New COVID-19 vaccine distribution rules raise concerns in Santa Clara County

The state this week announced the COVID-19 vaccine will be administered based on age rather than a person’s risk factor, a change Santa Clara County health officials worry may affect equitable access.

Meanwhile, a coalition of local lawmakers is pushing Gov. Gavin Newsom to allow vaccines to be distributed by census tract, allowing the hardest hit areas to receive their shots first.

“While Santa Clara County on the whole may appear to have average COVID-19 infection rates, there exists serious health disparities among communities of color,” says a letter signed by 10 Bay Area senators and assembly members. For instance, 25% of the county’s population is Latino but this group accounts for more than half of all the county’s COVID-19 cases.

State health officials announced Jan. 26 eligibility will change and become solely based on age after Phase 1B, Tier 1, which primarily covers people age 65 and older. The idea, state officials said, is to accelerate vaccine distribution across all 58 counties and allow the state to increase capacity while ensuring the vaccine goes to disproportionately impacted communities.

“It’s very clear that the state is taking much more control over what’s happening with vaccinations,” said County Counsel James Williams.

State officials also announced Jan. 27 they’re piloting a notification system to alert all California residents of their vaccine eligibility. The service, called My Turn, has been rolled out in Los Angeles and San Diego counties. The system, which is expected to be available statewide in February, allows Californians to learn when it’s their turn for a vaccine and to make an appointment.

Finally, the state will hire a private company to allocate vaccines directly to providers to “maximize distribution efficiency.” This will also give the state greater visibility into what is happening on the ground, officials said. Santa Clara County officials said this change would limit their view into the vaccine pipeline.

“If now they’re changing the allocation system, the obvious significant concern on the ground is how do we actually get the vaccine that’s needed to providers,” Williams said. “The biggest vaccine provider that’s serving our most vulnerable populations is without a doubt the Santa Clara County health system.”

Pending further state guidance, Santa Clara County’s Health System began offering vaccines to residents 65 and up Jan. 27.

Williams told Santa Clara County supervisors the state’s announcement took the county by surprise, and it’s hard to tell how a plan to hire a company to distribute vaccines to counties will be rolled out.

“This raises a lot of questions that we hope to get answers to,” Williams said. “It is extremely concerning and we hope that the state will establish a pretty direct pipeline to our county health system.”

Williams said the state changes could significantly affect county operations. But without more details, it’s uncertain to what extent those impacts will be.

The revisions, particularly to vaccine eligibility, didn’t sit well with Supervisor Susan Ellenberg.

“I think it would be much more equitable, much more beneficial, much more impactful in reducing cases if we focus next on those high risk (employees),” Ellenberg said. “We’re talking about equity… it doesn’t translate if we’re not prioritizing (residents) by their job as opposed to by their age.”

Ellenberg asked county staff to find out how flexible the state’s new guidelines are and whether the county could deviate.

Also on Jan. 26, Santa Clara County’s legislative committee sent a letter to Newsom asking the state to allow counties to distribute vaccines first to vulnerable populations. The proposal was led by San Jose Assemblyman Ash Kalra and Councilmember Magdalena Carrasco, whose East San Jose district has the highest COVID-19 cases and deaths — particularly among communities of color.

The letter said allowing local jurisdictions to distribute the vaccine by census tract “recognizes these disparities and promotes equitable allocation of limited resources.”

“I hope the county will get the flexibility it needs to focus attention on the working class, mostly Latino neighborhoods being hit the hardest by the pandemic,” Kalra wrote in a Facebook post.

Dr. Marty Fenstersheib, Santa Clara County’s COVID-19 testing officer, said the state’s plan lacks specificity and clarity. 

If there’s one limiting factor for the county’s vaccine capabilities, it’s the availability of doses distributed by the state, Fenstersheib said. County health officials — based on the limited information available this week — can’t tell if this would mean more vaccines for county health care providers.

According to the county’s vaccine dashboard, more than 127,000 people have received their first dose of the COVID-19 vaccine. Nearly 32,000 residents have received both doses.

Still, the county up currently is only receiving 40,000 doses a week. Earlier this month, Public Health Officer Dr. Sara Cody announced a goal of vaccinating 85% of the county population by Aug. 1.

To reach this goal, Fenstersheib said, about 100,000 residents would need to be vaccinated every week between until Aug. 1.

“You can see we are pretty far from having the ability of vaccinating and getting close to our goal,” Fenstersheib said.

Contact Madelyn Reese at [email protected] and follow her on Twitter @MadelynGReese