Vaccine Watch: Everything we know about COVID-19 vaccination progress in Santa Cruz County

(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:

Updated Jan. 22: Dignity Health announced Friday it has now given 5,000 COVID-19 vaccinations to phase 1a health care workers in Santa Cruz County.

In a press release, the health organization said, “The vaccine has now been offered to all hospital employees and affiliated physicians. To date, nearly 80 percent — more than 2,000 staff members in all — who wished to receive the COVID-19 vaccine have received it, with many already having been administered their second and final dose.”

Vaccine Watch

Lookout’s Vaccine Watch, the latest on vaccine distribution countywide, is among eight Lookout initiatives documenting all aspects of the pandemic. For more, go to our COVID 2021 section, sign up for COVID Text Alerts and our COVID PM newsletter here, and leave feedback and ask questions at the end of this story.

Additionally, Dominican Hospital vaccine clinics have administered nearly 3,000 doses to phase 1a workers across the county, including paramedics/EMTs, hospice workers, behavioral health and safety net clinic staff, mortuary services employees, and staff in local physician offices.

Earlier this week, on Tuesday, Kaiser Permanente sent a message to its patients stating that it is running short on vaccines.

“As of January 16, we have administered more than 170,000 vaccines in California. Each week, we receive a fraction of the vaccine required to meet our demand. Kaiser Permanente cares for more than 1.5 million members age 65 and older, and last week we received a vaccine supply of just 20,000 first doses. Our ability to expand and speed vaccine distribution depends on vaccine supply made available to our state. At the current rate, we’re looking at vaccine distribution that is much slower than any of us find acceptable.”

A complete picture of vaccine distribution throughout Santa Cruz County isn’t known because vaccines are being distributed by the federal government through multiple channels, including to Dignity, Kaiser and other private health systems that are not providing geographical breakdowns of how their shipments are being doled out. A separate federal-state partnership with CVS and Walgreens is providing vaccines to nursing homes and assisted-living centers, and there has been only limited disclosure about the progress of that program.

At a Lookout event Thursday night, county health officer Dr. Gail Newel warned the vaccine distribution locally is going slower than hoped for, and that revised state guidelines allowing multi-county health systems like Dignity health, Kaiser Permanente, and Sutter/PAMF is creating inequities in vaccine access.

As of Friday, Jan. 22, some 1,626,542 vaccine doses had been administered statewide, primarily to top-priority health care workers and nursing home residents, according to state data. That’s about 38% of the 4,245,700 doses California’s health departments and health care providers have received.

Here’s what we know about vaccine distribution so far — and what we’re trying to learn:

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

Here’s what we know about distribution in Santa Cruz County:

  • Hospital staff: County health officials said on Jan. 15 that staff at Dominican and Watsonville Community hospitals began receiving their second dose of the Pfizer vaccine last week, and that effort will continue this week. On January 22, Dignity Health reported that the vaccine has been offered to all of its staff, 80% of whom have taken it, over 2,00 staff members in all.
  • Nursing home and assisted-living staff and residents: All of the skilled nursing facilities in Santa Cruz county have either already hosted a vaccination clinic, or will before the end of the month. But so far Dominican Oaks is the only assisted living facility where vaccines have been administered, and most of the rest are still waiting for clinic dates. Overall, fewer than 500 of 1,849 residents of long-term care in Santa Cruz County have received a vaccine.

  • Firefighters, paramedics and EMTs: Watsonville Community Hospital facilitated the vaccination of all the county’s fire agencies, a total of about 450 people.

Total vaccine doses available in the county (excluding doses administered in nursing homes):

Updated January 22, tally of vaccines in county health allocation:

  • Received: 19,000
  • Distributed: 8,090

The vaccination pipeline starts at the national level, where federal officials apportion doses for each state, said Dr. Mark Ghaly, California’s Health and Human Services secretary. States then allocate those doses.

The county health department is only one of four venues through which people will receive the vaccine here. The other three are the federal pharmacy partnership program for skilled nursing and assisted living facilities, health systems such as Sutter Health/PAMF, Kaiser Permanente, and Dignity Health, 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 Health, Kaiser Permanente and the UC health system. Most of the general public will likely get their vaccination through this system by calling their doctor’s office to make an appointment as soon as they are eligible.

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: A new development is that 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.

What we are working to learn: How many doses has each health system gotten? How many doses have been administered, including in Santa Cruz County? How many doses do the health systems expect to get in the coming days, including doses set aside for Santa Cruz County? How many people have gotten two doses through the health systems, both systemwide and in Santa Cruz County?

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 federal government via a partnership between the CDC, state government and pharmacy chains, including Walgreens and CVS.

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, is already in progress. Phase 1b, could be offered vaccines within weeks. People over the age of 65, which is technically part of phase 1b, are also now technically eligible and are being offered vaccines through some health systems including Sutter/PAMF (though they are only offering to over 75), and Dignity Health-Dominican.

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Phase 1a includes frontline health care workers and residents and staff of long-term care settings. Per the vaccine allocation tool created for government agencies, the estimated population of people in Santa Cruz County that fall under Phase 1a is 14,700 people.

Phase 1a is organized into the following tiers, according to the California Department of Public Health:

Tier 1

  • Workers in acute care, psychiatric and correctional facility hospitals.
  • Workers in skilled nursing facilities, assisted living facilities, and similar settings for older or medically vulnerable individuals.
  • Residents in both of the above settings.
  • First responders: Paramedics, EMTs, firefighters and others providing emergency medical services.
  • Dialysis center workers.

Tier 2: Workers in:

  • Intermediate care facilities for persons who need non-continuous nursing supervision and supportive care.
  • Home health care and in-home supportive services.
  • The community health and public health fields.
  • Primary Care clinics, including Federally Qualified Health Centers, Rural Health Centers, correctional facility clinics, and urgent care clinics.

Tier 3: Other settings and health care workers, including:

  • Specialty clinics
  • Laboratory workers
  • Dental and other oral health clinics
  • Pharmacy staff not working in settings at higher tiers.

Here’s a look at the next tiers:

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

What we are working to learn: An exact number of people who might fall under each category of the various tiers of Phase 1b and 1c in Santa Cruz County — and the time frames for vaccinating them. “This is heavily dependent on supply availability, and the guidance provided by the state and federal governments,” county spokesman Jason Hoppin says.

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.

County officials said in a press conference on Jan. 15 that they hope the county can begin to move to phase 1b (beyond those in the 65-75 year-old group) in February. As previously noted, some healthcare systems have already begun phase 1b.

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:

What we are working to learn: Will you be able to choose which vaccine you get or will it be based on which vaccine is available? Which groups will have to go through their health care providers and which won’t? What will happen if you don’t have insurance?

How will I know when it’s my turn to get a vaccine? Is there a way to ‘get in line?’

This process is still in development.

Reaching the thousands of education and child care providers in Santa Cruz County — some of whom work in schools, some of whom work in private homes, and others who might work part-time at daycare centers — is just one example of how the next phases will be more difficult logistically.

The county has a survey that residents who are self-employed, small business owners, or for any reason feel they are not connected to a health care system, should fill out this survey from the county. While it’s not a formal registration of any kind, responses will help the county keep track of who is waiting for a vaccine and is a way to “get a foot in the door,” according to county health officer Dr. Gail Newel.

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.

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 CalMatters, a Lookout content partner, and the Los Angeles Times, another content partner.

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