Homebound senior wants COVID vaccine yet can’t get shot doctor prescribed

Here’s the story of one elderly American citizen who agreed to be vaccinated against COVID-19, yet hasn’t been able to receive a shot as of mid-June, 2021.

Someone I care about has a very complex medical situation. Her health is fragile, and her immune system is compromised.

My loved one is frail and almost completely housebound; it is a struggle even to get her to scheduled doctors’ appointments with ample notice. Sometimes, her body simply won’t conform to the constraints of sitting in a passenger vehicle. Hospital bed in dining room

She certainly would not be able to wait 30 minutes on a hard chair in a physician’s practice—let alone standing in an aisle at a local pharmacy—the way my kids and I did after our jabs. At the same time, due to a history of severe allergic reactions to drugs and vaccine components, the risk of an adverse reaction is higher than average for this patient.

Consultations with her various specialists resulted in a consensus that the Pfizer product is the only recommended COVID-19 vaccine for her.

Thus far, none of her providers has been able to offer access to a prescribed dose of COVID-19 vaccine during a routine visit. Internet-savvy family members continue searching for a solution that will accommodate her specific needs with no luck to date.

The patient’s state of residence now offers at-home vaccinations for those who are homebound. Unfortunately, the program sends its providers out with the Johnson & Johnson single dose vaccine only. According to the toll-free hotline, there are no exceptions unless the patient is under 17 years old.

This patient, though unable leave home for a shot, cannot take advantage of her state’s offering for housebound residents. According to the Journal of the American Medical Association, approximately 6% of U.S. seniors were completely or mostly homebound as of 2015.

Without a doubt, American wealth and power has provided a tremendous benefit to average citizens who’ve been amongst the earliest to access life-saving vaccines against the novel coronavirus. Public health, however, relies upon the breadth of its network to protect every resident. Many of our most vulnerable are still waiting as vaccines near expiration dates in medical center freezers.

Evidence of widespread vaccine hesitancy proves we must keep working to remove barriers to access for those willing, yet unable, to be vaccinated in currently available settings. Lives—and our loved ones—depend upon it.

Chocolate cake recipe adapted for GoSun solar oven (gluten free)

Last year, I wrote about my favorite fuel-free cooking appliances. One of them is a GoSun Sport model solar oven that I use right on the balcony, just a step outside my kitchen. It’s a space too narrow for safe use of a full size gas or charcoal grill even if I were comfortable cooking on a fire.

Saratoga Jacks 5.5L thermal cooker next to goSun Sport solar ovenIf you’re anything like me, investing in a solar oven for summer cooking without heating up the kitchen leads you right to the need for an adapted chocolate cake recipe to suit it.

Here’s a peek at one of the mini cakes I managed on my first attempt.Sun oven baked mini chocolate cake about two fingers wide and a finger long

We’re “enjoying” the first heat wave of the season just a few days into meteorological* summer, but the kids and I had a hankering for sweets.

It is 100% accurate that I have questioned the need to ever eat—let alone cook—hot meals once the thermometer reads about 75º F. Sorry, kids! Then again, my interest in baked goods rarely wanes even while the mercury rises.

ReallyWonderfulThings.me GoSun Sport adapted chocolate cake recipe (Gluten Free)

Here’s a printable PDF copy of the recipe Sun Oven GF chocolate mug cake adaptation by willo for ReallyWonderfulThings.me.Picture view of solar baked cake recipe

Observant readers may notice that I forgot to add the chocolate chips to the batch I photographed for this post. The result will be delicious either way. Continue reading

Post-COVID, I’ll remember NCL, Delta & Alaska Airlines put safety first

Norwegian Cruise Line (NCL) Holdings announced on May 7th that, if Florida’s government holds to its misguided law preventing private businesses from enforcing vaccine compliance, NCL will take all of its sailings to other ports outside that state. For a Miami-based company, that’s a pretty bold promise.

While my sun-loathing, beach-avoiding tendencies made Florida’s appeal a mystery to me in the past, its near total lack of sensible governance paints it as a positively terrifying “vacation” destination today. I’m hardly the only one to notice Governor DeSantis’ lunatic anti-corporate stance on this question, either.

I want to commend NCL for making a rational commitment to protect passenger safety even as the pandemic wanes. I haven’t cruised with Norwegian yet, but taking a firm line on this issue after a year of unprecedented collapse in the travel industry gives me a powerful reason to consider them more seriously in the future.2012 Carnival cruise Saint John NB Canada - 3

I’ve only taken a handful of cruises, having traveled twice with Crystal Cruises, once on Holland America Line, and once with Carnival. I’m delighted that Crystal has also adopted a 100% vaccinated passenger policy at this time.

