Miscommunication plagues Sonoma County vaccination campaign

Sonoma County officials on Sunday blamed miscommunication with a contractor for an error on a website that allowed 9,000 ineligible people to schedule a coronavirus vaccination last week, the latest in a string of lapses that have left residents confused and angry.

The mistake, which triggered a massive effort to cancel thousands of appointments reserved for people 75 and older, has resulted in the delay of other immunization initiatives in Sonoma County as the mess is sorted out.

The county announced Sunday that local residents over the age of 65 should be able to sign up for a vaccination in two to three weeks, offering some consolation to elders who have been anxiously awaiting their shot ever since Gov. Gavin Newsom granted them eligibility Jan. 13.

Faced with a shortage of doses, the county has prioritized people over the age of 75 as the first members of the general public to receive the vaccine. The variance between county and state standards for eligibility has resulted in widespread confusion and is at the center of the mistake last week that allowed thousands of Sonoma County residents to sign up for vaccinations prematurely.

The problem emerged last week when the county began accepting invitation-only appointments for a new clinic in Rohnert Park using a scheduling website created by OptumServe, the medical services company managing the clinic.

Individuals over the age of 75 invited to schedule a vaccination were given a link to the OptumServe website. The site, however, initially stated that vaccinations were available for people over the age of 65 in Sonoma County. A free-for-all ensued when one or more recipients of the private link shared it on social media Wednesday evening, sparking a rush that quickly snapped up every appointment into early March.

County communications manager Paul Gullixson said OptumServe published the website using the state eligibility standards as a default and failed to incorporate feedback from the county. Two of the four counties using the website — Sonoma and Contra Costa — currently limit appointments to people over the age of 75. The other two counties — San Bernardino and Riverside — have adopted Newsom’s standard and allow vaccinations for anyone over 65.

Ken Tasseff, Sonoma County’s vaccine mission manager, instructed OptumServe to add the county’s eligibility standards to the website during a conference call involving officials from all four counties Tuesday before the Rohnert Park clinic opened the next day, Gullixson said.

“All four counties were on the phone, and we agreed that So. Cal would have the 65+ standard and Bay Area with the 75+ standard. We talked it through on the phone, and they showed us a mock up on screen because they had not yet finished the live site,” Tasseff said in a statement provided by Gullixson.

“Unfortunately, the wording and screening were not in place before the website was leaked and people started using it,” Gullixson said in an email Sunday.

Gullixson said he did not know when the sign-up link was first shared with members of the public. The county discovered Thursday morning that OptumServe had not changed the eligibility standards on its website and was accepting appointments for anyone over 65. The website was updated by noon Thursday, but 9,000 people who do not qualify for vaccinations in Sonoma County had already signed up for appointments, Gullixson said.

Now OptumServe, at the county’s behest, is canceling appointments for everyone below the age of 75. Anyone who received a shot in Rohnert Park will be eligible for their second dose within 21 days, regardless of their age, Gullixson said.

Because the county supplies the doses administered by OptumServe at the Rohnert Park clinic, it can decide who gets the vaccine. People over the age of 75 represent roughly 7.5% of the county’s population but account for 65% of the COVID-19 deaths, making them a top priority for the county.

“The velocity with which appointments were being scheduled made us realize that if we didn't do something right away, then those 75 and older would not have a chance for the vaccine until March or April or later, which is not equitable,” said Dr. Urmila Shende, county vaccine chief. “We are simply doing our best to protect our most vulnerable.”

‘Tell the truth’

David Carlson is one of the people impacted by the mishap. A 76-year-old Rohnert Park resident with diabetes, Carlson is eager to get his first dose of vaccine. He attempted to sign up for the clinic at the Rohnert Park Community Center as soon as he heard about it, but by that time, the site had been flooded and no appointments were available. Shende said 85% of those signing up were younger than 75.

“I’m not angry or anything,” Carlson insisted. “I’m just saying if I was a corporation with a performance like that, I’d lose my shirt. Just tell the truth, for god’s sake. If you don’t know, say you don’t know. But don’t tell people a bunch of crap.”

It has been a common sentiment during the early rollout of the vaccination program here.

Despite gains in the effort to inoculate Sonoma County against the novel coronavirus, there remains widespread confusion and annoyance among many residents, especially seniors, over the lack of information about eligibility and appointments.

The on-the-ground battle to slow the spread of a virus that has infected more than 26,000 Sonoma County residents and killed at least 260 is improving. Between Monday and Thursday last week, an average of more than 2,000 shots went into arms daily in the county, up from about 210 per day during the first week of the campaign, which began Dec. 15. Those figures do not include the federal CVS/Walgreens program serving residential elder care facilities.

