DALLAS — As COVID-19 vaccines become more available to older Texans and those with underlying health conditions, confusion remains about how those who qualify under the state’s rollout plan are expected to demonstrate their eligibility.

Health care providers have access to medical records and can reach out to eligible patients about the vaccine. But state or locally run vaccination sites don’t have medical files.

And while health officials want initial vaccines to go to those at higher risk of developing serious illness — a move that will lessen the burden on overwhelmed health care systems — they also don’t want to make it hard for people to get vaccinated.

Currently, Texans eligible for the vaccine under the state’s plan include front-line health care workers and those in long-term care facilities, known as Phase 1A, and those over 65 and people 16 and older who have underlying health conditions, known as Phase 1B.

Health conditions on the state’s list include, but aren’t limited to, cancer, chronic kidney disease, chronic obstructive pulmonary disease, Down syndrome, certain heart conditions, organ transplant recipients, obesity and severe obesity, pregnancy, sickle cell disease and Type 2 diabetes.

The state health department told health care providers to refer to medical records to confirm underlying health conditions. If the provider doesn’t have access, people eligible under Phase 1B can disclose their conditions — but they don’t have to provide documentation, said Lara Anton, a spokeswoman for the department.

“We don’t want to create barriers that would prevent people from getting vaccinated,” Anton said. “It’s important to remember that every person vaccinated helps slow the spread of the virus.”

Matt Richardson, director of Denton County Public Health, which the state has designated as a vaccination hub, said the county has done its best to balance ensuring that people are eligible and honest about their status and getting “as many doses in as many arms as possible.”

“It would bother us if people weren’t being truthful, and yet that is a small price to pay,” he said, adding that the ultimate goal is to get the community to reach herd immunity as quickly as possible. “It would bother us much more if we were withholding vaccines and delaying an efficient, effective process.”

Dallas County’s health department, also a vaccine hub, is focusing on those over 75 and has not yet opened appointments to younger people in the 1B category. When they do, health officials won’t require medical records, said Dr. Philip Huang, director of the county’s health department.

While it’s possible someone could be dishonest about his or her 1B status, people should remember the goal of phased vaccine rollout is to “make the limited vaccine that we have practical,” Huang said.

“We hope people will all understand and hope everyone would rather protect their grandparents and their mother and other people’s grandparents and mothers, and understand this is in all of our best interests,” he said.

Tarrant and Collin counties’ health departments also have been designated as vaccine hubs. A spokesperson with Collin County said patients are not required to provide medical records to get an appointment. Tarrant County did not respond to requests for comment.

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