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Santa Clara County provided excess doses of the vaccine over the past month to a senior county official and dozens of other non-health workers, raising new questions about providers’ discretion to vaccinate people with lesser strain. priority in a chaotic statewide rollout.
While Santa Clara County isn’t the only vendor experiencing the problem, its choices raise eyebrows in part because the county has simultaneously taken a tough stance against other vendors who deviate from normal protocols, recently cutting the vaccine. at Good Samaritan Hospital because he improperly vaccinated teachers in Los Gatos.
As of Jan. 11, the county has relied on a written plan that explains what to do with the excess vaccine, which should be used up quickly once it begins to thaw. This involves first offering the vaccine to people in phase 1A, the highest priority, followed by those aged 75 and over, then transporting the vaccines to the specialized center in Valley at the VMC or to the hospital. regional Saint Louise.
As counties across the state work to ethically manage the extra daily doses amid a general shortage, the protocol appears to leave room for what will happen next. At least twice, quick-thaw vaccines have landed in the arms of county employees considered to be in Phase 1B, including County Councilor James Williams and others who don’t regularly come face to face with coronavirus patients. Some of those employees, including Williams, are also much younger than those now prioritized for immunization.
The largest group was vaccinated on December 30, nearly two weeks before the county established written rules for additional doses, when County Director Jeff Smith cleared about 45 county employees who work in the center. from county emergency operations to obtain vaccines that the county said were otherwise directed to the garbage.
State guidelines prioritize healthcare workers and those living in long-term care facilities in Phase 1A, followed by over-65s, educators, food and health workers. agriculture and Phase 1B emergency responders, including EOC employees.
“These are not by definition niches known in advance. These weren’t appointments made – what was unique that day was that it was a much larger number, ”said Williams, who is around 30 years old. “Usually we’re talking about onesies, two or maybe a dozen.”
At around 4 p.m. on Dec. 30, Smith said he received a call that the Valley Medical Center employee health center had a batch of unused Pfizer doses and that no higher priority health workers nearby. needed. With approximately 90 minutes to deliver the doses, Smith allowed those physically present at emergency operations headquarters in San Jose – including Williams, office workers, analysts and other support staff – to receive their first doses this afternoon. Williams said he was one of the “very, very last people online.”
By that time, about 6,000 county health workers and support staff had been vaccinated across the county.
“There wasn’t a group of people available at the hospital, so the emergency operations center staff seemed reasonable to me,” Smith said. “My thought process was, ‘Well, if there aren’t doctors, nurses, and technologists available then we should go to emergency departments.’ “
The state’s immunization guidelines as of December give providers some leeway to move down the priority list when vaccines are about to expire or people do not show up for appointments. Health departments can “temporarily adjust prioritization” only after “intensive and appropriate efforts to reach priority groups at this time,” according to the California Department of Public Health, which did not respond to a request for comment Friday.
Yet how exactly these scenarios play out in real life has caused both confusion and heated debate. Last week, the county sanctioned Good Samaritan Hospital for donating what the hospital called excess vaccines to teachers – also as part of the Phase 1B cluster. The county argued that the hospital’s actions included a series of “problematic” events in which teachers were offered vaccines at later dates, not just too much vaccine.
County workers in Phase 1B only received the vaccines on the day they became available and except for other options, Smith and Williams said.
In another case, on January 12, Deputy Director of Emergency Management David Flamm alerted emergency operations staff, public health staff in the field and other 1B workers of a link registration to register for same-day appointments “approved by county management,” according to the email obtained by that news organization.
Flamm said Friday that was the only time he had been asked to send such an email and the vaccines appeared to be available at multiple sites. “DO NOT TRANSFER !!!!!” the email told recipients, adding, “If you are not able to get vaccinated today, we anticipate that there will be additional days in the coming weeks when this opportunity arises.”
“With all the vaccination operations going on, it seems to me that there is always a small delta between those administered and cancellations, or any number of issues, so I just anticipated that it could potentially happen again,” Flamm said.
In total, there have been “at least two” cases of 1B workers receiving vaccines in addition to the Dec. 30 group, but with far fewer numbers, Smith said.
“We were in a situation where we had a shortage of vaccines, a challenge to interpret state rules, a lot of people who would love to have the vaccine – and we were trying, and still are trying, to focus on caring initially. health professionals and emergency responders, ”Smith said. “It’s a use or a loss situation.”
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