COVID-19 vaccine expansion to people 50 and older sparks excitement, concern in Sonoma County

All Californians 50 and older will become eligible for the coronavirus vaccine Thursday, a huge expansion of the immunization campaign that has Sonoma County leaders deeply worried the scant supply of doses will fall far short of demand.

The shift will draw another 60,000 Sonoma County residents into a system that is currently receiving fewer than 12,000 doses a week from the state, county officials said. They warned the public to brace for frustrating delays in the coming weeks before there is enough vaccine for every person seeking a shot.

“We’ve been here before, where the state has prematurely opened up eligibility for vaccines, which creates the expectations that the vaccines will be available to everyone,” Sonoma County Supervisor Susan Gorin said. “And we found that is not the case.”

Indeed, the state’s guidelines for eligibility, tailored to the clamor of voters as well as science, have previously left elected officials and public health staff scrambling to catch up to demand.

There are currently 103,459 people aged 50-64 in Sonoma County, according to Kate Pack, the county’s chief epidemiologist. Of those, 23,930 were partially vaccinated and 19,894 were fully vaccinated as of Tuesday, she said. That leaves just under 60,000 who will become state-eligible Thursday.

Local health administrators declined to hazard a guess at how long it might take to work through that population at current rates.

“It really depends on the vaccine supply, over which we have absolutely no idea and no control at this point,” said Dr. Urmila Shende, the county’s vaccine manager. “So it’s very hard to answer that question.”

The widening of eligibility recalls an earlier expansion, on Feb. 19, when Gov. Gavin Newsom declared everyone 65 and older eligible in the state, along with food production, restaurant and grocery store employees. It was the largest swelling of eligibility to date, activating an estimated 63,000 Sonoma County residents, and it sparked lingering problems.

The 65-and-up announcement came precisely as the county was in the process of canceling vaccination clinics and appointments due to disruptions in the supply chain, caused by a blast of Arctic weather across much of the United States.

Knowing they had no chance of accommodating the influx of newly eligible recipients — and fearful the oldest and most vulnerable residents would go without doses — county leaders decided to hold the eligibility threshold to 75 years rather than move it to 65.

“And I think that’s really paid off for us as well, given that we have a 0% test positivity in people 75 and older,” said Dr. Sundari Mase, the county health officer.

But the disparity created headaches of its own when an internet link started circulating on social media and residents under the age of 75 began flooding the appointment calendar at a clinic run by OptumServe in Rohnert Park. The county wound up canceling thousands of appointments.

The county is unlikely to distance itself from state guidelines again, with the OptumServe debacle in recent memory and public health officials well aware of the tremendous eagerness among those over 50 who have yet to be vaccinated.

“At this point, I don’t think so,” Shende said. “There has been so much talk of it at this point, it would be very difficult to change that. I just hope that people have the understanding that just because they’re eligible doesn’t mean that the vaccine is going to be there on that day.”

The three large hospital groups operating in Sonoma County — Kaiser Permanente, Sutter Health and Providence St. Joseph — all said they, too, will follow the state’s lead on the timing of expansion.

All of them, along with the county and its partner clinics, will face what Shende called “the looming challenge of eligibility.”

That challenge, now as before, comes down to supply. The allotments of vaccine doses the state sends to the county (recently, through the insurer Blue Shield) have been largely flat since mid-February. And they are expected to actually decrease from 12,890 to 11,220 doses this week, then to 10,914 the following week, according to state-generated numbers provided by Ken Tasseff, the county’s vaccination site coordinator. Those figures do not include doses going directly to pharmacy chains like CVS and Safeway, which are part of a direct federal allocation system.

Once again, the county is being asked to vaccinate more people with fewer doses. This time, officials are bracing for the blowback.

“I worry that we’re creating a false sense of hope, you know?” Supervisor Lynda Hopkins said. “I think it’s going to be a situation where demand greatly exceeds supply, which creates a very frustrating situation, I think for the county, I think for the public, I think for the providers.”

And it may not be the last moment of conflict. The state expects to open the tiers even further, to everyone 16 and older, on April 15. That move will dwarf all others, potentially adding well over 150,000 county residents to the rolls, Pack said.

There is consensus that this is not a problem peculiar to Sonoma County. The allocation from the federal government to California went from about 1.2 million to 1.1 million this week, and is projected at around 1 million next week, Tasseff said.

But that pipeline will grow significantly, and soon, according to state Sen. Mike McGuire, D-Healdsburg. He said his regular meetings with state and county officials have him convinced California’s allotment will increase to something closer to 4 million doses per week by mid-May or early June.

“For the time being, during this transition period, folks have the right to be frustrated, but the hope is real,” McGuire said. “And that’s the first time I can say that since the start of the pandemic.”

Assemblyman Jim Wood, D-Santa Rosa, agrees. In fact, he believes the time isn’t far off when the sticking point shifts from vaccine supply to the local systems created to deliver it.

“Obviously, the biggest constraint is the vaccine itself,” Wood said. “I would also argue it will be a manpower and infrastructure issue. The county and its local clinics, plus Kaiser, Sutter, they have set up a really good infrastructure. Even with that, it takes time to administer the vaccines. I think in the not-too-distant future, we will have way more vaccine than capacity to get it into arms.”

Wood is deeply invested in the issue. A licensed dentist, he has been administering coronavirus vaccinations during off hours.

Until supply catches up with capacity, county health officials and officeholders are asking for patience, another resource that has been in rare supply during this public crisis. Most of all, they’re seeking to avoid a frenzy over competition for shots, like we saw in February.

“That is our plea, for people to understand that there are many who are much more vulnerable,” Shende said. “And for all of us to be healed from this pandemic, we really need to make sure that those who are most vulnerable and do not have options for accessing the vaccine right away will be given an opportunity.”

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