When Essex County began offering COVID-19 vaccines last week, some residents discovered they would have to head to a hospital or their physician’s offices instead of the county clinics if they had certain medical conditions.

The vaccine is currently available only for health care workers and residents and staff of long-term-care facilities.

Residents wanting to register with the county to get vaccines are taken through a list of questions such as:

  • Have you ever had a severe allergic reaction (e.g., anaphylaxis) to something? For example, a reaction for which you were treated with epinephrine or an EpiPen, or for which you had to go to the hospital? 
  • Do you have a bleeding disorder?
  • Do you have a weakened immune system caused by something such as HIV infection or cancer, or do you take immunosuppressive drugs or therapies?
  • Are you breastfeeding?

If the survey taker answers yes to any of those questions, an appointment cannot be made with the county, and the person is directed to call his or her physician. 

Some residents with medical conditions apparently are concerned they are being “disqualified” through the questionnaire.

County Commissioner President Brendan Gill said the reason some people will be directed to a doctor or hospital is for health and safety precautions in case of a reaction to the vaccine.

“It’s not that anyone is disqualified from it,” Gill said, but that the county is concerned that it won’t be able to respond properly if someone has a severe medical reaction. 

The decision was made at the advice of the county health officer and county physicians after reviewing data and guidelines from the Centers for Disease Control and state Department of Health. 

“I don’t think anyone would want to be in a position, God forbid, that a proper screening wasn’t done,” Gill said. 

County spokesman Anthony Puglisi said the county compiled the screening questions after reviewing CDC data and guidelines.

“Out of an abundance of caution, our position is that those with certain medical conditions should be vaccinated under the close supervision of their physician,” Puglisi said.

CDC recommends that people with a history of severe allergic reactions not related to vaccines or injectable medications – such as allergies to food, pets, venom or latex – may still get vaccinated. People with a history of allergies to oral medications or a family history of severe allergic reactions, or who might have a milder allergy to vaccines (no anaphylaxis), may also still get vaccinated.

The CDC advises people with a history of allergic reactions wait 30 minutes after receiving their shots, so they can be monitored for any reactions: “If you have a severe allergic reaction after getting the first shot, you should not get the second shot. Your doctor may refer you to a specialist in allergies and immunology to provide more care or advice.”

The CDC acknowledges very limited data exists regarding the safety of the vaccine for pregnant women. While pregnant or breastfeeding women who are in one of the first three phases may seek the vaccine, the CDC says, both groups are advised to consult with health care providers. 

The CDC advises that while people with weakened immune systems or autoimmune disorders may receive coronavirus vaccines, since they are at increased risk of COVID-19, they should be advised that limited safety data exists, especially regarding the Moderna vaccine and mRNA vaccines in general. Patients with bleeding disorders are likewise advised to consult with their physicians, who will determine if the they can safely receive the vaccines. 

Vaccine sites, the CDC advises, should have certain medical equipment on hand, including blood-pressure cuffs, stethoscopes and EpiPens. 

Of the six Essex County vaccine facilities, Montclair residents are being directed to the former Kmart building on Prospect Avenue in West Orange. 

In addition to the county sites, New Jersey is opening six “mega sites” for people to receive vaccines, starting with front-line health workers. The clinic for the northeast region, including Montclair, will be at the Meadowlands complex in Bergen County. 

Montclair is expected to start community microclinics in January. 

Stephen Adubato, a dentist with a practice in Nutley, said he went for his first dose on Dec. 30 at the West Orange location.

“I was amazed. It went like a well-oiled machine, which I think is unusual for a county operation,” Adubato said.

About 20 people were ahead of him, he said, and he was in and out in about half an hour, including the 15 minutes he needed to wait after receiving the vaccine. 

It is likely that the county sites could see between 4,500 and 5,000 people a day, Gill said. 

About 2.7 million people nationwide have received vaccines as of Dec. 30, according to the CDC’s vaccine tracker. 

In the next phase, 1B, the vaccine will be given to other essential workers and to people over the age of 75, as well as front-line essential workers such as police officers, firefighters and grocery store clerks. In the 1C phase following that, those over 65 and those under 65 who have underlying medical conditions, as well as other essential workers will get vaccines, before they are made available to the general public in a final phase. 

New Jersey has a goal to vaccinate 70 percent of the state’s adult population by late spring. 

Adubato said he got a postcard in the mail, which was sent to Essex County residents, inviting them to make appointments if they fell into Phase 1A for frontline medical workers, and to residents and staff of long-term-care facilities. Adubato also got an email from the New Jersey Dental Association, advising its members to get vaccinated. 

Gill said the county is trying to encourage as many people as possible to get vaccinated, as safely as possible. He added that county health officials are making decisions based on the data and information that is being provided to them, and that there are still a lot of unknowns on how different people with different conditions will respond to the vaccine. 

People who are showing what may be symptoms of COVID-19, including a cough, fever, muscle aches, nausea or loss of taste or smell, will not be able to make appointments through the county to get vaccinated, and should instead make appointments to be tested for COVID-19. 

Gill urged everyone to have patience. "There’s no playbook on how to vaccinate 4.5 million people in three months," he said.