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Bay Area County officials this week expressed great frustration with the way the state has allocated valuable vaccines, saying they are not getting enough doses and the supply is unpredictable.
Officials say the chaotic system makes it difficult to plan how many doses can be given on a given day and the staff needed to do so. Many counties also say they have the capacity to administer many more doses, if only they could get them from the state.
As local hospitals grapple with a record increase in COVID-19 cases and deaths, California has fallen behind nearly every other state in its vaccination pace. Lawmakers and healthcare professionals are calling on the California Department of Public Health to provide more transparency on its distribution plan – or, at least, a little more predictability for the number of doses counties will receive each week.
“It’s hard to plan,” a spokeswoman for the San Francisco Department of Public Health said. “It’s like you’re having a wedding for 200 people and the caterer says you could get food for 25 people or food for 500 people. It’s very difficult. “
The amount of vaccine that counties receive each week also varies widely. San Francisco received 3,900 doses in the first week of January, and 11,825 the following week. Next week, the county was told it would receive 4,275 doses – a huge drop for no reason given.
While the bulk of California’s doses are given to large healthcare providers, like Kaiser and Sutter Health, county health departments are also responsible for immunizing tens of thousands of frontline workers and those who have no insurance.
Darrel Ng, a spokesperson for the California Department of Public Health, said counties will begin to see greater amounts of vaccine and greater predictability of supply as manufacturing increases. California’s supply is controlled by the federal government.
Still, county officials say the lack of predictability has put them at a significant disadvantage.
“You don’t know how many volunteers you need, how many chairs to put in or if it’s worth it (to create a site) if you don’t know when the vaccine is coming, and how many there are,” said Monica Gandhi , specialist in infectious diseases at UCSF. “Their hands are tied.”
San Francisco has received 33,975 doses to date and 12,330 injections have been given to people on Thursday. According to the county, the health department expects all available doses to be used up within the next week and is requesting another “large volume order” from the state.
However, the county said it was still hampered by “inconsistent distribution” and “operational challenges”. That includes: some doses are being attributed to establishments that are further ramping up their operations and uncertainty as to which brand of vaccine they will receive – Pfizer or Moderna. The brand is important because people need two doses of the same vaccine, several weeks apart.
Much of the available supply is also reserved for second doses.
In Santa Clara County, County Director Dr Jeff Smith said the public health department requested 100,000 doses on Sunday, but was told on Tuesday that it would only receive 6,000. Time, Marin experienced the opposite problem this week: 6,000 more doses than officials expected.
Matt Willis, the county’s public health official, said the extra doses were “exactly the problem we want” but it was difficult to suddenly scale up the distribution plan.
The Marin County Supervisory Board on Wednesday sent a letter to Governor Gavin Newsom, saying the county had “the infrastructure ready and available for a much more robust public health COVID-19 vaccination program.” But the problem is the limited supply that has been allocated to the county.
Dennis Rodoni, chairman of the supervisory board, noted that nearly 30% of Marin’s population is over 60 years old. He urged the governor to prioritize high-risk counties, as well as “be prepared to deliver vaccines in much greater volume. “
Every state in the country faces a nationally limited vaccine supply and ever-changing regulations from the Trump administration. But California has been particularly slow to get vaccinated in the arms: of the approximately 3.5 million doses received by the state, 975,293 had been administered as of Thursday, according to the Centers for Disease Control and Prevention.
This represents about 28% of the shots used, which puts California far behind the majority of states.
Nearly 50 state lawmakers sent a letter to Newsom on Wednesday, demanding “reliable forecasts” and weekly updates on how much vaccine each county will receive over the next month.
“We are all aware of the limited number of vaccines that have been made available to states,” the letter said. “But we believe we need to plan for a more effective and efficient deployment of these vaccines so that we can further improve the public health of Californians and begin to rebuild our state.”
The state health department is working to speed up vaccine distribution. In the meantime, the agency told The Chronicle on Wednesday that it has no plans to change the current process for sending vaccines to communities and hospitals.
The state is expected to launch a website and call center next week so people will know better when they are eligible for a vaccine. Newsom also relaxed state guidelines on Wednesday to allow people 65 and older to receive the vaccine. But these measures will not respond to criticism from county officials.
Some counties do not know how and when the newly eligible population will be able to get vaccinated. The San Mateo County Health Department said on Thursday it did not have enough vaccine doses to move on to the next phase and vaccinate those over 65, and would continue to focus on immunization health workers.
The state distributes doses to each county based on guidelines from the federal government. Most of California’s supply has gone to regional health systems, like Kaiser and Sutter.
This system has also frustrated local politicians, who say they have not been made aware of the number of vaccines made available to their residents through private providers. Lawmakers in Santa Clara and San Francisco have called on major healthcare systems to regularly disclose the number of doses given to them by the state.
Meanwhile, as California struggles to ramp up its vaccine distribution, more than 450 Californians die from COVID-19 every day.
“It’s horrible,” said Gandhi, the infectious disease specialist at UCSF. “The irony is that you can only get by with vaccines.”
Trisha Thadani is a writer for the San Francisco Chronicle. Email: [email protected] Twitter: @TrishaThadani
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