At any time, Fresno County resident Angélica Salceda has at least four websites open on her phone, hoping that one of them can tell you when it’s time for her parents to be vaccinated.
Every day, she checks the websites of the health departments of Fresno County and the neighboring county of Madera, where her parents live, as well as the medical provider’s website and the state’s recently launched My Turn portal.
Salceda fears that his 66-year-old father, who milks cows on a dairy farm, and his 64-year-old mother, who cares for children, could be exposed to the coronavirus through their essential jobs.
“I am very confused by the launch of the vaccine,” she said. “We are all at this point, especially those of us looking for appointments for the elderly, where we look everywhere.”
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In a state known as the birthplace of Big Tech, the distribution of vaccines in California has been slow, confusing and frustrating for many of its 40 million residents. The initial deployment used a fragmented approach that relied on counties and cities with their own health departments to distribute Covid-19 vaccines to eligible populations. But this approach only deepened the disparities between California’s wealthy areas and the state’s most vulnerable communities.
While wealthy regions like the San Francisco Bay area in northern California and Long Beach in southern California were able to effectively vaccinate their first batch of eligible residents, overworked communities in parts of Los Angeles and the Central Valley have struggled to meet to initial demand, as supplies remain low across the state.
“We are one of the most innovative states in the world, not just the country, and yet we have failed in the most basic ways,” said Nick Vyas, executive director of the University of Southern California’s Global Supply Chain Management Center. “We missed the opportunity to set up the right system the first time.”
California administered more than 3.5 million doses as of Wednesday, but is still behind many states in general vaccinations, according to the Centers for Disease Control and Prevention. The state used only about 60 percent of its vaccine doses distributed, ranking it in the bottom third of all 50 states.
The problem was especially pronounced in Fresno, a small county with a large proportion of agricultural workers. The county council of supervisors recently sent a letter to Governor Gavin Newsom begging for more doses after the county was forced to cut back on vaccination efforts because of dwindling supplies.
Last week, Fresno was able to deliver 30,000 doses a week, but the state’s current allocation is only 8,000 a week, said Joe Prado, manager of the community health division of Fresno County.
“There is a significant discrepancy between our delivery system and the actual doses we are receiving,” he said. “We had to completely reduce the number of doses we are administering in our distribution system, because if you do not reduce this amount, we will be without a second dose for our community.”
Meanwhile, San Francisco leveraged its own resources and those of major healthcare providers, such as the University of California, the San Francisco health care system and Kaiser Permanente, to begin establishing mass vaccination sites. The first, at City College in San Francisco, opened on January 22, and the city says it plans at least two more high-volume sites that could eventually vaccinate 10,000 people a day.
Mayor London Breed said the city also plans to administer vaccination through the city’s community clinic network and use mobile vaccination teams to send vaccinators to high-risk neighborhoods.
Dr. Susan Philip, San Francisco’s director of disease prevention and control, said the vaccine’s launch in the city would be worse without the presence of major health systems like UCSF and Kaiser.
“We have a robust healthcare system. We have many health professionals who are here in San Francisco, ”she said. “This is really a strength that we have – this great health workforce here.”
But, added Philip, the huge workforce is a kind of double-edged sword for the city. This means that it will take longer to vaccinate the entire health workforce, delaying vaccination for other high-risk groups, including teachers and people aged 65 and over.
Los Angeles County experienced a similar problem with its robust medical workforce. Public health officials were still working to vaccinate 700,000 to 800,000 medical workers when Newsom opened eligibility for people over 65.
When counting seniors and medical professionals, the county would need 4 million doses to inoculate the first set of eligible residents. As of last week, the county had received less than 1 million doses.
But even within Los Angeles County, disparities have arisen in cities with independently administered public health departments. Long Beach, a coastal city with a robust port economy, has administered nearly 50,000 doses, covering most of its health care professionals, and has now moved on to vaccinating teachers, food service workers and people over 65.
Dr. Tomás Aragón, director of the state Department of Public Health, said that cities like Long Beach benefit from “double coverage” because they can count on the county and their own health departments to meet demand. But with 10 million residents, the great county of Los Angeles is “like a country in itself,” he said.
“We are going through a lot of growing pains,” said Aragón. “These vaccines were only approved in mid-December, when we were in the middle of a winter wave.”
To address the initial shortcomings, Newsom, which is facing a recall effort, and the Biden administration announced a pilot program to create community vaccination sites in Oakland and Los Angeles. The initial sites, part of a larger effort to open 100 sites in President Joe Biden’s first 100 days in office, aim to vaccinate needy communities.
“This is a community-based and equity-driven partnership,” Newsom told NBC Nightly News. “You have to go where people are.”
One of the centers will be at the Oakland Coliseum, where the Oakland Athletics baseball team plays, and the other will be at California State University in Los Angeles. Both will be neighbors of communities hard hit by the pandemic.
The announcement follows a major change – it was revealed last week that California is creating a centralized vaccine distribution system led by insurance giant Blue Shield.
The sudden change favors the use of technology in the war against Covid-19, but presents potential problems for communities that do not have access to the internet, much less smartphones or computers.
“It is very disheartening to see the level of disparities with regard to the launch,” said Salceda de Fresno. “The state has to do better to ensure that our communities have access to the vaccine, information on how to obtain the vaccine and a number of alternative ways to obtain the vaccine.”
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Salceda, director of democracy and civic engagement at the American Civil Liberties Union in Northern California, considers herself a technology expert and fluent in the digital space. It was her patience that helped her unravel the bureaucratic tangle that is her friend Sonja Diaz’s vaccination marking system in Los Angeles.
Diaz, a Los Angeles resident who is founding the director of the UCLA Latino Policy & Politics Initiative, spent hours browsing the county’s online portal to make appointments for several of his elderly relatives, who were having trouble confirming vaccinations at Dodger Stadium.
She documented the hour-long experience on Twitter, saying his 85-year-old grandfather couldn’t figure out how to open a QR code attachment or print it out. His uncle and his mother were unable to open a text code sent to their phones.
Finally, Salceda accessed the Los Angeles vaccination portal and helped Diaz make appointments for four relatives.
“It’s like winning at Lotto or getting the Golden Ticket at Charlie and the Chocolate Factory,” said Diaz.