Dr. George Rutherford, an epidemiologist at the University of California, San Francisco, said the most obvious problem with administering the vaccine in the San Francisco area was clear: “There aren’t enough doses, period,” he said. “That’s it. Everything would work well if you had enough doses.”
The San Francisco department of public health and the city’s hospitals were “taken aback” by the lack of doses, said Rutherford, and by the expansion of eligibility for people 65 and older, which probably overburdened the system. Several channels of vaccine delivery – such as Kaiser Permanente and the University of California, San Francisco – receive the doses on their own, he said, further complicating an already complicated delivery system.
“So it is a little difficult for the city to understand exactly what is left, what they need to do, where the holes should be filled,” said Rutherford. Still, new vaccination sites are opening in San Francisco, which Rutherford said would help speed up the process as more doses become available. “There is a tension between efficiency and equity,” he said. “It is never easy.”
Dr. Grant Colfax, head of the San Francisco Department of Public Health, said the city was “very close to running out of doses” and said that the general lack of coordination led to distribution problems.
“I think what this really is, is a continuation of the consequences of the lack of a coordinated federal response,” he said. “Basically, cities and counties were left alone to deal with this pandemic.”
He said that local jurisdictions “simply lacked the resources and capacity” to handle the complicated effort without assistance. “It manifested itself in a very tragic way.”
In Austin, Texas, Curt Fisher, 76, who served on the boards of several high-tech start-ups, experienced firsthand the confusing obstacles to securing a vaccine. He had been playing golf with friends for several weeks, when they learned that Austin Public Health had vaccines available.