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North Carolina Gov. Roy Cooper speaks during a press conference on Aug. 13, 2020. North Carolina Gov. Roy Cooper speaks during a press conference on Aug. 13, 2020.

North Carolina Gov. Roy Cooper speaks during a press conference on Aug. 13, 2020.

Paul Specht
By Paul Specht February 17, 2021

How are the CDC, North Carolina treating Type 1 diabetes in the vaccine rollout?

If Your Time is short

  • It's unclear who paid for the billboard and why, specifically, they commissioned it.
  • Knowingly or unknowingly, it touches on a controversial issue surrounding diabetics and the vaccine rollout.
  • Unlike other states, North Carolina does plan to vaccinate people with Type 1 diabetes ahead of the general population.

A billboard in Johnston County suggests North Carolina Gov. Roy Cooper is shortchanging people with type 1 diabetes.

A WRAL viewer emailed a photo of the billboard on U.S. Highway 301 to PolitiFact. It says:

"Gov Roy Cooper does not consider Type 1 diabetes an under lying health issue! Think about that!"

The billboard does not show who paid for it. Warren Stancil, the president of the billboard company, InterState Outdoor Inc., said he doesn’t know the buyer’s identity.

"This was an anonymous person who bought the ad space. All I know is what’s in the message," Stancil said in an email. The ad went up around Jan. 22, he said.

Given the timing of the message in the midst of a vaccine rollout, we’re assuming for the purposes of this check that the messenger is likely referring to where diabetics fall in North Carolina’s inoculation schedule.

The billboard’s message touches on a controversial subject. To date, the U.S. Centers for Disease Control and Prevention does not consider both types of diabetes to carry the same level of risk for COVID-19 complications. In North Carolina, meanwhile, the health department has grouped Type 1 and Type 2 diabetes together and people with either condition qualify for covid vaccines in Group 4, ahead of the general population.

Type 1 diabetes and COVID-19

The CDC’s webpage about how the virus affects people with medical conditions says people with Type 2 diabetes are at increased risk, while people with Type 1 diabetes "might" be at increased risk.

Under current CDC recommendations, people with Type 1 diabetes would be vaccinated with the general population.

Advocacy groups such as the American Diabetes Association and JDRF (formerly known as the Juvenile Diabetes Research Foundation) are lobbying the CDC to place higher priority on people with Type 1 diabetes. 

A study published in December found that Type 1 diabetes "independently increases the adverse impacts of COVID-19," while another recent study found that Black COVID-19 patients were more likely to develop a serious complication of Type 1 diabetes than white patients.

Still, JDRF spokeswoman Cynthia Rice said that, as a result of the CDC’s recommendations, "many states" haven’t prioritized people with Type 1 diabetes. So the American Diabetes Association has been contacting governors and state agencies across the country, spokeswoman Daisy Diaz told PolitiFact.

Type 1 diabetes and North Carolina

In North Carolina, the health department currently considers both types of diabetes to be "chronic conditions." Where does that put diabetics in North Carolina’s vaccine rollout?

Let’s say someone has diabetes but isn’t over age 65, doesn’t work in an essential industry and doesn’t meet any other criteria for moving up North Carolina’s vaccine priority list.

That person would be in Group 4 of the state’s five groups:

Group 1: Healthcare workers, long-term care staff and residents

Group 2: Older adults

Group 3: Frontline essential workers

Group 4: Adults at increased risk of severe illness

Group 5: Everyone else

Asked about North Carolina’s plan, Rice said: "That is the policy we are seeking around the country, with Type 1 included with other disease that increase risk of severe illness from COVID."

Possible confusion

While people with both types of diabetes are prioritized in North Carolina, old versions of the health department’s website may have given people the wrong impression.

Take for example the department’s FAQ page about COVID-19 vaccines. Under the "getting vaccinated" section, the department lists chronic conditions that make someone a higher priority for vaccination.

The page currently lists both types of diabetes as chronic conditions.

However, according to an internet archive, the page excluded Type 1 diabetes from its list of chronic conditions as recently as Feb. 12. The webpage quoted CDC guidance, mentioning only Type 2 diabetes as a chronic condition.

That exclusion may be why some media outlets have mentioned only Type 2 diabetes when reporting on North Carolina’s rollout.

North Carolina has tried to follow most CDC recommendations, said SarahLewis Peel, a spokeswoman for the health department. However, Peel said, North Carolina has always intended to prioritize all diabetics for vaccines. 

People with both types of diabetes have been prioritized together since the state released its guidance for Group 4 on Jan. 25, she said.

Our ruling

The billboard says "Cooper does not consider Type 1 diabetes an (underlying) health issue!"

North Carolina’s vaccine rollout prioritizes people with type 1 diabetes ahead of the general population. So it’s clear that Cooper, to some degree, considers the disease to be an underlying health issue.

We rate this claim False.

Our Sources

Photo provided by WRAL viewer.

Email interview with Warren Stancil, president of InterState Outdoor Inc.

Email interview with Cynthia Rice, JDRF spokeswoman.

Email interview with Daisy Diaz, spokeswoman for the American Diabetes Association.

Email and phone interviews with North Carolina Department of Health and Human Services spokeswomen Chris Mackey and SarahLewis Peel.

Story by StatNews, "People with type 1 diabetes have a higher risk of dying from Covid-19. Why are they lower on CDC’s vaccine priority list?" posted Jan. 11, 2021.

Pages on the U.S. Centers for Disease Control and Prevention website, "COVID-19 and people with certain medical conditions," and "The Advisory Committee on Immunization Practices’ updated interim recommendation for allocation of COVID-19 vaccine." 

Statement by the American Diabetes Association, "The American Diabetes Association urges CDC to give equal priority to people with Type 1 and Type 2 diabetes for vaccine eligibility," posted Jan. 13, 2021.

FAQ post by JDRF on Jan. 11, 2021.

Study, "COVID-19 Severity Is Tripled in the Diabetes Community: A Prospective Analysis of the Pandemic's Impact in Type 1 and Type 2 Diabetes," published online by the National Library of Medicine on Dec. 2, 2020.

Study, "Inequities in Diabetic Ketoacidosis Among Patients With Type 1 Diabetes and COVID-19: Data From 52 US Clinical Centers," published online in the Journal of Clinical Endocrinology & Metabolism on Dec. 19, 2020.

North Carolina Department and Health and Human Services webpage, "Frequently Asked Questions about COVID-19 Vaccinations," PDF: "COVID-19 vaccines: Your best shot against COVID-19," webpage and PDF: "Group 4 -- Adults at high risk for exposure and increased risk of severe illness."

Archived NC DHHS webpage, "Frequently Asked Questions about COVID-19 Vaccinations," saved on Feb. 12, 2021 by Archive.org’s Wayback Machine.

Story by ABC11, "When can you get vaccinated? North Carolina makes changes to phases," posted Jan. 14, 2021.

Story by WECT, "NCDHHS announces those 65 and older are eligible for vaccinations," posted Jan. 14, 2021.

Story by WBTV, "Phase 1b of vaccine distribution plan begins across N.C.," posted Dec. 30, 2020.

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How are the CDC, North Carolina treating Type 1 diabetes in the vaccine rollout?

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