But that progress isn’t nearly enough to overcome the exasperation people are feeling over the flow of communication. The primary complaint, voiced over and over again, is the lack of a central web portal where county residents can sign up for appointments.

Unfortunately, the scattered nature of vaccine distribution in the United States and in California has left individual counties to devise their own plans. Many of them have elected to manage appointments, or at least to monitor eligibility. Some have not.

No main hub

In Northern California, Marin, Napa, Lake, Solano, San Francisco, Alameda and San Mateo all have sign-up buttons on their main COVID-19 public health websites. Contra Costa County features that, too, though it takes a couple extra steps to get to its MyChart system. Sonoma, Mendocino, Santa Clara and Santa Cruz do not offer such options.

“In retrospect, every good idea sounds good,” Sonoma County Supervisor Chris Coursey said of the absence here. “I don’t know if we would have had the resources. A few months ago, we were scrambling to have enough resources for testing. Now we’re scrambling for testing and vaccinating. Do we have the resources for testing, vaccinating and a notification system? We’re learning as we go along.”

Gullixson cautions against overstating what these sites actually do. Most, he said, are mere registries in which counties ask you to plug in your age, occupation and, perhaps, whether you have risk factors such as working in a congregant setting.

“At the end, it tells you whether you’re eligible for a vaccination or not,” Gullixson said. “If the issue is about getting central appointments, I don’t know of any county doing that, or at least doing it well. Because that’s a very different beast.”

Still, even a basic registry would likely make residents feel heard and tamp down anxieties about missing out on vaccination opportunities. Gullixson said Sonoma County was in the process of building just such a sign-up system when Newsom announced plans to introduce MyTurn.ca.gov, a site that will provide the same service on a statewide level. Sonoma County residents can sign up there now to receive more information as eligibility tiers open up. As an appointment system, though, it’s currently limited to Los Angeles and San Diego counties.

The state hopes to expand MyTurn to other counties by “the beginning of February,” Lori Nezhura, co-chair of California’s COVID-19 vaccination task force, said Tuesday during a town hall hosted by state Sen. Mike McGuire, D-Healdsburg.

Until it’s functional, most Sonoma County seniors must find their own ways to the vaccine.

Pointing fingers

The county has been posting information and links at its main COVID-19 page on SoCoEmergency.org for weeks, and the basic piece of advice remains the same: Consult your primary doctor. That hasn’t done much to assuage public angst.

The truth is that major hospital networks such as Kaiser Permanente, Sutter Health and St. Joseph Health, all of which are linked at the county site, aren’t doing a whole lot better at keeping their patients up to date. Those providers all have moved into vaccinating people 75 and older, but none of them have enough doses to fully service that age demographic and appointments have been hard to lock down.

The lack of guidance has created infuriating feedback loops. Early in the rollout, Gullixson said, some of the local hospital groups were telling their patients to contact the county for information, just as the county had been directing people to consult their primary care physicians.

“I think there was a lot of pointing fingers going on,” Gullixson said. “But part of that was a system that was ill defined and not scripted. Providers were left to figure out how this was going to work. We don’t blame them for that.”

A similar glitch still existed a couple weeks ago, with the county vaccine site directing patients of Northern California Medical Associates to schedule appointments through their providers, though those doctors had no ability to do that. NCMA asked the county to remove the link from its webpage.

Many federally qualified health centers have begun vaccinating their senior populations. Gullixson said it isn’t feasible for the county to direct that flow of information. “It’s up to them to get the word out,” he said. “Because they’re targeting their people. They reach out, they schedule, they book appointments.”

Sonoma County is now building its vaccination capacity through a network of satellite clinics, arranged by the county but managed by independent contractors. Six were up and running as of this weekend, and two of those, at the Sonoma County Fairgrounds in Santa Rosa and the Rohnert Park Community Center, were focusing on residents 75 and older.

These sites are significant additions to the vaccination effort, but they require yet another layer of navigation for hopeful recipients, as evidenced by the recent OptumServe snafu.

“It is confusing,” Coursey said. “It’s confusing for consumers of the vaccine. It’s confusing for distributors of the vaccine. It’s confusing up and down the line. We haven’t figured this out as a country yet, let alone as a county.”

That’s no solace for Carlson. After substantial effort, he was eventually able to make an appointment in Rohnert Park, for March 6. Then, he said, his slot was vacated without notification, though he is officially eligible.

“I do not trust them to tell me when appointments will again open,” Carlson said. “This website is messed up in several ways. I’m 76 and I’m mighty tired of this incompetence.”

You can reach Phil Barber at 707-521-5263 or phil.barber@pressdemocrat.com. On Twitter @Skinny_Post.