The state announced this week that the COVID-19 vaccine will be administered on the basis of age and not a person’s risk factor, a change that Santa Clara County health officials fear could affect equitable access.
Meanwhile, a coalition of local lawmakers is pressuring Governor Gavin Newsom to allow vaccines to be distributed by census tract, allowing the worst-hit areas to receive vaccines first.
“Although Santa Clara County as a whole may appear to have average rates of COVID-19 infection, there are serious health disparities between communities of color,” says a letter signed by 10 senators and members of the Bay Area assembly. For example, 25% of the county’s population is Latin, but this group represents more than half of all COVID-19 cases in the county.
State health officials announced on January 26 that eligibility will change and become exclusively based on age after Phase 1B, Level 1, which mainly covers people aged 65 and over. The idea, state officials said, is to speed up the distribution of the vaccine in all 58 counties and allow the state to increase capacity, ensuring that the vaccine goes to affected communities disproportionately.
“It is very clear that the state is having much more control over what is happening with vaccines,” said city councilor James Williams.
State officials also announced on January 27 that they are testing a notification system to alert all California residents of their eligibility for the vaccine. The service, called My Turn, was deployed in Los Angeles and San Diego counties. The system, which is expected to be available across the state in February, lets Californians know when it’s their turn to get the vaccine and make an appointment.
Finally, the state will hire a private company to distribute vaccines directly to suppliers to “maximize the efficiency of distribution”. This will also give the state greater visibility of what is happening at the site, officials said. Santa Clara County officials said this change would limit their view of the vaccine pipeline.
“If they are now changing the allocation system, the obvious and significant concern at the site is how we will actually get the necessary vaccine from suppliers,” said Williams. “The biggest vaccine supplier that serves our most vulnerable populations is, without a doubt, the health system in Santa Clara County.”
Pending guidance from the state, the Santa Clara County Health System began offering vaccines to residents age 65 and older on January 27.
Williams told Santa Clara County supervisors that the state’s announcement took the county by surprise, and it is difficult to say how a plan to hire a company to distribute vaccines to counties will be implemented.
“It raises a lot of questions that we hope to get answers to,” said Williams. “It is extremely worrying and we hope that the state will establish a very direct channel for our municipal health system.”
Williams said changes in the state could significantly affect county operations. But without further details, it is uncertain how far these impacts will be.
The reviews, especially regarding vaccine eligibility, did not please supervisor Susan Ellenberg.
“I think it would be much fairer, much more beneficial and much more impactful in reducing cases if we then focused on high-risk (employees),” said Ellenberg. “We are talking about equity … it doesn’t translate if we don’t prioritize (residents) for their work as opposed to their age.”
Ellenberg asked county officials to find out how flexible the new state guidelines are and whether the county could differ.
Also on January 26, the Santa Clara County Legislative Committee sent a letter to Newsom asking the state to allow counties to distribute vaccines to vulnerable populations first. The proposal was led by San Jose deputy Ash Kalra and city councilwoman Magdalena Carrasco, whose district of East San Jose has the highest number of COVID-19 cases and deaths – particularly among communities of color.
The letter said that allowing local jurisdictions to distribute the vaccine by census tract “recognizes these disparities and promotes equitable allocation of limited resources”.
“I hope the county gets the flexibility it needs to focus attention on the working class, especially in Latin American neighborhoods that are hardest hit by the pandemic,” wrote Kalra in a Facebook post.
Dr. Marty Fenstersheib, Santa Clara County COVID-19 testing officer, said the state plan lacks specificity and clarity.
If there is a limiting factor for the county’s vaccination capabilities, it is the availability of doses distributed by the state, said Fenstersheib. County health officials – based on the limited information available this week – I can’t say whether that would mean more vaccines for county health providers.
According to the county vaccine panel, more than 127,000 people received their first dose of the COVID-19 vaccine. Almost 32,000 residents received both doses.
Still, the county is currently receiving only 40,000 doses a week. Earlier this month, public health officer Dr. Sara Cody announced her goal to vaccinate 85% of the county’s population by August 1.
To achieve that goal, said Fenstersheib, about 100,000 residents would need to be vaccinated every week by August 1.
“You can see that we are a long way from being able to vaccinate and getting close to our goal,” said Fenstersheib.
Contact Madelyn Reese at [email protected] and follow her on Twitter @MadelynGReese