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When California first received doses of the Pfizer / BioNTech coronavirus vaccine in mid-December, hospitals rushed to administer them to their frontline workers. Next come the long-term residential workers. But a month later, the state is lagging behind and vaccines are not picking up the guns as they should.
According to data from the Centers for Disease Control and Prevention (CDC) analyzed by Bloomberg, as of January 22, the state had administered only 37.3% of the 4,379,500 doses received. The percentage of doses administered in California is the lowest in the country. It is followed by Minnesota, Virginia, Alabama, Nevada and Kansas. (The jurisdictions with the highest percentage of doses administered are North Dakota, District of Columbia, West Virginia, New Mexico, and South Dakota.)
At the start of the pandemic, California was praised for successfully flattening the curve. It is only in the past two months that the state’s largest cities have seen an increase in COVID-19 cases. With that in mind, many wonder why the vaccine rollout was such a mess? And what is behind the gap between the vaccines obtained and the vaccinations administered?
Experts have a few theories. Some say it’s the result of the state’s decentralized public health system, such as Dr. Peter Chin-Hong, an infectious disease specialist and professor of medicine at the University of California, San Francisco.
“Part of the problem is that of course California is the most populous state, and because of that, it really reflects that it is not a national health system or a public health system,” he said. Chin-Hong said. “What you find is a bunch of duplications, redundancies or gaps – you could be a nurse for example and get an offer to get vaccinated in a nursing home if you work there, but if you also work in hospital, you also get an invitation. “
Chin-Hong said some healthcare workers received “multiple invitations,” while others did not receive any invites at all – and they were just healthcare workers. For a portion of the general population, such as people over 65 who Governor Gavin Newsom said were eligible for the vaccine as of last week, getting a vaccine is even more difficult for other reasons. – namely, the lack of vaccinators.
“California is leading the country in a wave of COVID right now, especially in southern California, and that makes healthcare workers who would normally administer vaccines in short supply,” Chin-Hong said. “And enlisting an army of volunteers was not as easy as you might think.”
Finally, Chin-Hong said there was a lack of transparency between the state, healthcare workers and the public regarding what is going on.
“No one really understands why we have such a discrepancy in terms of the number of doses allocated and how many doses have actually been achieved in the arms of people in California,” he said, noting that there is some variation in this feeling.
In Long Beach, for example, food workers get vaccinated; teachers are already following. Meanwhile, in the San Francisco Bay Area, 90,000 frontline health workers are eligible to receive the vaccine as part of the first phase (phase 1a) of immunizations. According to San Francisco’s New Vaccine Tracking System, 48,658 doses were given in San Francisco – but not all who received one live in San Francisco (they could work at a city health facility). Only 31,189 eligible San Franciscan residents received at least one dose of the vaccine. Technically, people 65 and over are eligible to get vaccinated, but they are officially part of phase 1b.
San Francisco supervisor Matt Haney said that until this week there has been a “lack of transparency” and “great confusion.”
“We’re making some progress this week, but before Tuesday there wasn’t even a place to register yet, and it’s as basic as it gets,” Haney said. “I think local and state governments are going to want to blame everything on the supply, and I think the supply is definitely a reason we can’t give everyone the vaccine tomorrow as much as we would like. lack of supply is no excuse for poor communication or no communication at all, and a lack of transparency and a lack of real accountability for widespread dissemination. “
Haney said, in particular, that local governments that seemed ready were getting their vaccines in people’s arms.
Amesh Adalja, a senior researcher at the Johns Hopkins Center for Health Security, told Salon that when it comes to states’ effectiveness in delivering available vaccines, preparation has been key. And unlike cities like San Francisco, it’s the states with more rural populations that seem to have their action together, as they plan ahead. As reported by Reuters, West Virginia has opted for a “hyper-local” approach, in partnership with independent pharmacies. By the end of last month, the state had already offered the vaccine to all of its residents of the faithful. Notably, West Virginia has chosen not to participate in a distribution partnership between the federal government and CVS and Walgreens.
“I think it was a really proactive approach that started long before the vaccine was available and has allowed some of these states to move forward much faster,” Adalja said. “West Virginia is a state where, ironically, a lot of people think they have few resources – and because of that, I think they’ve been very proactive.”
Adalja said it is possible that many large states are waiting for federal support, but that funding was not passed until the Christmas weekend.
“I think it really has to do with being proactive, but a lot of the blame doesn’t necessarily lie with the state, but mostly the federal government for not spending enough time on that last mile of vaccination and just assuming that once the vaccine was delivered it wouldn’t go smoothly, ”Adalja said, noting that the COVID-19 vaccine cannot be given“ on the fly ”like the flu vaccine.
Californians are now hopeful that a changing of the guard will bring a sigh of relief. President Joe Biden on Thursday released a national plan to speed up the process.
Dr Chin-Hong said a national strategy would certainly be helpful, especially since this is the first time the country has had one. But he fears that the confusion in California is also a symptom of the constant underfunding of public health for years.
“Public health has been without funding for many years, so you can’t put a Broadway show on overnight,” he said.
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