, director of public health informatics at the Regenstrief Institute, said in order to achieve herd immunity in the state, 70 percent, or roughly 4.8 million Hoosiers need to be vaccinated.

He said we’re not likely to reach that number until late summer – and that’s assuming everything goes to plan and everyone gets the vaccine when it’s their turn. 

If I’ve already had COVID-19, do I still need a vaccine?

Prevailing science says yes for a few reasons: while not common, there have been some reports of reinfection after recovering from COVID-19. In fact, reinfection appears to be more likely with the new strains. The available evidence, according to the CDC, suggests most people who recover from COVID-19 would have a degree of immunity for at least three months following initial diagnosis, some early research suggests that lasts for eight months or longer.

The CDC also says there isn’t enough information about the length of natural immunity – what you’d get from having the virus – and has not made a recommendation yet about whether you’d benefit from getting a vaccine if you’d previously had the virus. 

About 5-10 percent of participants in both the Moderna and Pfizer-BioNTech trials included participants who had the virus previously.

Indiana University is conducting a study to shed light on COVID-19 immunity, after a person has been infected or after being vaccinated.

Do I still have to wear a mask once I have the vaccine?

Yes. 

According to NPR’s Shots, studies of the new vaccines only measured whether vaccinated people developed symptoms, not whether they got infected. It's possible that they got mild infections — not enough to make them ill, but enough to pass the virus on to others. 

The CDC is calling for those who are immunized to continue wearing masks and practicing safe physical distancing until more is learned.

What’s in the vaccines? How is Johnson & Johnson’s different?

The FDA lists 10 ingredients in the Pfizer-BioNTech vaccine – mRNA, lipids ((4-hydroxybutyl)azanediyl)bis(hexane-6,1-diyl)bis(2-hexyldecanoate), 2[(polyethylene glycol)-2000]-N, N-ditetradecylacetamide, 1,2-Distearoyl-sn-glycero-3-phosphocholine, and cholesterol), potassium chloride, monobasic potassium phosphate, sodium chloride, dibasic sodium phosphate dihydrate, and sucrose.

Basically, that’s three types of fats, cholesterol, sugar, and four types of salt (including sodium chloride, which is table salt). 

The Moderna vaccine’s ingredients are listed as: lipids (SM-102, polyethylene glycol [PEG] 2000 dimyristoyl glycerol [DMG], cholesterol, and 1,2-distearoyl-sn-glycero-3-phosphocholine [DSPC]), tromethamine, tromethamine hydrochloride, acetic acid, sodium acetate, and sucrose.

That’s four different fats, salt, sugar, tromethamine, tromethamine hydrochloride, and acetic acid. 

Both the Pfizer-BioNTech and Moderna vaccines use mRNA to deliver a cheat code to your body’s immune system, without giving an inactive or a live but weakened version of the virus. 

The Johnson & Johnson vaccine is a vector-based vaccine: it contains a totally different virus than COVID-19, but it has parts of COVID-19 inserted into it, so your body can learn to respond to it. This vaccine uses adenovirus type 26, which can cause cold symptoms and pink eye. The strain in the virus is manipulated so it cannot replicate in your body to cause illness. 

The Johnson & Johnson vaccine’s ingredients are listed as: recombinant, replication-incompetent adenovirus type 26 expressing the SARS-CoV-2 spike protein; citric acid monohydrate; trisodium citrate dihydrate; ethanol; 2-hydroxypropyl-β-cyclodextrin (HBCD); polysorbate-80; and sodium chloride.

That’s the disarmed virus, acid, two types of salt, ethanol, sugar, and polysorbate-80 – which is a pretty common emulsifier in foods to hold ingredients together.

I have had allergic reactions in the past to vaccinations – can I still get the COVID-19 vaccine?

If you’ve had allergic reactions to vaccines in the past, you should talk to your primary care provider about the vaccine. People who have had severe allergic reactions may need to be monitored after receiving the vaccine. Polyethylene glycol – which is in both Moderna and Pfizer-BioNTech vaccines – has been pointed to as what has triggered some anaphylaxis. 

