Why is the vaccine rollout so slow in Sonoma County?
“Something is wrong with Sonoma County!” Martin Webb, a retired high school principal, said in an email. “Contra Costa County started yesterday (to) give shots to those over 65 in Fairgrounds and did over 2000. Why can they do it but not Sonoma. Someone put us behind the ball on this issue.”
Webb’s plea, sent to a reporter Jan. 16, might have been a little more adamant than most. But his point of view is shared by countless people in Sonoma County.
Why, they wonder, aren’t more of their neighbors being vaccinated against the novel coronavirus, which has infected more than 24,700 county residents since last March, killed 247 of them and done lasting damage to the local economy and to the social fabric of our community? We had weeks, perhaps months, to prepare for this mobilization. What could possibly be bogging it down to this extent, where assisted living centers are waiting in confusion for first doses and 85-year-old cancer survivors have no idea when their turn will arrive?
The answers aren’t very satisfying, because they are predictably tangled and complex. All levels of public governance, from the administration of President Donald Trump to county administrators, bear some share of responsibility. The state of California has made the situation worse by promising vaccine availability it cannot facilitate. But beyond clunky messaging, it can be hard to identify specific, egregious acts of incompetence in the first few weeks of the rollout.
“A lot of public health resources had to be diverted to controlling the pandemic itself,” said Lee Riley, a professor of epidemiology and infectious diseases at UC Berkeley. “Then we suddenly need to distribute this vaccine. Health officials were overwhelmed, and also front-line providers.”
As of Thursday, the last day for which numbers were available, fewer than 26,237 doses of Pfizer-BioNTech and Moderna vaccine had been administered in Sonoma County since the vaccination campaign began Dec. 15, excluding doses taken into nursing homes by the CVS and Walgreens pharmacy chains. Dr. Sundari Mase, the county health officer, said in a meeting with county supervisors Thursday that 5,033 people had received both ends of a two-dose course at that point, the equivalent of about 1% of the county’s population.
In the week between Jan. 14 and Jan. 20, Sonoma County oversaw the delivery of an average of 905 shots per day. At that rate, it would take roughly three years to vaccinate the entire county, and more than two years to achieve herd immunity, which according to most experts occurs when something close to 70% of a population has been vaccinated.
There is widespread consensus that the federal government failed to build an adequate pipeline for vaccine distribution. The Trump administration invested tremendous energy in Operation Warp Speed, the effort to develop an effective vaccine. It was wildly successful, with Pfizer-BioNTech and Moderna receiving FDA approval in December for their competing formulas after nine months of trials. It’s a process that usually takes several years.
But the administration paid much less attention to what would come next — the distribution of vaccine doses to states and, ultimately, to on-the-ground health staff who would be putting shots into arms. In essence, each state was left to its own devices.
The major hurdles have been reported extensively. They include a lack of resources devoted to staffing and site selection, super-cold storage requirements for the Pfizer vaccine and an initial reluctance by some health workers to be immunized, which resulted in vials going unused in the early going.
But those factors are universal. None explains why California has lagged behind most other states in rolling out the vaccine.
Using the most recent data points, California ranked dead last among the 50 states in percentage of allotted doses administered (38.3%, according to Bloomberg) and 44th among the 50 states in doses administered per capita (4,565 per 100,000 residents, according to the CDC).
Riley, a former program manager at the World Health Organization who is currently director of the Global Health Equity Scholars Program, has sympathy.
“California is a big state, like a country,” he said. “It’s like trying to manage the vaccination system of a full nation. I would say we’re doing relatively well considering the complexity of the state. However, we could do better.”
Is Sonoma County doing better? It’s hard to say, because neither local nor state officials have been releasing data on doses distributed to the counties.
That wasn’t the case when the vaccination program began a month ago. In the excitement of the first week, Mase, the county’s health officer, reported that the state would immediately be shipping 4,875 doses of the Pfizer vaccine, the first to hit the pipeline, through her office.