In parts of the Bay Area, anyone 50 and older can get the COVID-19 vaccine right away.
In San Diego, health officials are vaccinating anyone with asthma or type 1 diabetes.
And in San Francisco, the injection is available to anyone who is HIV positive or is considered obese.
As the supply of the COVID-19 vaccine increases, an increasing number of 61 health departments in California have broken state health guidelines and made vaccines available to potentially millions of additional people, creating joy among residents and frustration and envy among residents. residents of counties that are adhering to stricter rules.
“All the decisions the authorities made put me on the outside, looking in,” said Mike Zimmerman, 48, a communications worker who lives in downtown Los Angeles. Zimmerman repeatedly found himself almost, but not quite, making the cut: a few blocks from a prioritized zip code, a few years from a few age cuts, in a job category removed from the state’s priority list.
“My industry has been cut from this list while others have become eligible,” he said. “My job went from being vaccinated to not being vaccinated, although my work is no less dangerous.”
At least four counties – including Contra Costa, San Luis Obispo, Butte and Solano – have recently reduced their age requirement for vaccination to 50. In Tuolumne, there are 45. Several others, including San Diego and San Francisco, are now vaccinating people who are considered overweight or with any chronic health condition.
Some counties that have expanded access have seen interest dwindling in vaccines, while others have received additional doses through the state or pharmacies. Other counties, including Los Angeles, are still struggling to secure enough doses to meet demand.
Dr. Barbara Ferrer, head of the LA County public health department, said on Tuesday that she expects the county to open vaccines for everyone before May 1, a date set by Governor Gavin Newsom, but much depends on the supply. In the early days of open eligibility, the county should focus on vaccinating residents in the neighborhoods most affected by COVID-19, she said.
Access to the expanding but still irregular vaccine has created some confusion. Overweight people – those with a body mass index between 25 and 29.9 – can be vaccinated in San Diego County, but not in neighboring Orange County, for example. Contra Costa County residents in their 50s are now eligible, but Alameda County residents are not.
It is up to each county to limit vaccines to those who live or work locally, state officials say. But some federal and retail pharmacy sites do not have these limitations, and the temptation to cross county boundaries is strong.
LA County continues to follow state guidelines for vaccine eligibility, the health department said on Tuesday. County-run sites will not vaccinate people who do not live or work in the county and have overbooked if people from other counties are able to get a place, Ferrer said.
Governor Gavin Newsom said California is expected to receive about 1.8 million doses this week. More than 15.1 million doses have been administered in the state, which recently expanded access to the vaccine to nearly 5 million people with underlying health problems and disabilities.
The state’s standards are even more conservative than many others, including Alaska, West Virginia and Mississippi, which are vaccinating everyone aged 16 and over. Georgia, Arizona and Texas are following suit this month. Everyone aged 50 and over is eligible in Florida and New York, and in Indiana and Ohio are vaccinating residents in their 40s.
Opening vaccination to more people will increase competition for qualified people who have difficulty scheduling an appointment. This includes elderly people without reliable access to the Internet, patients with language barriers and essential workers with multiple jobs and little time.
Some counties, like San Diego, said they chose to follow the Centers for Disease Control and Prevention guidelines, which are broader than those in the state.
This county is now explicitly offering vaccines for people with a BMI over 25: about 169 pounds for a man with an average height of 5 feet and 9 inches and 145 pounds for a woman with an average height of 5 feet and 4 inches. It is also vaccinating people with asthma, hypertension, dementia, type 1 diabetes and other conditions that may put them at greater risk.
It is unclear how many people are now eligible in San Diego County, as “many have cross comorbidities and do not line up in beautiful columns”, but the vast majority of vaccination appointments are still being claimed, a spokesperson for the Health and Human Services, Anita Lightfoot said.
More than 30% of San Diego residents received a dose, compared with 26% across the state.
San Luis Obispo County on Monday expanded access to residents between the ages of 50 and 64 – about 50,000 people – in part because additional doses sent by the federal government to retail pharmacies like CVS eased the pressure at drugstore locations. county vaccination, said spokeswoman Michelle Shoresman.
“We started to see more suppliers getting bigger, more stable supplies and more online pharmacies,” said Shoresman.
When California expanded access to the vaccine for people with serious underlying health conditions and disabilities, San Francisco health officials “interpreted this eligibility criterion more broadly” to include residents with HIV or a BMI of 30 or more, he said. a health department spokesperson.
They also prioritized people with disabilities, including mental health and substance abuse disorders, the city said. About 10% of the population of San Francisco identifies themselves as deaf or disabled.
Not all counties are basing their expansion on stable supplies. Northern California’s Solano County has experienced a sharp decline in vaccine distribution in the past two weeks, but opened eligibility for people over 50 last week, officials said.
The decision was based in part on demand, not supply: reserves are decreasing. “When people are being notified and consultations are not being held, that’s when we know we have to open,” said Jayleen Richards, the county’s public health administrator.
Some at-risk community members who have not yet been vaccinated said the most recent opening was premature. A few days after Solano expanded eligibility, Yvette Espinoza, 29, showed up for a confirmed appointment at Dunnell Nature Center and found the facility closed.
A piece of paper fell from the front door and landed on the floor. “No vaccine – it’s over,” he said in a black marker.
“I collapsed,” said Espinoza, who has several underlying health problems. “I was seeing mothers walking with their children in wheelchairs and people struggling to get out of their cars just to be disappointed. We really need to fix the system. “
Solano County is now asking the state to send more doses.
In Tuolomne County, authorities recently expanded eligibility for residents 45 and older, partly due to the vaccine’s hesitation, said Dore Bietz, coordinator of the Emergency Services Office. The county received a constant amount of vaccines for everyone who is eligible and interested in vaccination, said Bietz, and received extra doses.
Other counties continue to complain that a limited supply is hampering their vaccination efforts. State and local officials have warned for weeks that supplies would remain stable until late March or early April, when allocation is expected to increase significantly.
Last week, in Santa Clara County, authorities postponed appointments for the second dose of thousands of Kaiser Permanente customers.
“The lack of sufficient supplies from the state has been frustrating for everyone,” said Dr. Marty Fenstersheib, Santa Clara County Test and Vaccine Officer, “particularly those who are eligible for the vaccine and want to be vaccinated, but have been unable to subscribe. “
Times staff writer Jaclyn Cosgrove contributed to this report.