The announcement from Health Director LaQuandra Nesbitt represents a change in the city’s plans for vaccinating people whose health puts them at additional risk from the virus, following criticism from the public.
Earlier, Nesbitt had said she was considering opening appointments first to people over 50 with health complications, then to younger sick people. Younger adults with serious conditions — including those with cancer or who are permanently disabled — argued in testimony at a D.C. Council hearing, in letters to city leaders and in the news media that they were equally or more endangered by the virus than some older people with less-serious illnesses who qualify before them.
Ankoor Shah, a pediatrician who is running the city’s vaccine program, said at a council meeting Wednesday that the stories from these young people “tug at my heart.”
On Thursday, Nesbitt said the city’s scientific advisory committee decided not to sort this group by age, in part because many patients with HIV and sickle-cell anemia do not live to 50. They wanted to make sure those patients qualified right away, she said.
But while the city expanded eligibility, it significantly shrank the pool of people who qualify by eliminating two conditions that had earlier been on the list: people who smoke and people whose body mass index classifies them as overweight but not obese.
Under the rules that Nesbitt announced Thursday, the city will offer vaccines to people with a BMI of 30 or higher — classified as obese — but not to those whose BMI falls between 25 and 29.9, which originally was in the city’s plan.
While nearly 24 percent of adults in the District are considered obese, according to the Centers for Disease Control and Prevention, more than half the city’s residents are considered at least overweight.
Many states are vaccinating people with a BMI over 30, or in some states over 35 or 40. Medical experts had questioned the District’s original plan, saying scientific studies offer little proof that people with BMIs from 25 to 30 suffer worse outcomes from coronavirus than those at a healthy weight.
Smoking, on the other hand, has been shown to put patients at much higher risk of severe complications from the coronavirus.
Nesbitt said she removed smoking on its own as a qualifying condition for a vaccine on the theory that those who smoke might have other conditions to qualify them for a shot.
Pregnancy remains one of the conditions that will qualify D.C. residents for a vaccine, and Nesbitt said she encourages residents to take advantage, despite the lack of scientific research into the effects of the vaccines on pregnant patients.
The city allocates more than 60 percent of the doses it receives from the federal government directly to health-care providers, including major hospital systems and nonprofit health clinics. Most patients with these health conditions, city leaders predict, will seek a shot from their doctor — meaning doctors will have their medical history on file and will know which patients qualify.
Those who don’t have a doctor affiliated with a health system delivering vaccines will need to register through the city’s website. No doctor’s note or documentation will be required; patients will need to agree to a statement affirming they have one of the qualifying conditions.
Coronavirus cases across the greater Washington region have been falling for weeks. On Thursday, the District reported 121 new cases and seven deaths, Maryland reported 986 cases and 31 deaths, and Virginia reported 2,304 cases and 15 deaths.
Regional leaders continued their push for the federal government to take on responsibility for vaccinating some of the area’s federal workforce.
Christopher Rodriguez, the District’s emergency management director, said again Thursday that he expects the Federal Emergency Management Agency will rebuff last week’s request by D.C., Maryland and Virginia that FEMA vaccinate 30,000 workers.
But seven Democratic members of Congress from the region asked the CDC and the Office of Personnel Management in a letter Thursday to find a way for federal workers’ vaccines not to come from local supplies.
“Rather than foisting federal employees into Virginia, D.C. or Maryland’s supply of vaccines and increasing their essential worker vaccination responsibilities, the federal government should vaccinate federal employees through a separate federalized allocation,” they wrote
The District also published new maps showing, in more granular detail, where people who have gotten vaccinated live in the city. The maps showed major gulfs between wealthier, Whiter neighborhoods and poorer, majority-Black neighborhoods. In Tenleytown and the Palisades neighborhood, more than 2,000 people have gotten at least one shot. In Douglass and Washington Highlands, fewer than 300 people have.
By portion of the population vaccinated, 18 percent of Chevy Chase residents have at least one shot, while 3 percent of Anacostia and Bellevue residents do.