At the same time, allow me to commend Delta for being the airline which blocked middle seats longer than any other major U.S. carrier. Delta ended that policy on May 1, 2021.

By contrast, American Airlines decided after just a couple of months in 2020 (April to June) that cramming passengers three abreast on flights of any duration—while an airborne virus sickened tens of thousands per day in a way science did not yet clearly understand—was sound policy.

AA made this choice well before the second surge of cases and deaths in the United States.AA entertainment welcome screen above pocket with A321S safety card visible

You can bet that Delta has moved up on the list of airlines I’ll choose to fly with going forward.

The day I got my first vaccine jab, I booked tickets home to see my dad for Christmas 2021.

I noticed when Alaska Airlines made the news for banning Alaska state Senator Lora Reinbold. The dis-Honorable Senator Reinbold repeatedly ignored staff instructions, violating a mask order designed to protect her fellow passengers.

Most of those good people were likely Reinbold’s constituents, yet she couldn’t be bothered to don a few square inches of cloth to reduce the risk of infecting them all with a contagious disease. The senator couldn’t know if any those in her vicinity were high risk; she simply didn’t care more about human life than she did political posturing.Tail of Alaska plane visible on tarmac through airport terminal window

I’m incredibly appreciative that Alaska Airlines chose to institute a face covering policy even before the United States federal government implemented its own mandate. I’m proud to say that Alaska is the airline with which I’ve had elite status for the greatest number of years.

I’m gratified that I’ve regularly paid a premium for flights with this airline that chose to do the right thing, even when doing so cost them the business of customers who couldn’t—wouldn’t—be bothered to take any small measure to respect others.

It’s interesting to me that I’ve long felt that customer service was better on Alaska and Delta than on other domestic airlines, even as frequent fliers began complaining bitterly about changes in the latter’s SkyMiles Frequent Flyer program devaluing their points. Personally, I prefer good service and more stringent safety protocols to a higher return paid in free trips.

This post is the product of a lot of noticing, over the course of a pandemic, which big companies took specific kinds of thoughtful action, and how often those actions corresponded with my previous impression of a given corporation. Trader Joe’s and American Airlines disappointed me; Delta, Alaska, and NCL have earned a great deal more of my esteem.

I have a long memory, and I’m the kind of traveler happy to pay a premium to support my values. Here’s hoping some pandemic-era changes in the aviation industry remain, and that the skies stay a little friendlier in the future.

Honestly admit vaccine side effect costs & better support the “hesitant” to increase compliance

When you get your COVID-19 vaccination—and I’d argue that approximately 99% of those reading this post have a moral imperative to do so—a realistic assessment of the facts suggests that you are likely* experience some uncomfortable side effects though they may be very mild.

News coverage, even in sources specifically geared toward those of us living with chronic conditions, heavily emphasizes the societal good which vaccination will bring—which is real enough—but most writers lean too heavily toward cheerleading at the expense of offering valuable information people need to cope with the particular pressures of their own individual lives.

I would like to stress that those of us more vulnerable than average to infirmity should plan for several days of being less effective in our work and daily lives after vaccination. It’s better to be prepared than to be caught flat-footed after the fact.

Politicians and business leaders who want the economy to boom should be offering solutions to make such preparations possible for the millions of Americans living in and at the edge of poverty who can’t afford to construct such safeguards for themselves.

Roughly 30 million American adults want to take the COVID-19 vaccine but haven’t yet managed to actually get the shot(s). Closer to 28 million are instead “vaccine hesitant,” stating they would probably or definitely not get vaccinated.Redacted official CDC COVID-19 Vaccination Record Card

Sufferers of autoimmune disease, getting your jab may well bring on a flare. That was my experience after my first dose, and I’m glad I dug down far enough through coy, dissembling news coverage and popular health reporting to be forewarned about the risk.

Here’s one published case study in The Lancet regarding the health of one gentleman with rheumatoid arthritis after getting the BioNTech-Pfizer vaccine. This article on Creaky Joints is the most honest that I read, speaking directly to specific reactions people with autoimmune conditions might expect.

I would take that first dose again, however, and I did return for my second shot of the Moderna vaccine.

I began composing this post whilst “enjoying” the resultant joint pains, exhaustion, and headache that came with full vaccination. Dose two also induced half a day of resounding nausea that could have been an exaggerated version of the queasiness I routinely get when very tired.

Side effects from the second shot prevented me from my normal activities—already constrained by my autoimmune disease diagnosis—for about two and a half days.

I.e., I would not have felt safe driving for at least two days after my second shot, nor would I have been healthy enough to go to work.

By comparison, after my first jab, I experienced sudden onset of extreme fatigue, headache, and an odd sensation I only associate with coming down with a virus that I can best describe as “the spaces in my joints feeling stretched out and wobbly.”Analog wall clock showing 12:06

Those shot #1 symptoms popped up about six hours after I received it mid-morning. I went to bed early, and the next day, all the viral infection type side effects were far less troublesome. I felt less than 100% the day after, but able to partake in most normal activities.

I.e., I could have worked through the side effects triggered by my first dose.

My arm ached significantly for a total of five or six days, however, and I developed an uncomfortable swollen feeling in my armpit several days later that was probably my lymph nodes reacting.

On the other hand, in the four weeks after my first dose of Moderna’s vaccine, I experienced the most significant stiffness, joint pain, swelling, and fatigue that I’d had since the pandemic began. Staying at home most of the time while society remained mostly shut down was generally very protective for me against my usual, recurrent autoimmune disease symptoms.

I used far less pain medication than usual between March of 2020 and April 2021. I went entire weeks without needing an NSAID anti-inflammatory or using prescription pain killers. Between my two doses of COVID-19 vaccine, I required at least one of those every day.

I.e., I would have struggled to meet the demands of a full time job plus family responsibilities on many of the days between my first and second vaccine injections.Prescription bottle of pain pills

It is worth noting that this potentially vaccine-provoked flare never reached peaks equivalent to the worst ones I had right after my diagnosis. Also, the flare absolutely could have been coincidental. But, again, it’s the only serious one I had through the entire pandemic right up until I got my first shot.

I’m not arguing against vaccination. I am suggesting some of us might need extra resources to meet our daily responsibilities when we elect vaccination, doing our part to protect the entire community. Stepping up comes with a cost.

I have a healthy, supportive spouse. My large family includes relatively helpful, fit teens able to pick up the slack with household chores. Family members have been able to stagger vaccine appointments so we never experienced side effects simultaneously. Our income is sufficient that purchasing takeout meals or prepared foods is not a burden. I am easily able to reach my regular doctor with any concerns because I’m well-served with health insurance and the means to pay for Direct Primary Care out of pocket—including an option to text message my GP directly for urgent issues outside business hours.

In short, I have the good fortune to control most aspects of my daily life, so I could plan around the reality of vaccine side effects. I had sufficient personal resources to fall back on to meet all of my post-vaccination needs. Far too many Americans are less fortunate, many in more than one of the areas I’ve mentioned.

Speaking specifically to the autoimmune-challenged community, I’ve been delighted to find that my second dose of the mRNA vaccine seems to have abruptly ended the prolonged flare I experienced in the four weeks between shots. After feeling much worse due to its side effects than I had in over a year, by the fourth day post-vaccination, I became more energetic—and had less joint pain and stiffness—than I could recall feeling in recent memory. bandage on upper arm

I.e., my RA flare ended abruptly along with my vaccine side effects from the second shot.

Given that vaccination clears lingering symptoms for as many as 41% of COVID long haulers, I was fascinated to observe what could be a related effect in myself after jab #2. Communicating this potential improvement in daily functioning to those who are vaccine hesitant while believing themselves to have had COVID—some of whom never got confirmation of a likely coronavirus infection due to the scarcity of tests early in the pandemic—seems like yet another missed opportunity in public health messaging.

Everyone who wants the economy to rebound fully should take all possible actions to enable workers, especially those at the margins of poverty with limited access to health care, to make, keep, and recover after appointments for inoculation. Full disclosure of the known risks and known benefits—but also realistic potential risks and probable benefits—could bring us closer to herd immunity and full fiscal and medical recovery.

COVID-19 still holds many mysteries for science to uncover. The need to offer accurate information as well as paid time off to over-burdened breadwinners and caregivers so that they can confidently book vaccinations—without risking their livelihood!—isn’t one of them.

America’s front-line, essential workers have already borne more than their fair share of the fight against this pandemic. Today, those who employ these millions should step up with specific support to enable each one to get his or her shots.

* I say “likely” based upon the CDC website stating, for the Pfizer vaccine, “84.7% reported at least one local injection site reaction” and “77.4% reported at least one systemic reaction.” For the Moderna version, they state “[s]ystemic reactions were reported by the majority of vaccine recipients” with over 80% experiencing injection site reactions.

COVID vaccination: appointment & liberation

Add me to the ranks of the partially vaccinated in America. Today, I received dose one of two of the COVID-19 vaccine available at a location convenient to my suburban home. Within three miles, which is “reasonably close” even by my auto-phobic standards.

Redacted official CDC COVID-19 Vaccination Record CardMy state redefined its list of eligible health conditions the day before my turn would have been due anyway. I don’t believe that the state knew* I went from one to two eligible conditions overnight—the system asked one to confirm only from the original list of “certain medical conditions” as I pre-registered—but that change moved me up one “priority group” within the current phase of eligible citizens.

