Los Angeles County’s COVID-19 vaccination effort underwent a “challenging” expansion Monday as people with underlying health conditions become eligible for shots.

But with no firm requirement that patients provide documentation of their medical condition, the move is raising fears of possible line-jumpers getting vaccinated before they are eligible.

“We certainly hope people won’t try to take advantage of the situation and will be honest in terms of presenting with legitimate chronic health conditions that are serious or disabilities that are significant,” Dr. Paul Simon, the county’s chief science officer, said Friday.

Following state guidelines, people with underlying conditions are urged to bring documentation to vaccination sites, such as a letter from a health-care provider or health agency. But if no such documentation is available, the person can merely sign a statement attesting to the fact that they have a qualifying condition. To maintain their privacy, people will not be asked by site workers to identify their health condition.

The county and other jurisdictions across the state have dealt with repeated instances of “line-jumpers” finding ways to access vaccine appointments before they are eligible for shots, sometimes by obtaining private appointment-access codes or presenting generic documents at vaccination sites to establish themselves as in-home care providers.

Simon conceded that the verification issue will present a challenge at vaccine sites.

“This expansion, I think, will be challenging,” he said. “We don’t feel that our front-line staff are in a position to screen and make decisions about who is or who is not eligible. I think if somebody simply attests to the fact that they have a serious condition or disability, they will be approved for vaccination.

“We urge people not to take advantage of that. Again, vaccine supply is very short. I think we all have a moral obligation to make sure that vaccine is reserved for those who are at greatest risk.”

He also stressed that people with underlying conditions will have to prove they live in the county to get vaccinated.

Like the state, local health officials are urging people with the qualifying health conditions to contact their doctor or health provider to see if they can obtain the vaccine through their office, rather than relying on a public vaccination site.

“Because many providers do not currently have vaccines, eligible persons with severe medical conditions should also consider other medical providers and pharmacies,” Simon said.

He said the county will be posting a list of medical providers with vaccines on its website.

According to the state, the new eligibility includes everyone aged 16 to 64 with an underlying health condition that makes them susceptible to severe illness or death from COVID-19. The qualifying conditions are:

— cancer;

— chronic kidney disease, stage 4 or above;

— chronic pulmonary disease;

— Down syndrome;

— weakened immune system from solid organ transplant;

— pregnancy;

— sickle cell disease;

— heart conditions;

— severe obesity; and

— Type 2 diabetes mellitus.

Also eligible will be anyone 16 or over who suffers from a “developmental or other severe high-risk disability” that leaves the person susceptible to serious illness or death from COVID. People will also be eligible if acquiring COVID will limit the person’s ability to receive necessary ongoing care or services; or if the disability would hamper the person’s ability to be treated for COVID.

In addition to people with underlying health conditions, homeless people also became eligible for vaccinations starting Monday, joining newly eligible workers — custodians/janitors, public transit workers and airport ground crew workers.

Simon said the addition of all those categories now makes roughly 5 million people in the county eligible for vaccinations, equal to roughly half of the county’s population.

But while millions more people are eligible, the county’s supply of vaccine for the week will actually shrink by about 60,000 doses, because the county won’t be receiving any more doses of the Johnson & Johnson vaccine until late March, due to manufacturing issues.

Simon said the county will receive about 260,000 doses for the week, with 70% of those shots being used for first doses, and 30% for people in need of second doses.

The county is also focused on sites that focus on vaccinating residents of the most vulnerable communities.

County Supervisor Hilda Solis announced Monday that an El Monte location was opening at Grace T. Black Auditorium at 3130 Tyler Ave.

“We have worked arduously to secure a vaccination site that would service our most vulnerable community members in El Monte, and I am committed to continue partnering with our communities across the 1st District to get as many shots in arms as possible, so we can finally put an end to this pandemic,” Solis said. “Brighter days are ahead for our communities in the San Gabriel Valley.”

The San Gabriel Valley has been among the hardest hit by the pandemic, with approximately 197,600 COVID-19 confirmed cases and over 4,600 deaths, Solis said. El Monte has confirmed 16,957 cases and 408 deaths, but vaccinations have lagged.

Solis characterized the opening as a “soft launch,” with 2,000 vaccines to be distributed on Monday, Tuesday, Wednesday and Friday, and increased supply anticipated in the coming weeks. The aim is to concentrate on vaccinating currently eligible El Monte residents. Community members can call the Jack Crippen Senior Center, 626-580-2210, to schedule an appointment.

As of the latest available count on March 10, more than 2.7 million vaccine doses have been administered in the county, including nearly 900,000 people who have had both doses of the two-shot regimen.

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