Quick Take
As COVID cases decline in Santa Cruz County, local health officials warn that restrictive federal vaccine guidelines championed by RFK Jr. could undermine public health efforts to encourage residents to get the latest booster shot.
COVID cases in Santa Cruz County are showing signs of falling after a summer surge, but new federal guidelines on who can get the updated booster shots have left local health officials worried that the confusing rules will limit access and undermine public trust.
The county saw a sustained increase in COVID cases from March to mid-August, when the amount of virus detected in county wastewater peaked, likely driven by the highly transmissible “nimbus” and “stratus” variants.
The rate of new cases has since started to drop. Local hospitals are seeing fewer COVID patients, with just four people hospitalized as of Sept. 3, down from seven in early August.
The annual summer surge typically begins to wane as new reformulated booster shots hit the shelves at major pharmacies every fall. However, this fall, county officials are worried that the federal government’s new vaccine rules could be creating hurdles for Santa Cruz County residents.
Robert F. Kennedy Jr., secretary of the Department of Health and Human Services and an outspoken vaccine critic, has approved the shot only for people ages 65 and up, along with younger people with certain health conditions. Those who don’t qualify must either get their doctor’s approval or attest to the pharmacy that they have an underlying health condition.
Santa Cruz County Health Officer Dr. Lisa Hernandez said she’s concerned that the stricter federal guidelines might further discourage people from getting the new booster shot, even if they’re eligible for it. She said guidance from the U.S. Food and Drug Administration appears to limit COVID immunization access to a large swath of the population, and also “undermines public health credibility” due to the lack of transparency around who is eligible and why the guidelines are changing.
“I think that’s part of the federal strategy. These actions are serving to confuse people to be unsure about whether they can get vaccines in the community,” she said. “And unfortunately, communities may suffer from it.”
Health care officials have raised concerns of waning COVID booster uptake rates over the past few years as the acute stage of the pandemic becomes a more distant memory.
According to the California Department of Public Health, only 23.3% of eligible Santa Cruz County residents received last year’s updated vaccine. People ages 65 and over had the highest uptake rate at just below 55%, and children under 5 had the lowest at 7%.
Hernandez is concerned that among those electing to not receive a booster, new, restrictive federal guidelines will prevent even more people from getting this year’s shot, causing vaccination rates to fall further.
States can set their own rules for how pharmacies can comply with the federal guidelines, with some states requiring a person to have a prescription from a doctor to prove eligibility. California’s rules allow residents to simply attest to their pharmacy that they qualify for the vaccine.
“As far as I understand, that just means that there isn’t additional verification that’s required by the pharmacies,” Hernandez said.
Hernandez added it’s unclear if local pharmacies will do their own checks to verify if a person is actually eligible for the booster shot. Some pharmacies, like Walgreens, are requiring patients to confirm they have one or more qualifying health conditions or risk factors that would make them eligible when scheduling an appointment online.
Other states are taking matters into their own hands more directly. Hernandez noted that Pennsylvania’s state board of pharmacy voted to allow pharmacists to follow vaccine recommendations from other trusted medical authorities, and other states including Colorado and Massachusetts have followed suit.
Last week, California, Oregon and Washington formed the West Coast Health Alliance in an effort to “safeguard public health” by providing evidence-based vaccination guidance separated from political agendas. Hawaii joined the alliance the day after it was formed. Hernandez said that the three West Coast states collaborated during the pandemic to align on guidance, too, and that the alliance’s focus right now is vaccines above all else.
Hernandez said she doesn’t know if the alliance’s guidance would take precedence over the federal guidelines because traditionally, the state follows what the federal government recommends. However, California has already supported both the American Academy of Pediatrics’ and the American College of Obstetricians and Gynecologists’ recommendations for COVID vaccinations.
“I think there’s a lot of pieces that need to come together in this vaccine puzzle,” said Hernandez. “The hope is that state governments can bypass or expand the access for people that are not formally approved by the FDA.”
Health agencies are also waiting for the Centers for Disease Control’s Advisory Committee on Immunization Practices to meet later this month, when it is slated vote on recommendations for some fall vaccines, including COVID.
But while much remains uncertain at the federal level, Hernandez said the most important thing to know is that both COVID boosters and flu shots are available now and the criteria for the flu shot has not changed — anyone 6 months and older can and should get the annual flu vaccination.
“If you’re eligible, and especially if you’re at the highest risk, you definitely want to get vaccinated early,” she said.
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