I pre-registered with the state’s mass vaccination system on Sunday, receiving notification three days later that my chance at snagging an appointment would open up within 24 hours. I was offered a turn to register for a mass vaccination site appointment at 09:49 on Thursday. I had until Friday at noon to take advantage of the option.

As it turns out, the state system only offered me appointments over 20 miles away. Given my continuing ability to shelter at home, I almost left it at that, planning to wait for my next invitation and hope it would be for a local site. Our state doesn’t have truly centralizing vaccination booking, however; the state system only books one in to seven major centers churning out thousands of doses per day.

I tried “the other way” of booking Thursday evening, i.e., last night. A local physician’s group had three appointments open for this morning. I took that as a sign that it really was my turn to book. Screen shot of COVID vaccine appointments confirmed at CVS PharmacySomeone else I know with one underlying medical condition was able to book via the CVS Pharmacy website. That screen grab makes a prettier picture than the black and white, all text shot from the doctor’s office where I went, so here is a CVS vaccine jab appointment confirmation. In both cases, the second, follow up appointment was automatically scheduled by the computer for the correct (3-4 week) wait after dose one, but the doctor’s office only shared my next appointment time with me after I’d arrived in person.

To be honest, I agonized a bit over whether it was really fair for me to take my place in line for the shot. There are many people who are more exposed than I am due to their working or living conditions. There are many people older, sicker, and at greater risk of dying from COVID-19 than I am. Those realities were reflected, however—if, perhaps imperfectly—by the state’s eligibility phase system.

I did not wangle, finagle, lie, cheat, or even fudge to make my appointment. I read and re-read the eligibility criteria, looking for any reason to find against the evidence that my government thinks I’m at higher than average risk from COVID.

I’m grateful to the reporting I’ve read in a variety of newspapers and magazines about the ethical considerations of “taking a shot from someone who needs it more.” The consensus is: if you meet the qualifications for the shot for which you’re signing up, it is your turn, and it is just and right to take it. To date, about a quarter of adults in my state have had their first shot, and closer to one third are fully immunized, similar to the national average.

No amount of logic erases the tendency to worry from those of us who are anxious, but I do fret less when I can ease the factual side of the equation. My worries on this issue are also alleviated by living with my frail, elderly mother-in-law. Her history of reacting to multiple vaccines and medications combined with a specific diagnosis she’s dealing with now makes her vaccination perhaps more risky than doing nothing.

It helps that my father-in-law has been fully vaccinated for awhile, reducing the threat that her closest companion could unwittingly expose her to the virus, but the kids’ gradual return to public life is already beginning. We’re scheduling dental cleanings again after a year of neglect, and some of DS1’s summer courses seem likely to include in person labs. We hope that DS2 will be get to finish out the year back with his friends at school.

With case rates coming down and vaccination ramping up, it no longer feels fully fair to expect my kids to give up all outside activities due to the adults’ choice to live in a multi-generational household. Even my introvert has confessed to missing the act of going somewhere to attend a class; my extrovert seems quite eager to start at a bigger, busier, fully “in person” school next fall.

Alaska Air account view showing trips in December 2021It may have been premature, but one of the first things I did, after booking my vaccine appointment, was to jump right onto Alaska Airlines’ website. I booked tickets—based upon DS2’s new school calendar—for us to spend Christmas 2021 with my dad in the state where I grew up.

Dad’s latest favorite joke is that he’ll “be immortal in just x more days,” where x stands for his distance from reaching a full two weeks after his second dose of the Moderna vaccine.

“I’m not sure that’s quite the right word, Dad,” I tease him. “Maybe don’t take up skydiving.”

“I-m-m… something!” he responds. “I’m pretty sure they said immortal.”

Somehow, he didn’t appreciate it when I suggested the word he was looking for could be “immature!” Not at his age, he retorts.

God and the pandemic willing, we will be heading west to see Dad over the summer, but I’m not quite ready to book an airline ticket for June just yet.

December, though?

I’ve got high hopes for December. And now I’ve got some airline tickets to go with them.

* I did add a comment to my submission stating that I was unclear whether to use their provided list vs. the new one the governor had just announced. It is possible that a human “corrected” my data after the fact, nudging me closer to the head of the line. I suspect that this comment box exists primarily to help the software developers improve the system, however. A newspaper article I read today suggests to me that availability is simply opening up across my state.

Here I must acknowledging that those rates have remained stubbornly higher than everyone had hoped due to the emerging COVID-19 variants, and that cases are currently kind of level in our own community. I speak more to the overall trend from the winter peak. We remain a “more cautious than average” household, I believe, even with 1/6 of our number fully immunized and 1/6 of us partially so.

The fact that many airlines have moved to discontinue the practice of charging exorbitant change fees to modify tickets helped tremendously in my decision to book now.