VACCINE WATCH: Kaiser working with state on vaccine ‘disparity,’ hopes to offer doses to 65-and-older soon

Vaccine
(Kevin Painchaud/Lookout Santa Cruz)

There are a lot of unanswered questions about the COVID-19 vaccine and how it will be distributed in Santa Cruz County. Here’s everything we know, as it becomes available.

In this article:

What is the vaccination progress in Santa Cruz County so far?

Updated Feb. 22: The three major health systems providing the COVID-19 vaccine to the majority of residents in Santa Cruz County say they are stepping up efforts to vaccinate everyone 65 and older — but that recent winter storms have been interrupting the supply chain and causing confusion locally, among other problems.

Both Dignity/Dominican and Sutter/PAMF have begun vaccinating patients 65 and up. Kaiser Permanente has not begun doing so, but officials with the health system said Sunday they hope they can begin that process soon.

In a statement, Kaiser said it “has been receiving a disproportionately small share of vaccine” and that it is nearly finished “offering vaccination appointments to our 270,000 members aged 75 and older.

“We have been actively engaged with the state to address the disparity in vaccine supply we have received, and as a result, the state is adjusting its allocation system and we will begin receiving a more appropriate amount of vaccine going forward,” the statement added. “We are ready to administer this new supply and more. In the coming weeks, as new supplies allow, we anticipate broadening availability in the 65 years and older age group starting with those at higher risk.”

Kaiser also said it will be communicating that information to patients. “Once contacted, members can make a vaccination appointment online or by phone. We will communicate directly to our members when vaccination appointments are available, and update the kp.org/covidvaccine website as new information becomes available.”

Meanwhile, the winter storm is creating confusion for vaccine providers statewide, with some having to reschedule appointments.

Some Sutter/PAMF patients in Santa Cruz County got a call Friday to say their second vaccine dose would be delayed due to weather-related issues, only to receive another call hours later saying they could actually keep their original appointments.

While patients are understandably concerned, the CDC has released guidance recommending that if the second dose of either the Pfizer-BioNTech or Moderna vaccines cannot be administered at the recommended time interval (21 to 28 days, depending on the vaccine), it “may be administered up to 6 weeks (42 days) after the first dose.”

VACCINE NUMBERS: As of Feb. 19, providers have reported administering 6,929,954 doses statewide. That’s about 78% of the 8,828,480 doses California’s health departments and health care providers have received.

In Santa Cruz County, 66,887 does of the vaccine have been administered countywide, ranking the county No. 8 statewide in terms of vaccines put into arms per capita. Statistics on how many people have received two doses and how many doses have been received haven’t been made public locally because of the way the distribution system has evolved.

VACCINE DISTRIBUTION BACKGROUND: The vaccination pipeline starts at the national level, where federal officials apportion doses for each state. States then allocate those doses. The county health department is only one of four venues through which people are receiving the vaccine here. The other three are the federal pharmacy partnership program for skilled nursing and assisted living facilities, major health systems and independent health care providers through CalVax.

A summary of all four options and who they are serving:

Multi-county health systems: These are the big health networks that span multiple counties in California. In Santa Cruz, this includes Sutter/PAMF, Dignity/Dominican Health, Kaiser Permanente and, to a smaller degree, the UC health system. Most of the general public is getting vaccinated through these systems.

Federal pharmacy partnership: This is a program run by the CDC in partnership with national pharmacy chains to distribute vaccines to nursing homes and residential care facility residents and staff.

Local health jurisdiction (Santa Cruz County Health Department): Until this point, the county has been the biggest player in vaccinations, but county spokesperson Jason Hoppin said they will become less and less important as the health systems begin to play a larger role in getting doses out to the general public. The county is responsible for distribution of most of the phase 1a vaccines, with the exception of nursing home residents.

Independent providers: Independent providers — such as small health care groups and private doctors — can sign up to receive shipments of vaccines and distribute the vaccines themselves through CalVax. County health services director Mimi Hall said this will be especially important in relatively small counties like Santa Cruz where the public health office has limited capacity to oversee distribution of vaccines while trying to continue outbreak control and other aspects of pandemic response.

Who gets the vaccine next and how is it organized?

Vaccination distribution is being coordinated by the California Department of Public Health, with the exception of nursing homes. Staff and resident vaccinations in long-term care settings are being handled mostly by the aforementioned federal pharmacy partnership.

CDPH is organizing people into phases and tiers. Phases are the primary divisions, and tiers are used to decide prioritization within phases.

Prioritizations for phases and tiers are being decided at the state and federal level while the vaccines are rolled out. This means the full schedule of who will get vaccinated when is not fully planned ahead of time.

The first phase, Phase 1a, has been in progress for some time. People over the age of 65, which is technically part of phase 1b, are also now eligible and are being offered or soon will be offered vaccines through some health systems including Sutter/PAMF, Dignity/Dominican and Kaiser Permanente. Santa Cruz County teachers are now also being offered the vaccine.

Here’s a look at the next tiers:

California Department of Health's COVID-19 vaccination tiers
(California Department of Public Health)


When will each priority group get vaccinated?

A timely rollout will depend on vaccine shipments arriving on time, the amount distributed matching up to projections from the federal government and manufacturers, and quick deployment into people’s arms. Dr. Anthony Fauci said on Feb. 16 that he expected “open season” — when anyone who wants one can get a vaccine — probably won’t start until May or June, pushing back his earlier predictions that this would happen in April.

