Sonoma County vaccination data shows disparity among income levels, geographic areas

“DEMA was intended to be a temporary operation and officials are expecting to announce a new permanent clinic in Roseland soon,” county vaccine site coordinator Ken Tasseff said.

On the other end of the bar graph, one of the most heavily vaccinated ZIP codes — 95452, the Kenwood area of Sonoma Valley — is among the nine Sonoma County ZIP codes in the state’s highest quartile. About 55% of residents there have received at least one dose.

Using median income figures rather than the state’s Healthy Places Index exposes additional disparities.

For example, Rohnert Park had a median household income of $71,585 between 2015-19 (in 2019 dollars), according to the U.S. Census Bureau, below the county average of $81,018. Rohnert Park’s corresponding ZIP code, 94928, also has a relatively low vaccination rate at 27%.

While not surprising, the intersection of wealth disparity and vaccination disparity here is complex.

The rollout began in mid-December with health care staff, and the first expansion was to residents 75 and older. The first group skews white, and the second might, too. Data from the Pew Research Center in 2014 said the median age of California’s Latino population was 28 years. That same year, the statewide median was 36, according to the U.S. Census Bureau.

In the early stages of the coronavirus vaccination program, there was a lot of concern that many in the Latino community would be reluctant to accept the shots. Sonoma County has made an effort to address that, arranging to have Spanish-speaking community health workers called “promotoras“ go door-to-door in neighborhoods. Toledo doesn’t believe hesitancy has been a big factor.

“In my experience, there are a lot more individuals who want the vaccine than not,” he said. “It’s just harder to get them in. What the literature says, and what we say, is that once individuals start getting it, and their families and communities start getting it, hesitancy disappears. The key is making sure people who want it are getting it.”

But there are obvious reasons to believe wealthy residents may have a leg up in the pursuit of this precious resource.

“What I’ve seen at our site is, at the end of the day, people waiting to see if there is any leftover vaccine. And those individuals tend not to be essential workers,” Toledo said. “Essential workers in these more vulnerable ZIP codes tend to work two or three jobs just to keep a roof over their heads. They often don’t have access to reliable internet, which is a key part of the COVID-19 vaccination process.”

Any significant effort to bring the vaccine to disadvantaged populations is now being hampered by the sluggish allotment of doses coming into the county. That means most vials are currently being reserved for second doses, making it hard for vaccinators to expand their campaign to groups that haven’t already been addressed.

“Ken (Tasseff) is saying we’re making up that gap by 1% a day,” said Jason Cunningham, CEO of West County Health Centers. “But it’s stalled. We only have two vaccination clinics next week.”

Cunningham cautions against reading too deeply into the county’s ZIP code data, arguing there are significant lags in updating the information, which comes from the California Immunization Registry. Tasseff said the county vaccine dashboard should be an accurate reflection, since the data set is updated daily.

There are other anomalies in the ZIP code chart that go beyond class inequities. For example, the lowest vaccination rate in Sonoma County can be found in 94515, the hilly area near Calistoga at the eastern fringe of the county. Only 13.4% of residents there have gotten a dose. Annapolis is second lowest at 20.9%. Most chalk up those poor rates to remoteness.

But some of the best rates in the county belong to Geyserville and the tract just west of Lake Sonoma (95441, at a sky-high 90.7%), and to Cloverdale (95425, at 47.1%). Yet neither of those ZIP codes are population centers, and both have modest median income levels, in the $57,000 to $60,000 range.

Sometimes the reasons are more esoteric. In this case, one particular local provider, Alexander Valley Healthcare, is credited with a thorough vaccination campaign in the north county.

That group began vaccinating residents Jan. 27, a week before most federally qualified clinics, and hit the ground running with a drive-up clinic at the Cloverdale train depot, said Dr. Shellie Burdick, Alexander Valley’s chief medical officer. Burdick believes her organization’s logistical approach has reduced barriers and increased efficiency. She also credits particular individuals tied into the local community, such as Zeke Guzman of La Familia Cena.

“He has been able to sign up thousands in the local Latinx community, especially among our farmworkers,” Burdick said Wednesday. “He and his team have called people day and night to sign people up. And he can walk into a room full of people who are on the fence about the vaccine, and when he leaves, everyone wants it. I had extra doses today, I called him and he literally sent 10 people right over.”

Hopkins, the west county supervisor, has been vocal about getting doses into Latino neighborhoods. But she argued at the recent supervisors’ meeting that vaccine doses are, in and of themselves, a measure of equity. She raised the idea of targeting the five least-vaccinated ZIP codes in the county at any given time, wherever they may be, with pop-up clinics or a mobile unit.

“Some of these communities are very small, so you could actually make a substantial percentage improvement just with one day and a good-faith effort in partnership with our (local clinics),” Hopkins said. “Can we talk timeline? Can we talk moving metrics on equity? How can we stay nimble, and how can we really target, on a rotational basis, addressing these high-risk communities?”

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