Elected and nonprofit leaders throughout the Bay Area sent a letter to state health leaders March 12, urging them to change their vaccine distribution formula to better include local communities most impacted by the COVID-19 pandemic.
Local state representatives Assemblyman Marc Berman and Senator Josh Becker said in interviews that they signed the letter because the state's current formula for allocating vaccines does not take into account the needs of Bay Area neighborhoods where the pandemic has had a serious impact.
"The formula they were using didn't reflect parts of the Bay Area that had been really hard-hit," said Becker (D-Menlo Park).
Earlier this month, the state announced a new formula aimed at providing equitable vaccine access to communities that have suffered disproportionately from the COVID-19 pandemic. The formula allocates 40% of available doses to the lowest 25% of ZIP codes as measured by the California Healthy Places Index, or about 446 ZIP codes within the state.
The California Healthy Places Index combines 25 big-picture public health indicators like housing, education, economic and social factors to assess each neighborhood's general health and well-being. Throughout the pandemic, its data at the census tract level has been used to identify communities that may be vulnerable to COVID-19 and signal to state and local health departments where they should invest resources aimed at promoting health equity.
The new formula, however, uses ZIP codes instead of census tracts to determine the geographic boundaries of need, determined that no additional vaccines should go to Santa Clara or San Mateo counties.
It also overlooked much of the rest of the Bay Area. One San Francisco Chronicle analysis found that only 2% of Bay Area residents live in zip codes that will benefit from the new vaccine allocations, even though Bay Area residents make up 20% of the state's total population. And only 10 of the 446 ZIP codes selected for the additional vaccines are in the Bay Area, the San Jose Mercury News reported.
"The Bay Area is really getting the short end of the stick in regards to the equity metric," said Berman (D-Palo Alto).
Using ZIP codes as the basis for vaccine distribution may work in many areas of the state where there is a big geographic divide between poor communities and wealthier ones, he said, but it doesn't work as well in some parts of the Bay Area, where low-income neighborhoods that have been hit hard by the pandemic share ZIP codes with less impacted, wealthier neighborhoods.
One clear example is in the city of Menlo Park. According to county health data, a total of 1,529 people have been infected throughout the city boundaries that correspond closely to the 94025 ZIP code. The citywide infection rate translates to about 448 cases per 10,000 residents, lower than the overall infection rate in San Mateo County.
When the cases are broken down by census tract, about half of all of Menlo Park's cases are in just one area, the census tract corresponding to the Belle Haven neighborhood. In Belle Have alone, there have been 772 cases, or a rate of 1,331 cases per 10,000 residents – higher than the overall infection rate in hard-hit Los Angeles County.
Meanwhile, those served by the Ravenswood Family Health Network, which includes residents of Belle Haven and East Palo Alto, as well as Sunnyvale and Mountain View, were not receiving any additional vaccines under the new system, according to Luisa Buada, CEO of the health network.
"You can't look at the numbers and tell me that East Palo Alto, North Fair Oaks and Belle Haven haven't been significantly impacted by this pandemic," Berman said.
"A solution that leaves out 98% of the Bay Area, and leaves out east San Jose, East Palo Alto, Belle Haven and North Fair Oaks, not to mention other underprivileged communities in the Bay Area – that's obviously not the right solution," he said.
He added that he felt the state should adopt a more flexible model, where census tract-level data could be used in some parts of the Bay Area to more precisely identify the deeply affected areas.
"Let's come up with a flexible model that acknowledges that the underprivileged are in a very different circumstance than the rest of the state," he said.
An additional measure Becker said he'd like to see is that people in areas hardest hit by the pandemic be vaccinated as family groups.
View the full letter and its lengthy list of supporters here: