Enrolled Veterans may obtain their vaccination at either of the following locations:
Audie L. Murphy Memorial Veterans Hospital
Vaccination Clinic, 1st floor
7400 Merton Minter Blvd, San Antonio, TX 78229
9 a.m. to 4:30 p.m.
Frank M. Tejeda Outpatient Clinic
Vaccination Clinic, 1st floor
5788 Eckherdt Rd., San Antonio, TX 78229
9 a.m. to 3:30 p.m.
Veterans can show up or call ahead at (210) 949-9702 to schedule an appointment. Long wait times are expected at each facility. Proper identification is required in order to verify enrollment and schedule both doses (approximately 21 days apart). Veterans can find more information and sign up to receive updates on VA’s .
TPR’s Carson Frame spoke with Christopher Sandles, CEO and medical center director for the South Texas Veterans Healthcare System, about vaccine distribution plans. This interview has been edited for length and clarity.
CF: So far, South Texas VA has received several thousand doses of the Pfizer vaccine. Can you provide a breakdown of where those are going?
CS: We've received around 8,000 doses. So that's a combination of initial doses, which we need to give to both staff and patients. Obviously, in some cases, it's the second dose. Most of the second doses at this point are for healthcare workers.
CF: When do you expect future shipments of the Pfizer BioNTech vaccine? Has that been worked out yet?
CS: We're getting regular shipments. They're not on a fixed schedule. But we have received more notifications of availability of the vaccine that I was anticipating for our healthcare system — because we were one of the early sites. It was the Pfizer vaccine that we received the most of. So we're going to be using that in this weekend's clinics. I do anticipate that, for our more remote sites — like Victoria, TX, for example — it will be the Moderna vaccine that we'll be using because of the lessened requirements for temperature.
CF: Do you think the Moderna vaccine will eventually become available at Audie Murphy VA as well? Or will Audie Murphy dispense the Pfizer vaccine for the foreseeable future?
CS: It's going to be Pfizer for the foreseeable future. There's been strong recommendation, for patient safety reasons, not to intermingle the vaccines. They will be stored in pretty close proximity to each other. And it's not recommended that we mix the two. Obviously, you don't want to inject a veteran with Pfizer and then inadvertently give a Moderna vaccination to follow. There's just not enough science on that to know what the implications may be. So we've opted to isolate them by campus. So if one campus has Pfizer to begin with, we're going to stick with that. Same for Moderna.
CF: Is there a way for veterans to schedule a vaccine appointment, or is it all first-come, first-served?
CS: We would prefer that veterans schedule their appointment. When they call to schedule for this Saturday (for example), they'll also have the opportunity to schedule the subsequent vaccine at the same time.
If veterans present unscheduled and they meet the criteria for vaccination—which at this point is 75 or older—then I would expect us to vaccinate them. Now they may have to wait a bit longer because we'll need to go through that scheduling process—not just to get them an appointment for that same day, but also the subsequent appointment. So that may cause them to remain at the facility a little bit longer. But I want to vaccinate as many veterans as we can on these events.
CF: Do you have an estimate as to how many veterans will show up for the first clinic on January 9th? Obviously times have been pretty chaotic and you're trying to get the word out. But do you have any ballpark?
CS: We just decided to go ahead and move forward with this. We get a lot of questions from veterans on a regular basis. And they do have a very close network. So I anticipate word’s going to spread pretty aggressively. Enrolled in the health care system, we've got approximately 12,000 who are 75 or older. For this Saturday (Jan. 9), we've made appointment slots available for about 1000. But given the number of staff we're going to have, and the capacity to vaccinate, we could do 2000 or more potentially, if we had that level of demand.
CF: How are you communicating about the vaccine availability to those older veterans? Are you reaching out by phone? Sending letters? Obviously there are some connectivity issues that a lot of these elderly folks have.
CS: Well, that's part of it is talking to the media. But we also have an automated system that we've been using as we get to certain age groups and we're ready to start scheduling these appointments. It's called Audio Care. A lot of our veterans are familiar with it. It’s the same system we use when we call them before appointment and have them confirm whether they're coming or not. So it would be a familiar phone number. But the questions they're being asked are different. So when they get that automated message, it asks them if they're interested in receiving the COVID vaccine, and they press a certain digit for yes or no. So if a veteran responds that they're interested, and they're in that age group category, we call them back and actually schedule the appointment.
CF: It sounds as though you're making the vaccine available first to the 75-and-older group, but that unused doses could be distributed to younger veterans. How will you determine when it's appropriate to release those reserved doses? Are you going to wait to get verbal confirmation from those older veterans that they don't want the vaccine?
CS: We're still working through some of those details. We're likely going to have a process where, if a veteran presents who isn’t in the intended age category, then we're going to put them on a standby list. Just like if you were trying to get on a flight to go from Dallas to San Antonio and it wasn't your scheduled flight. But if the seat’s available, you know, we'll get you on the plane.
So we're taking a similar approach— because we don't want to run into a situation where we're wasting doses— since we’re drawing multiple doses from single vials. So if we have veterans who are in standby status, we’ll give them a call back and let them know, “If you can present here in the next three hours, you’ll get the vaccine.”
CF: Will younger veterans have to meet certain criteria, like having a preexisting condition, to get on the standby list?
CS: No, not at this point. With the flow of activity, not much of clinical review is going to be feasible. But we're really looking at age group classes, right? So it's 75 and older first. The next group could be 65 to 75, for example. So if that younger group were to present, regardless of their comorbidities, then there's either going to be doses available, or they are not going to be doses available. If there are doses available, the first person on standby would get one, provided we weren't able to get it to a veteran over 75. But like I stated, we've got so many veterans that are in the 75 and older age category, I doubt we'll have very many doses that find themselves in a standby status. Still, we want to be prepared for that just in case.
CF: It sounds as though the emphasis is on getting as many doses out into the population of enrollees as you possibly can.
CS: Absolutely.
CF: Does the nationwide VA have a listing of eligible veterans or a tier system? Has it given different regional VA facilities proper tools to prioritize dosing?
CS: We've got one of the most comprehensive informatics systems out there, given the fact that we're the largest healthcare system in the country. They have put a lot of tools in place for us, whether it's helping us keep track of employee vaccinations by occupation, or keep up with veteran vaccinations by age group. So we've got a lot of information that we can use as we're reaching out to try to schedule appointments. But, again, with this being such a unique circumstance, it does require action on the veterans’ side as well.
Because if we don't have the demand we expect from veteran 75 years or older— or they decline the vaccine—we want to ensure those doses don’t go to waste. I talked earlier about the standby situation. In situations like that, I can't wait for three days to find a 65 year-old with a comorbid condition. I've got three hours before I have to throw the dose in the trash. So we want to make these vaccines get into people’s arms above all.
CF: So with the cold storage requirements, once you once you've moved that vaccine, it has to be administered with a short timeframe. Right?
CS: Exactly. Once you draw it up, you cannot re-freeze it. You have to use it. So yes, we want to try to get vaccines into as many veterans in at-risk categories as we can. But there will always be instances where circumstances change, someone changes their mind, or they don't show up for a scheduled appointment. So South Texas VA has to be ready to give that vaccine to someone else.
CF: Are you going to be doing COVID testing before administering doses to veterans? Or are you going to go ahead without that?
CS: We’re going to be vaccinating regardless. We won't have the means to do COVID rapid testing prior to administering the vaccine. We’ll go through the typical COVID screening though— asking questions about temperature, exposure and other medical symptoms.
CF: The coronavirus infection numbers in the San Antonio area are skyrocketing right now. And we have reports that the UK variant has reached Harris County, which means it probably won't be long before it's widespread in the state. Do you have a message for veterans about how to stay as safe during this time? Should they be taking any extra precautions?
CS: I know a lot of folks are tired. In the case of healthcare workers, many of us are physically and emotionally exhausted. I think many in the general public are exhausted with the messaging. But in all honesty, what we need to do to get this virus under control is the same thing that it was nine months ago. We need to socially distance. We need to be certain that we're wearing masks. We need to keep our hands clean. But the other thing that we need to do is aggressively move to vaccination. And the more Americans we can get vaccinated quickly, the more likely that 2021 is going to be brighter than 2020. So we're doing everything we can here at South Texas Veterans Health Care System to be part of that solution. But it does require veterans to voluntarily step up and help us lead the charge.
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