Sonoma County braces for COVID-19 vaccine eligibility of anyone age 16 or older

By the time the sun rises Thursday morning, everyone in California 16 and older will be eligible for a coronavirus vaccination, considered the key to eventually ending the pandemic.

It’s a broad promise that has been anticipated for months, but the expansion of eligibility is fraught with challenges, including here in Sonoma County where the supply of vaccine doses has sharply lagged demand.

An estimated 205,906 people between 16 and 49 live in the county. And about 60% of that age group, or 122,836 people, had yet to receive at least one of two required vaccination doses as of Wednesday, said Kate Pack, the county’s lead epidemiologist.

This inoculation eligibility expansion will be well over twice as large as any other since the first shot went into an arm locally in mid-December, and vaccination rollout advanced. The county started its critical COVID-19 inoculations by vaccinating health care workers. Then it moved to age-based eligibility, beginning with people 75 or older, and most recently added residents 50 to 64 on April 1.

Even as the county and state have broadened shot eligibility by age, occupation and health conditions, the tight vaccine supplies have persisted.

“Without a sustained and increased vaccine supply, we aren’t going to be able to offer vaccination to everybody who wants it once the tier goes to everybody 16 and older,” Sonoma County Health Officer Dr. Sundari Mase said during a meeting with The Press Democrat’s editorial board last week. “That is a concern.”

The state Department of Public Health said it received 2.4 million vaccine doses from the federal government last week and 2 million doses this week, and is expecting to get 1.9 million next week — a reduction of more than 20% over the two-week period. That declining availability is passed along to counties.

And it isn’t just overall supply vexing Sonoma County, it’s the lack of stability.

Two weeks ago, for example, the state informed county health staff members they’d be receiving 10,900 doses the week of April 4, said Ken Tasseff, the county’s vaccination site coordinator. Shortly thereafter, the state boosted that estimate to 11,200. When the shipment finally came, though, it was 15,300 doses — an unexpected spike the county would soon learn was a mistake that would have to be leveled out in subsequent weeks.

“This is one of our great frustrations, the inability to plan based on knowing how many vaccines we’re getting,” Tasseff said.

Next week, the county expects 13,380 vaccine doses, far below its ability to administer 40,000 shots at county clinics, he said. The anticipated doses and vaccination capacity don't include what local hospitals and pharmacy chains will receive and administer.

Most epidemiologists agree that, with the rise of viral variants that could prove more resistant to vaccines, at least 75% of the population will have to be fully vaccinated to reach herd immunity, the point when enough residents have been inoculated to prevent the virus from easily being transmitted from one person to another.

“I was predicting it would probably be end of summer by the time we were able to achieve that, based on the kind of supply of vaccine we were receiving,” Mase said. “We were optimistic, but now again we’re seeing a decline in vaccine supply.”

Sonoma County could have chosen to set the vaccination eligibility bar higher than age 16 for a period, but Mase said she has no plans to do that.

The state’s move to significantly widen eligibility will set the table for the intended full reopening of California on June 15, as long as virus transmission and related hospitalizations are manageable.

The overall supply of vaccine into Sonoma County has been growing, but many of the doses go directly from the state to major health care networks such as Kaiser Permanente, or from the federal government to large pharmacy chains like CVS. The county has little control over who gets those shots.

For that reason, county health staff has consistently maintained that the vaccine it helps to distribute is the key to ensuring local vaccination equity among underserved communities.

In many cases, those residents do not have the internet access and expertise to compete for online appointment slots that will become even more elusive with the addition of 123,000 people eligible for shots Thursday.

“For those doses that we and our partners have control over, their continued focus is on lowest (income neighborhoods), highest-risk occupations, those that are oldest, those that are homebound,” Tasseff said.

The county has been working to vaccinate its Latino community, which makes up 27% of the population but has been afflicted with 64% of the coronavirus cases here, since early February. Part of that effort has been to identify geographic areas of need. Of the 232,402 residents who were partially or fully vaccinated as of Tuesday, 62% were white and 18% Latino.

The county has been somewhat successful in leveling the playing field. A month ago, the most affluent of the four quartiles in the Sonoma County’s Healthy Places Index — a measurement of income and quality-of-life factors such as access to health care and education — had received 31% of the vaccinations, compared to 20% for the lowest quartile. The latest figures show the highest quartile has nudged downward to 29.5% while the lowest has inched up to almost 22%.

The Roseland neighborhood, which currently has one of the lowest vaccination rates in the county — 45% of residents there have received at least one vaccine dose, ranking No. 29 among the 32 ZIP codes represented on the county dashboard — is a big priority. The county announced the opening of a clinic at Santa Rosa Community Health’s Lombardi campus on March 23. And late last week, the clinic moved its operation to a larger space at Roseland Library.

Next in line may be the Springs area just north of the city of Sonoma, another heavily Latino area that has been relatively neglected in the vaccination campaign. The county hopes soon to run clinics five days a week in the Springs, probably at Saint Leo’s Catholic Church.

Meanwhile, the county is shifting the focus of the OptumServe clinic in Rohnert Park from elder residents to underserved residents. That’s a reflection of the successful effort to immunize seniors, who have suffered about 80% of the virus-related deaths in Sonoma County. As of Wednesday, more than 85% of the county’s residents 70 and older had received at least one dose of vaccine.

Sonoma County and its partner clinics also are trying to immunize at-risk populations such as the homeless and the homebound. But those efforts are now hampered by a national suspension of the Johnson & Johnson vaccine, a one-shot, easily stored alternative that is valuable in immunizing people with transportation or shelter issues.

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