The most common allergic reaction – especially in flu shots – are in people with egg allergies. The most common flu vaccines are developed with egg-based technology, but the FDA and CDC said common food allergies and medicines shouldn’t prevent most people from receiving the vaccine.

What if I’m immunocompromised or taking medications that affect my immune system?

The FDA guidance says you should talk to your primary care physician and make that decision with them. 

They’ll likely give you the OK, but be sure to bring up these concerns with your doctor to make an informed decision. If your doctor says it’s OK, FDA guidance says to give your vaccine provider a heads up.

The other thing to keep in mind: the state has started prioritizing five different underlying health conditions, which include people in treatment for cancer, sickle cell disease patients, and folks who have had organ transplants. For Hoosiers with comorbidities, state officials have asked them to reach out to their primary care providers – there will be a separate registration link provided to that group.

My doctor has suggested I get a particular version of the COVID-19 vaccine. Can I choose which one I receive?

Yes and no. The ingredients and side effects are very, very similar for both the Moderna and Pfizer-BioNTech vaccines. 

If your primary care provider has recommended you receive one over the other, your best option is to call the vaccine provider to see which vaccine they have. Indiana is distributing both vaccines, and it depends on a number of factors which is available in any given county. But there isn’t a whole lot of choice in the version of vaccine.

Will I have to pay for the vaccine?

No. 

Vaccine providers will be able to bill insurance for a fee to administer the vaccine, but will not be able to charge you. They can seek reimbursement for uninsured patients from the Health Resources and Services Administration’s Provider Relief Fund.

Can I get or spread COVID-19 from the vaccine?

No. 

There are several different types of vaccines. Rotavirus and MMR vaccines use a live but weakened version of the virus to teach your body to develop long-term immunity to a disease. Flu and rabies shots use an inactive version of the virus, but that’s why you don’t develop long-term immunity from those viruses. 

The COVID-19 vaccine doses developed by Pfizer-BioNTech and Moderna use a new type of vaccine, an mRNA vaccine. This type of vaccine has been in development for about three decades, but is only now being used for COVID-19. According to the CDC, mRNA vaccines teach your cells how to make a protein – or even just a piece of a protein – that triggers an immune response inside our bodies. That immune response, which produces antibodies, is what protects you from getting infected if the real virus enters our bodies.

The Pfizer-BioNTech and Moderna vaccines require two doses to be effective – more similar to many childhood vaccinations than getting a flu shot.

However, studies of the new vaccines only measured whether vaccinated people developed symptoms, not whether they were infected. There’s still a lot of ongoing research into whether someone who has been vaccinated can be infected with the virus and spread it to someone who is not vaccinated.

Why do we have to get a second dose of the vaccine?

If you want the full protection of the vaccine, you’ll have to get the second dose. In an FDA analysis of the Pfizer-BioNTech vaccine, after only one dose, a little more than 50 percent of participants were still protected from the virus. But that jumped up to 95 percent after the second dose. 

That applies to the Moderna and Astra-Zeneca vaccines as well. 

What are the side effects of the vaccine?

WITF, a station in Pennsylvania, asked that question of Johns Hopkins Bloomberg School of Public Health’s Dr. William Moss.

He said at this point, we only know the short-term side effects – which appear in about 5 to15 percent of participants.

Those include inflammation, soreness at the injection site, a low-grade fever, headaches, muscle aches and fatigue. These can last from 12 to 36 hours after vaccination. 

The CDC includes some tips on how to best alleviate some of those side effects – including placing a cool, wet washcloth over the injection site and taking an over-the-counter medicine.

This story was originally published on Dec. 14, and has been updated Dec. 18, Jan. 12, Feb. 2, Feb. 10, and most recently, March 2.

Contact Lauren at lchapman@wfyi.org or follow her on Twitter at @laurenechapman_.