Blue Shield, Santa Clara County argue over COVID vaccine shortage

The company running California’s COVID-19 vaccination efforts refused a request for more vaccines for Santa Clara County from Kaiser Permanente, county leaders said today.

Kaiser is one of the region’s largest health care providers but has been given too few doses of the vaccine to cover its patients. That sparked the creation of the county’s “no wrong door” policy, which allows people eligible for the vaccine to sign up for a shot at any open appointment regardless of provider.

Under that plan, more than 20,000 Kaiser patients had signed up for vaccination appointments through the county’s health system last month, said Supervisor Cindy Chavez on Thursday. But the county didn’t have enough supply to accommodate every appointment.

Chavez said the county reached out to Kaiser, which contracts through the state with Blue Shield, for help. Kaiser asked Blue Shield to help Santa Clara County out with a few thousand more doses.

The private health insurance provider said no, Chavez said.

“That is not the flexibility we need on the ground,” she said.

Blue Shield puts the blame on the state.

“When Santa Clara County’s vaccine shortage issue was raised, Blue Shield in its role as third party administrator for the state’s vaccine program, recommended to the state that Santa Clara County receive extra doses,” Blue Shield spokesperson Matthew Yi said. “The state made the final decision to resolve the issue which was communicated along with allocations for all counties yesterday.”

Yi said Blue Shield does not make final vaccine allocation decisions.

“All vaccine allocation decisions are made by the state of California, not Blue Shield,” Yi said.

The state referred all questions about the gap to its new formula for distributing vaccines based on equity.

“We look forward to working with the county to vaccinate Santa Clara (County) residents,” said California public health department spokesperson Darrel Ng.

That formula, however, bypasses every ZIP code in Santa Clara County. Local officials have called the state’s equity formula a potential disaster for the county’s neediest.

Those canceled appointments and denied vaccines had a huge ripple effect in the community.

“We (the county) had to pause new appointments, and that’s a huge concern to us,” Chavez said. “For more people, particularly elders that need their second dose, who we have to call and say, you can’t come in for your second dose, that isn’t fair.”

Morgan Hill City Councilmember Yvonne Martínez Beltrán recounted how the 49 COVID-related deaths in her city of 50,000 have severely hurt her people.

“In the past week, we have had no appointments available (in Morgan Hill) because of the impact of this change,” Martínez Beltrán said. “Please, governor, if you’re listening … empower us to help our community.”

Blue Shield’s state deal

At the end of February, Gov. Gavin Newsom announced an agreement between the state and Blue Shield through which the company would distribute vaccine doses. At the time, Blue Shield officials said they would aim to administer four million vaccines by the end of March and have 25 million Californians vaccinated by summer.

“Blue Shield’s role is to enhance the California vaccine provider network to increase capacity so that communities in every corner of our state have access to vaccines, especially those hardest hit by the pandemic,”  Yi said.

Santa Clara County officials refused to sign on to the agreement with Blue Shield, saying there is a system that works locally. The county is asking, Chavez said, to keep its previous partnership with the state, a partnership that has worked the past few months.

The county has the infrastructure to vaccinate up to 200,000 residents per week, she said. According to the county’s vaccine inventory dashboard, between all health providers in the entire county, only 83,000 appointments are scheduled.

Local leaders have said they prefer the distribution remains in the county’s hands.

“I trust these people,” said John Horner, vice president of the Morgan Hill Unified School District trustee board. He gestured to speakers who had come before him, many from community health clinics across the county. “I don’t trust Blue Shield. Let them do the work they know how to do.”

Supervisor Susan Ellenberg, who sits on the California State Association of Counties, said an agreement is in the works with the state. But Ellenberg said she still didn’t know if that will increase vaccines coming back to the county.

Need-based program bypasses Santa Clara

At the same time, the state announced it would be setting aside 40% of vaccines for low-income and hard-hit communities, classifying them by ZIP code. Not a single ZIP code within the county was chosen to receive that allotment of vaccines. But that, Chavez said, is not related to Santa Clara County’s refusal to sign on to the Blue Shield contract.

“I don’t believe this is an act of retaliation,” Chavez said. “I think everyone is trying to do what we think is best. But we know what’s best for our community.”

Yi reiterated that the 40% allocation decision was also a decision made by the state.

“We understand the frustration everyone feels during this time where the supply of vaccines from the federal government is limited,” Yi said. “We are committed to working collaboratively to meet California’s needs now and into the future.”

Kaiser officials couldn’t immediately be reached for comment.

Contact Madelyn Reese at [email protected] or follow @MadelynGReese on Twitter.