Estimated breakdown in Santa Cruz County

While we don’t have exact numbers yet of the groups to be vaccinated in Santa Cruz County, we were able to get estimated populations of 13 different “priority groups” based on guidelines set by an advisory committee for the U.S. Centers for Disease Control and Prevention. California officials are strongly considering the CDC guidelines as they continue to build their phases and tiers.

To help local officials plan a vaccine rollout, Surgo Ventures/Ariadne Labs created a Vaccine Allocation Planner Tool to break down the estimated number of people in each county who fall in different priority groups.

Here is the estimated breakdown for Santa Cruz County:

What we know about the two vaccines

At present, the U.S. Food and Drug Administration has granted emergency use authorization to vaccines by two manufacturers — Pfizer-BioNTech and Moderna.

Here are the basic differences between the two vaccines:


How to make a vaccine appointment

Santa Cruz County officials have provided this breakdown of all the places a person might go to get vaccinated. Two big things to note:

  • If you are in Phase 1a but are not linked to any of the health care systems, you can fill out a survey by the county that will help them notify you of when and where you can receive a dose of the vaccine.
  • If you are not 65-plus or a health care worker and would like to be notified when it is your turn, you can sign up here through the state’s “My Turn” system.

This story will be updated periodically as new information about the vaccine rollout becomes available. Here’s a look at the latest available information:

Kaiser Permanente

Who is eligible? Kaiser Permanente members who are health care workers and those who receive care through Kaiser and are age 75-plus.
To make an appointment: Call Kaiser at (866) 454-8855 or use their online portal to schedule an appointment.

Sutter Health/Palo Alto Medical Foundation (PAMF)

Who is eligible? Eligible healthcare personnel in Phase 1A regardless of insurance and people who receive care through PAMF and are ages 65-plus.
To make an appointment: Call (844) 987-6115 or make an appointment on their online portal.

Dignity Health Medical Group – Dominican

Who is eligible? Dignity Health patients who are 65-plus or who work in health care
To make an appointment: Call (831) 288-6526 or sign up through the patient portal.

OptumServe

Pedestrian clinic location: 250 Main Street, Watsonville
Who is eligible? People who are in Phase 1A of the vaccine rollout, 75-plus from anywhere in Santa Cruz County and South County residents who are 65-plus and live in the 95019, 95076 and 95077 ZIP codes.
To make an appointment: Call (877) 218-0381 or register here.
Days open: Thursday thru Monday, with 210 appointments each day

County Public Health (County Fairgrounds)

Who is eligible? Health care personnel in Phase 1A who live or work in Santa Cruz County and people who are age 65 and older and live in the 95019, 95076 and 95077 ZIP Codes.
To make an appointment: Appointments for the Fairgrounds are full as of Feb. 9. Registration is being done through “targeted outreach,” the county said.

Salud Para La Gente

Who is eligible? Health care or home health care and in-home supportive personnel in Phase 1A, regardless of insurance. Also, those who are 75-plus and receive primary care through Salud Para La Gente.
To make an appointment: Call (831) 728-0222

Santa Cruz Community Health (SCCH)

Who is eligible? Health care or home health care personnel in Phase 1A, regardless of insurance or primary care provider and those who receive primary care through Santa Cruz Community Health and are age 65 and older, patients or non-patients.
To make an appointment: Call (831) 427-3500. If you are a health care worker, certification of status is required.

Emeline Health Center

Who is eligible? Healthcare personnel included in Phase 1A, regardless of insurance and people who are 65-plus and receive primary care at the Emeline Health Center.
To make an appointment: The health center is currently reaching out to registered patients. You can also call (831) 454-4100

Watsonville Health Center

Who is eligible? Health care workers in Phase 1A, regardless of insurance and those who are 65-plus and receive primary care at the Watsonville Health Center.
To make an appointment: Call or text (831) 515-9399. If you send a text message include your full name, date of birth and phone number. You can also contact the clinic main line at (831) 763-8400

Homeless Persons Health Project (HPHP)

Who is eligible? Healthcare personnel included in Phase 1A, regardless of insurance and people who are 65-plus and receive primary care at HPHP.
To make an appointment: Call (831) 454-2080 or register here.

How is race and equity being incorporated into the vaccination plan?

It’s complicated. To avoid the kinds of controversy and lawsuits the state has dealt with over affirmative action in other settings, public health officials are basically trying to address the racial inequities of COVID-19 without talking about race. Instead, they are focusing on high-risk essential occupations, which are often disproportionately held by people of color.

These two stories dive more deeply into the subject:

Even as the rate of new coronavirus cases falls, there are still troubling signs of the impact of COVID-19 on Black and...

How will you know when to get the second dose?

According to the county’s plan, at the first vaccination appointment, providers will be required to enter vaccination information into the California Immunization Registry (CAIR), which will be referenced when administering the second dose.

Also, people who received the first dose will be given the CDC/CDPH vaccine reminder card that will include instructions for when they need to return for the second dose.

“This reminder card will serve a dual purpose to provide patients and other providers documentation regarding the specific type of vaccination administered to the patient,” the county wrote in its plan. “It will be recommended that patients bring this card to their appointment for the second dose of the vaccination.”

The county’s COVID-19 Vaccination Division will also review CAIR data to check for overdue vaccines and follow up with providers on a bi-weekly basis.

This story was originally compiled by Mallory Pickett, Tulsi Kamath, Isabella Cueto and Patrick Riley. It has since been updated with information from Pickett; Kamath; CalMatters, a Lookout content partner; and the Los Angeles Times, another content partner.

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