Why is Sonoma County not vaccinating 65-year-olds?
Dale Beltz couldn’t believe it.
A number of his friends in their 60s had just received coronavirus vaccinations at a new Sutter Health clinic that opened this week at Luther Burbank Center for the Arts in Santa Rosa, despite county guidelines that resulted in the cancellation of thousands of appointments at other clinics for people younger than 75.
“How can this be!! My wife and I are 67. Everything I read says 75 and up currently,” the Coffey Park man wrote in an email to a Press Democrat reporter on Thursday. “I know this has been a mess but it just continues to get worse!!!”
The rollout of the vaccination campaign in Sonoma County has resulted in widespread confusion and anger, for a simple reason: On Jan. 13, Gov. Gavin Newsom declared that all Californians 65 and older were eligible to be vaccinated. But he gave counties the latitude to set their own criteria, and Sonoma County put the cutoff at 75.
Even after more than 55,000 doses of vaccine administered in Sonoma County, the rules remain perplexing to many county residents, especially the seniors who fall into the 65-74 age range. Many feel they’re walking a tightrope of eagerness and guilt. Web portals built in accordance with the state standards allow them to sign up for shots, even after they enter their birth dates, while county leaders constantly urge them to wait for their turn in line.
“The hiccups are there. It’s a very hard process, we understand that,” county health officer Dr. Sundari Mase said Thursday. “We apologize to everybody who’s been put out as a result of the process, but keep in mind that we have the community’s best interest at heart.”
Sonoma County officials have been consistent in their explanation: Newsom told everyone over 65 they’re eligible, but the county does not have nearly enough doses of vaccine to serve that large population. So Sonoma County is rationing what arrives here by focusing on a smaller demographic, one that has disproportionately suffered COVID-19-related hospitalizations and deaths.
“We are getting a trickle every week, and that forces us to prioritize in a way that makes sense,” said Dr. Urmila Shende, the county’s vaccine chief. “So over the next few weeks, two months, as our supply starts to increase, then we will be able to expand our tiers. But at this point, we simply do not have the supply.”
This week, Sonoma County received a total of 7,425 doses from the state, a number that is independent of vials going to local hospital groups Kaiser Permanente, Sutter Health and St. Joseph Health.
“Which is up from last week,” Shende said. “But it’s still not nearly enough to vaccinate everybody at the same time.”
So the county is focusing on its most vulnerable population, and staff and government leaders say there is ample evidence to define that as 75 and older. According to the county, those 75 and older make up 7.5% of the local population but account for 24.2% of COVID-19 hospitalizations and about 65% of deaths.
Conscious of the risk posed to its oldest residents, the state of California originally prioritized people older than 75 above other seniors. In its initial vaccination scheduling system, people 75 and older were put in Phase 1B, Tier 1, while people between the ages of 65 and 74 were placed in Phase 1B, Tier 2.
That changed Jan. 13, when Newsom elevated all of those seniors to Tier 1. He was responding to widespread criticism that the state’s complicated ranking system was one reason the vaccine rollout was so inefficient in the nation’s most populous state. The merging of the two age levels was seen as a way to simplify.
Newsom’s announcement set up a disconnect with Sonoma County, though. Over 20% of the county’s population is 65 or older, almost double the number statewide. While counties with younger populations believe they have enough vaccine to move forward on immunizing everyone older than 65, Sonoma County has concluded supplies are not adequate for that at the moment.
Hospital clinics, like the one opened by Sutter this week at LBC, can set their own eligibility standards because their parent organizations procure vaccine directly from the state. But the county, which controls less than half of the doses administered locally, can set qualifications for its doses, too.
It is a life and death decision. Public health data shows that people older than 75 account for 65% of the COVID-19 deaths in Sonoma County, compared to 53% statewide.
That was enough to convince Mase to hew to the more limited age criterion for Phase 1B, Tier 1, and county leaders have aligned with her.
“I don’t want the Board of Supervisors or any political group to be deciding who goes next in line,” county supervisor Chris Coursey said this week at a public board meeting. “We’re making that decision with our staff of experts, epidemiologists, people who understand that the way to save lives is to take care of the most vulnerable first. We’re going to prioritize what the experts believe is the best way to get us through this life-and-death situation, not who makes the most noise politically.”