Sonoma County health officials prepare to distribute first COVID-19 vaccines

One of the darkest periods of the pandemic in California and across the country is being met with the promising arrival of the first round of vaccines for COVID-19.

Sonoma County health officials expect to receive 4,875 doses of a vaccine produced by Pfizer in about two weeks, the first round allocated for the county out of about 327,000 doses expected for the entire state of nearly 40 million people.

These first doses will begin to inoculate less than 1% of the county’s half-million residents, starting with workers at risk of becoming infected in places like hospitals and skilled nursing facilities while caring for those who have contracted the disease.

Sonoma County Deputy Public Health Director Dr. Kismet Baldwin said the county is working closely with local hospitals, clinics and other organizations to coordinate how many doses to provide each facility in this initial round, expected to arrive between Dec. 16 and 18.

“It is helpful to know we’re going to get in this first shipment,” Baldwin said. “But do we have enough for everyone in the (most critical) prioritized group? No. That is not enough.”

Most people will not benefit from this first round, but federal health officials have said vaccines could become widely available as early as the spring.

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, this week said he is hopeful that by April anyone will be able to walk into a pharmacy and get a vaccine.

The arrival of the first doses come amid what Gov. Gavin Newsom has described as California’s third wave of COVID-19 — escalating case numbers and hospitals overwhelmed by those very sick from the disease. Many parts of the state, including the Bay Area, are preparing for new stay-home restrictions after Newsom announced the state is adopting more aggressive measures to slow a worsening surge.

Sonoma County has reported a steadily rising influx of cases, with 1,018 cases last week through Friday night.

For the seven-day period ending Friday, Sonoma County has reported nearly 150 new cases per day, up from about 83 cases per day from Nov. 15-21.

Other parts of the state have also seen a dramatic rise in illness from the coronavirus. Over the past seven days, the state has averaged 17,007 cases per day, a 61.6% increase from two weeks ago, according to an analysis by the Los Angeles Times.

California needs at least 2.4 million doses to cover health workers in acute care settings, emergency medical providers like paramedics and skilled nursing caregivers, according to state Sen. Mike McGuire, D-Healdsburg.

McGuire described the process for determining who within the top priority group should receive a vaccine as a matter of triage that will take into account a worker’s age and medical history, geographical location and ethnicity along with other factors.

“Early in on this process, the demand heavily outweighs supply,“ McGuire said.

Locally, the first 4,875 doses of the Pfizer vaccine will be used for the first of two shots needed to inoculate that number of individuals, Baldwin said. County officials expect another round will arrive in time for a second dose to be given 21 days later as required to be effective, according to Baldwin.

The state rolled out a priority system to help local public health departments coordinate the distribution of the vaccine to the most critical front-line health care workers first.

Health care workers in acute care, psychiatric and correctional settings; those working in skilled nursing, assisted living facilities and other group care sites for medically vulnerable people as well as paramedics, EMTs, other emergency medical providers and dialysis centers should be given priority, according to guidelines from the California Department of Public Health.

Next come those working in intermediate care facilities, home health care settings, community health workers, public health field staff, primary care clinics, rural health centers, correctional and urgent care clinics.

The third tier of these first-priority people include specialty clinics, lab workers, dental and oral health clinics and pharmacy staff not working in higher-tier settings.

Sonoma County’s health department is working as an intermediary between state health officials coordinating vaccine distribution and local health care entities, which will be vaccinating a succession of groups of people as doses become available.

Baldwin said the county will provide doses to local health organizations based on surveys still underway to determine the number of critical staff at each location, but “we don't have all of the numbers in yet.”

Those entities will be charged with ensuring the most vulnerable workers are inoculated first.

“There's actually many different levels of thinking to figure out how that prioritization is going to happen and one is, who's the highest risk?” Baldwin said. “The other is trying to maintain our workforce and our health care systems because they're also the ones that are taking care of the people with COVID.”

Also unclear is when vaccines will be available to elderly residents in long-term care facilities, one of the most vulnerable groups hit hard by COVID-19. Most of the at least 160 people who have died after contracting COVID-19 in Sonoma County were residents of skilled nursing or residential care facilities, county officials have said.

There are about 5,500 long-term care beds in the county, according to Crista Barnett Nelson, executive director of Senior Advocacy Services, a regional agency that runs the Sonoma County Long-Term Care Ombudsman program, a key watchdog and representative for residents of care homes. Though they are not all filled, it’s a benchmark to help officials plan for how to vaccinate as many of those residents who choose to do so, she said.

Barnett Nelson said she is still gathering data to determine how many employees work at the county’s 190 long-term care facilities.

Once more vaccines are available, pharmacy chains CVS and Walgreens have been tapped by the Centers for Disease Control and Prevention to send trained staff into skilled nursing and other long-term care homes to inoculate residents. More than 3 million people live in these facilities across the country.

“Our first allocation will be a tiny impact on our hospital caregivers and medical staff,” Barnett Nelson said.

Sonoma County’s three hospitals couldn’t provide numbers this week for the number of doses the organizations would need to vaccinate its top-priority employees.

Santa Rosa Memorial Hospital’s parent company, Providence St. Joseph Health, has developed software to classify its employees “to make sure that we focus vaccination where we need it most, namely our ED, ICU and COVID Care units,” spokesman Christian Hill said in a statement.

“We will be prioritizing vaccine for high-risk areas and high-risk employees at our hospitals,” Hill said.

A Sutter Health spokesperson said vaccination will be voluntary and will be offered at no cost to front-line workers.

“Front-line health care workers who are treating COVID-19 patients and high-risk groups will be prioritized,” the spokesperson said.

Once the vaccine is available to the public, the rollout could work a lot like getting a flu shot at clinics or the pharmacy.

Petaluma Health Center is preparing to expand its drive-thru shot programs and looking into using neighboring parking lots near its Petaluma, Rohnert Park and Marin County clinics, which serve 45,000 patients.

“We want to be able to get thousands of people through every day for a couple of days because it’s going to come quickly — that’s best-case scenario,” Toledo said.

The clinic has begun to create reports for the most vulnerable patients based on age and other risk factors such as chronic disease. The clinic will contact those patients to schedule a vaccine for those wanting to be inoculated.

A next crucial step will be to prepare to help people feel confident the vaccine is safe, Toledo said.

“We’re hearing that individuals or patients, especially Spanish-speaking and patients of color, are feeling that the vaccine may not be so safe,” Toledo said. “It’s not limited to that group, but that community disproportionately feels that way, so we need to prepare education and coaching and counseling.”

You can reach Staff Writer Julie Johnson at 707-521-5220 or julie.johnson@pressdemocrat.com. On Twitter @jjpressdem.