Questions and anxiety increase with slow implementation of the COVID-19 vaccine in San Diego

With a needle stick, an elderly man from Chula Vista was vaccinated against COVID-19 on December 21, receiving cheers and applause from a room full of health professionals.

Carlos Alegre had just become one of the first san diegans to receive a vaccine that fights the new coronavirus, raising people’s hopes that the municipality, and the country, will come out of the pandemic, perhaps in the middle or late summer.

That hope still exists. But the vaccine’s launch did not start quickly. A new variant of the virus is helping to bring infections to record levels. And a post-New Year’s Eve spike could make things worse this week and push the overcrowded hospitals in greater San Diego into a crisis mode.

The situation is generating a lot of public anxiety and many, many questions, some of which are answered here.

How many of the 3.4 million people in San Diego County received the COVID-19 vaccine?

No one provided an accurate count. A county spokesman said on Friday that 58,000 people were immunized. But this can be underestimated due to delays in reporting. And the figure does not include residents of nursing homes who were vaccinated in these facilities by CVS and Walgreens. Pharmacies are leading a national vaccination effort that will involve more than 90 percent of California’s long-term care facilities.

The overall vaccination figure also does not include the military community in San Diego County, which is among the largest in the United States. The Navy inoculated many officials and frontline officials and began to immunize some of the more than 105,000 uniformed active duty personnel in the municipality. But for security reasons, the Navy does not disclose the number of people who have been vaccinated to date. The VA San Diego Healthcare System immunized nearly 3,100 people.

It is also unclear how many total doses of the vaccine were delivered to the county, hospitals, military and other parties involved in immunizing people. No one is gathering the data and publishing it publicly – although that may change.

“When we have the data, we will share it,” said county supervisor Nathan Fletcher. “We continue to push. It’s frustrating. We would like to know today exactly how many (doses) are here. “

Is it possible to gather this data?

It is being done in many other places. Indiana’s main website reports how many people received the first dose of a vaccine, the number of people fully vaccinated and divides the numbers by county, age, sex and ethnicity. Ohio does something similar. The same is true with UC San Diego. But California, despite its position as the center of the information technology universe, does not. Nor does San Diego County.

Is vaccination implementation going better in other parts of California and elsewhere in the USA?

Generally speaking, no. About 2.3 million doses of vaccine were distributed across California as of Thursday, according to the Centers for Disease Control and Prevention. Less than one in four doses (about 528,000) was actually administered.

This echoes the situation across the country. The leaders of Operation Warp Speed, the US government’s attempt to accelerate the development and distribution of vaccines, declared that 20 million Americans would be vaccinated by the end of December. It is the beginning of January and around 6 million people have received the vaccine COVID-19. That is less than 2% of the country. In comparison, Israel vaccinated more than 17% of its population, according to a database maintained by researchers at the University of Oxford.

Deployment in the United States got off to a slow start for a number of reasons, including the fact that it started during the holidays and vaccines must be kept at extremely low temperatures at each stage of the shipping and storage process.

This could improve soon. Dr. Anthony Fauci, the country’s leading infectious disease specialist, said vaccinations are accelerating and may soon reach 1 million doses a day.

UC San Diego Health said on Thursday that it is partnering with the county to immunize 5,000 people a day, starting on Monday.

Who was vaccinated in San Diego County during the first three weeks of implantation?

The focus is almost entirely on health professionals, employees and residents of nursing homes. They fall into the highest priority group, known as Layer 1A. Several San Diego hospital systems – including UC San Diego Health, Sharp HealthCare and Rady Children’s – have vaccinated most of their employees and are starting to administer a second dose of vaccine, as the Pfizer and Moderna vaccines require a booster injection. CVS and Walgreens started administering the vaccine in San Diego nursing homes the week of December 28, although it is unclear exactly how many people were vaccinated through this program.

How long will it take to vaccinate people in that first group and who is eligible to be immunized next?

The county says it will take several weeks to finish with 1A. Then it moves to 1B, which focuses on older people and essential workers most likely to be exposed to the virus – people like firefighters, police, grocery workers, bus drivers and teachers.

The next phase will focus heavily on people aged 75 and over – a very vulnerable demographic. As of Friday morning, 1,211 of the 1,738 people who died of COVID-19 in San Diego County were 70 or older. The county is home to approximately 200,000 people aged 75 and over.

This group will also focus on educators and caregivers of children, as well as emergency services and food and agriculture workers.

Then things move to Level 2, which includes some 275,000 people aged 65 to 74, along with hundreds of thousands of people in the transportation, industrial, commercial, residential, critical manufacturing and shelter sectors. .

Other states have already started vaccinating some older residents outside nursing homes and non-healthcare workers in phase 1B, including Texas and Nebraska. In fact, there is no requirement that states complete Phase 1A completely before proceeding. In fact, the CDC vaccine advisory committee discussed how states can speed up one phase and slow down another, and the state of California said that doses of vaccine that would otherwise be wasted can be administered to people in the next phase.

Can people in 1B register in advance to receive the vaccine?

Not yet, but supposedly at some point. “We will have (this feature) before we enter Level 1B,” said Nick Macchione, county director for Health and Human Services. “A place where everyone can register and find out when their turn comes, who is notified and where to go.”

Other places, like New Jersey and parts of Ohio, already allow people to pre-register for the vaccine.

The county said that, once eligible, residents of San Diegans will be able to be vaccinated through their existing health care providers, local pharmacies, community clinics or county-administered vaccination sites.

Who comes after that?

Group 1C includes about 600,000 people aged 50 to 64 and people aged 16 to 64 who have an underlying health or disability condition that increases their chances of developing severe COVID-19. Vaccination will also go to people working in the wastewater, defense, energy, chemicals and hazardous sectors, communications, IT, financial services and government operations sectors.

Will employees prioritize who gets the vaccine first in these various sectors?

Yes. The CDC advised that vaccination at each stage should be prioritized for those individuals at greatest risk of exposure to coronavirus or developing serious illness. This was also true during phase 1A, with healthcare professionals in close contact with COVID-19 patients being the first in hospitals to be vaccinated.

What if a person is not at great risk, but does crucial work? For example, would a 21-year-old person making repairs to a warship at a local defense company be vaccinated before a healthy 51-year-old accountant at the same company?

So far, the state has not provided a detailed analysis of how to split doses beyond phase 1A. And with demand exceeding supply, clear guidelines on how to distribute the vaccine equitably will be the key to avoiding further chaos and confusion.

When will people who do not fall into any of these categories – the general public – be vaccinated?

The county says it is likely to be spring, starting March 20. But it is not clear at what time of spring vaccines will begin.

How many people in the county and in the country need to be vaccinated to slow the spread of the virus?

That is the big question, and CDC estimates range from 55 to 82 percent of the population needs to be vaccinated or recover from a natural infection to obtain collective immunity. Fauci said we could reach that point in the summer, but we won’t know until we get there, said epidemiologist Corinne McDaniels-Davidson of San Diego State University.

The arrival of a new, more infectious strain of coronavirus certainly does not help, as even more people will need to be vaccinated to control the pandemic.

“It will take longer to reach the community’s immunity level,” said McDaniels-Davidson. “We will have a really devastating year, especially in the first six months, if things don’t slow down.”