California’s equity drive may slow Sonoma County vaccinations
New state guidelines unveiled Thursday that set aside 40% of coronavirus vaccines for the poorest Californians threaten to further inhibit shipments of doses to Sonoma County, where deliveries of the precious vaccine have remained stagnant in recent weeks.
Sonoma County leaders, who have labored to build a network of clinics capable of vaccinating 40,000 people a week, now expect to receive fewer than 8,000 doses next week for the third straight week.
“For a while, doses were ramping up and it felt good,” Lynda Hopkins, chair of the county Board of Supervisors, said Thursday. “Suddenly we have the capacity to vaccinate 40,000 per week, and we’re basically at the same place we were a month ago with the doses.”
The state’s plan, as outlined by Health and Human Services director Dr. Mark Ghaly, reserves 40% of California’s vaccine supply for ZIP codes in the lowest quartile of the state’s Healthy Places Index (HPI). That index relies heavily on income data, but also includes factors such as housing, transportation and access to health care.
The lowest quartile represents roughly 400 ZIP codes, Ghaly said. None are in Sonoma County, according to an interactive HPI map created by the Public Health Alliance of Southern California.
The precise impact of the new directive on the local vaccination campaign is unknown at this time. But the implication is worrisome for a county whose allocation of doses has been almost flat for several weeks.
Two weeks ago, Sonoma County got 8,025 doses from the state (a figure that includes vials shipped directly to medical providers). Last week it received 7,610. The county got 7,680 this week, and is scheduled to receive 7,700 doses next week.
“It’s like a flow of water that never seems to trickle down to Sonoma County,” Hopkins said.
That trend has locked the valve on a vaccine pipeline that had been steadily growing since the national program rolled out in mid-December. This is the first week Sonoma County has received its allotment plan for the following week directly from Blue Shield, now in charge of coordinating California’s vaccination effort.
“We really don’t have any information, whether it’s related to the rollout at all,” Dr. Urmila Shende, the county’s vaccine chief, said of the low number of doses coming. “I think it has more to do with just limited supply and the wait for the supply and manufacture to increase.”
Vaccine shortages linger
The ongoing shortages forced the county to forego first doses at all of its affiliated vaccination clinics this week, and spurred Sutter Health to cancel even second-dose appointments at sites throughout its network. A Sutter spokeswoman said Thursday that the provider is being allocated 30,000 doses next week and 30,000 for the week of March 15 across Northern California — just two-thirds of what it needs to complete second-dose courses for approximately 90,000 seniors and health care workers.
“We are hopeful the state will provide the additional 30,000 so we can bring back all of our patients for their second dose of the vaccine within the CDC’s recommended time frame,” she said.
This atmosphere of scarcity is incongruous with President Joe Biden’s pledge this week of vaccinating every adult American by the end of May, and with the introduction of a third vaccine formula to the national supply chain, a one-dose version developed by Johnson & Johnson. Sonoma County is set to receive 1,700 doses of Johnson & Johnson next week, yet its total allotment remains almost unchanged.
“We were under the impression Johnson & Johnson would be on top of a stable allocation of Pfizer and Moderna,” Hopkins said. “That was not the case. Staff was in kind of a panic when we found out, trying to make sure we have adequate supply for second doses.”
Sonoma County has not yet had to cancel any second doses this week or next at the clinics it coordinates with independent site managers, said Ken Tasseff, the county’s vaccine site coordinator.
The state’s decision to set aside doses for underserved neighborhoods makes sense. Those areas have suffered disproportionately during the pandemic, especially in communities of color. Residents of those neighborhoods have been infected by the coronavirus at a higher rate, and tend to have more existing health conditions that could make them vulnerable to COVID-19. They are more likely to live in overcrowded or congregate spaces, and less likely to have been able to work from home over the past year.
And they have found it harder to get vaccinated. Ghaly said lowest-quartile HPI communities have been receiving 16% to 17% of the state’s vaccine supply to date, as opposed to 34% for the highest quartile. For those reasons, the new equity goal was greeted warmly by a wide range of health and social justice advocates.