(Updated Dec. 21 to include new VA vaccination locations.)

In the days since the Food and Drug Administration provided the first emergency use authorization for a COVID-19 vaccine in the U.S., thousands of doses have been shipped nationwide … and an uncounted number of medical facilities, care centers, and government agencies have been asked to clear up questions on how the rollout will work.

As part of MOAA’s ongoing effort to provide health care information to its members, you’ll find some of the details on the early stages of this process below. Don’t be surprised if your specific question doesn’t yet have a solid answer – many of the pieces remain in flux, and many of the guidelines remain short on detail in the early going. MOAA will provide updates as new information becomes available.

DoD

Sites: DoD released plans Dec. 9 outlining the basics of the department’s response. These include the locations where the initial inventory of vaccine doses – just under 44,000 – will be distributed:

• California: Coast Guard Base Alameda, Naval Medical Center San Diego (including Camp Pendleton).
• Florida: Naval Branch Health Clinic Jacksonville, Naval Hospital Pensacola (including Keesler Air Force Base, will administer vaccines to residents at the Armed Forces Retirement Home in Gulfport, Miss.)
• Hawaii: Tripler Army Medical Center
• Indiana: National Guard (Franklin)
• Maryland: Walter Reed National Military Medical Center (will administer vaccines to the Armed Forces Retirement Home in Washington, D.C.)
• New York: National Guard Medical Command (Watervliet)
• North Carolina: Womack AMC
• Texas: Brooke AMC, Darnall AMC
• Virginia: Naval Medical Center Portsmouth (including Coast Guard Base Portsmouth)
• Washington: Madigan AMC
• International: Camp Humphreys, South Korea (Allgood Army Community Hospital); Kadena Air Base, Japan (Kadena Medical Facility); Landstuhl Regional Medical Center, Germany.

Priority: DoD has divided recipients into phases.

• Phase 1A includes health care providers and support personnel at military treatment facilities and other care locations. This may include non-clinical staff, contractors, and others who may be in close contact with COVID-19 patients.
• Phase 1B includes personnel supporting “critical national capabilities,” to include those preparing for overseas deployment. The vaccine will not be mandatory while under emergency use authorization, DoD officials stated, though that could change once regular authorization is granted.
• Phase 1B and Phase 2 both include high-risk beneficiaries.
• Phases 2 and 3 include other beneficiaries.

Who gets it: “I think in that first batch you'll see the retirement homes, the medical community and a very -- you know, a handful -- couple dozens of senior leaders for leadership and messaging purposes,” Assistant Secretary Of Defense For Health Affairs Thomas McCaffery at a Dec. 9 briefing.

[FROM CDC.GOV: What to Expect After Getting a COVID-19 Vaccine]

Health.mil released its first full post on the vaccine, including details on priority and other concerns, on Dec. 15.

VA

Sites: The VA announced the 37 sites that will distribute the department’s initial vaccine allotment. Here’s the full list. A VA spokeswoman told Stars and Stripes the department received 73,000 doses of the vaccine.

On Dec. 21, the VA announced an additional 128 sites offering vaccinations, including 113 that would offer the new Moderna vaccine, which can be stored at warmer temperatures. See the full list here.

Priority: Health-care workers and veterans at the VA’s long-term care facilities will have early access to the vaccine. After those populations, VA will begin vaccinating beneficiaries “based on factors such as age, existing health problems and other considerations that increase the risk of severe illness or death from COVID-19,” per a Dec. 10 news release.

More details came a few days later in the form of an 88-page vaccine rollout plan, issued Dec. 14. Per that report, “Populations of focus for initial COVID-19 vaccination may include” the following:

• “Critical workforce,” to include health care providers and those “maintaining essential functions of society”
• Staff and residents of long-term care and assisting living centers
• Patients ages 65 and older
• Patients with conditions making them more susceptible to COVID-19

A day after the report's release, VA went into more detail via a blog post: "Under this phased plan, VA will begin vaccinating health care personnel – as they are essential in continuing to care for patients throughout the pandemic. At the same time, VA will vaccinate Veteran inpatients in Community Living Centers and Spinal Cord Injury and Disorder Centers."

Veterans "receiving care from VA at high risk of severe illness from COVID-19" will be offered the vaccine after health care personnel, per the post.

Coverage: Plans call for free vaccines for all enrolled veterans who want one, once supplies are available. Supply-chain issues may also delay vaccines for rural veterans and VA care providers.

FAQs: VA has compiled a series of answers to frequently asked questions about the vaccine and its administration.

Cost and More

Per multiple reports and federal guidance, the vaccine itself will be free to all Americans, regardless of insurance. Providers may charge for giving the shot, but all insurance plans are expected to cover that portion of the bill, with some federal money available to cover that cost for uninsured individuals.

Per the Centers for Medicare and Medicaid Services website, “Providers that participate in the [Centers for Disease Control and Prevention] COVID-19 Vaccination Program contractually agree to administer a COVID-19 vaccine regardless of an individual’s ability to pay and regardless of their coverage status, and also may not seek any reimbursement, including through balance billing, from a vaccine recipient.”

(TRICARE For Life users, take note: Medicare Part B will cover vaccines without coinsurance or a deductible thanks to an Oct. 28 rule change.)

Those seeking care outside DoD and VA channels will be part of a distribution/priority system designated on a state-by-state basis. For more information about your state, visit the links on the last pages of this National Governors Association report.