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The next tier of COVID-19 vaccines, Phase 1B Tier 1, could come “very soon, as supply increases over the next few weeks,” Dr. Robert Schechter, co-chair of California’s Drafting Guidelines Workgroup, said on Wednesday, Jan. 6.
Schechter made the statement, somewhat reluctantly, during a meeting of the Community Vaccine Advisory Committee after being pressed to provide a more definitive estimate for when the next phase of vaccines might roll out. But before that happens, front-line health care workers and residents at long-term care facilities who are in the Phase 1A groups will need to have completed their vaccinations, which require two injections about three weeks apart. The state has administered only about one-third of the 1.3 million vaccines it has as of Jan. 3, Gov. Gavin Newson said.
Looking forward, the Drafting Guidelines Workgroup and the Community Vaccine Advisory Committee are preparing for who will receive the shots and how to make sure they are administered equitably. They face a dizzying array of research, decisions and logistics that must be adjusted to each new group as the vaccines roll out.
The next phase, 1B, would be split into two tiers. Tier 1 would focus on people ages 75 and older, and workers in education, child care, emergency services, food and agriculture. Phase 1B Tier 2 would include older adults ages 65-plus; workers in transportation and logistics; industrial, residential and commercial sheltering facilities and services; critical manufacturing; incarcerated individuals and homeless people.
A third group, Phase 1C, would include people ages 50 and older, 16- to 49-year-olds with underlying medical conditions and/or a disability; workers in water and waste management; defense; energy; communication and IT; financial services; chemicals and hazardous materials; government operations and community service.
Who is eligible for the vaccines within each sector is long and complicated. Among essential workers, personal care assistants and attendants are in the health care sector and qualify for vaccines under Phase 1A, the same phase as physicians. Farmworkers qualify under Phase 1B, Tier 1, under the food and agriculture sector, an essential need. Food and agriculture sector includes production, processing, and delivery systems that feed people and animals in the United States and overseas and also those who import many ingredients and finished products, a complex web of growers, processors, suppliers, transporters, distributors, and consumers.
“This sector is critical to maintaining and securing our food supply,” the state explained on its webpage of essential critical infrastructure. The California Department of Public Health also has posted sub-priorities within each tier here.
But there are also considerations for equity. Throughout the vaccine advisory committee’s meeting, participants emphasized the importance of ensuring the vaccines are distributed to vulnerable communities of color. The committee is considering ways to measure the vaccination rates by potentially comparing the percent of the eligible population vaccinated in vulnerable communities to the percent vaccinated in less vulnerable communities within counties, using the California Healthy Places Index, an online resource that displays community conditions that predict life expectancy and influence health.
Launched by the Public Health Alliance of Southern California, the index also has an interactive COVID-19 resource map. The map compares characteristics of vulnerable populations by race, ethnicity and health factors including environmental exposure to COVID-19 impacts within counties. It can be used to identify which populations might need more targeted vaccinations or be prioritized.
As of Jan. 6, Santa Clara County had disproportionately high death rates among Black, Latino and Native Hawaiian/Pacific Islanders per 100,000 population, the map shows. In San Mateo County, deaths among Native American/Alaskan Native populations skyrocketed above all other groups per 100,000 of population with Native Hawaiian/Pacific Islanders and Blacks following, according to the index map.
Determining when to move to another vaccination tier is a complex web of evaluating progress and the success rate of receiving, planning and coordinating doses, their distribution and administration, Dr. Eric Sergienko, health officer for the Mariposa County Health and Human Services Agency, said during the meeting. When to move to another tier will be determined through feedback from vaccinators. Health officials will ask whether more vaccines are needed for the current tiers and if there is new demand from previous tiers, he said.
“If not, it’s time to think about moving into the next tier,” he said. Health officials must also coordinate with state and adjacent local health jurisdictions, look at obtaining additional doses and coordinate with vaccinators to order the new doses, he said.
California’s Community Vaccine Advisory Committee discusses who will receive COVID-19 vaccine doses in the next phase of distribution and how to make sure they are administered equitably during a virtual meeting on Jan. 6. Courtesy Community Vaccine Advisory Committee YouTube channel.
Health officials also must clear several hurdles with the public to ensure that as many people will be vaccinated as possible. Jake Snow, technology and civil liberties attorney at the American Civil Liberties Union of Northern California, noted during the vaccination advisory committee meeting that there were some reports of people being asked to provide their Social Security numbers on vaccine paperwork.
“Some people might be hesitant to get the vaccine if they are required to give a Social Security number,” he said.
Health leaders must also work to dispel myths about the vaccines. One participant said she was told that the vaccine would sterilize people (it doesn’t). People also need to understand they will still need to wear masks even after they receive the vaccine as they could carry the virus to others even if they are immune, they said.
Find comprehensive coverage on the Midpeninsula’s response to the new coronavirus by Palo Alto Online, the Mountain View Voice and the Almanac here.
At this point, all of the first responders and health care workers have received at least their first dose. Now it’s time for the broader population to receive it. Since it’s most fatal to the oldest people, it makes sense to make it available to oldest people first. However, it would also make sense to have some portion of the vaccines available through a simple lottery. Whatever is done needs to be done quickly and without bureaucratic red-tape.
Dan– According to the mercury news not even close .
https://www.mercurynews.com/2021/01/08/coronavirus-santa-clara-county-boosts-vaccine-effort-amid-slow-rollout/
“However, just over three weeks since administering the first dose of the vaccine, fewer than a third of the health care workers in the first phase have been vaccinated, according to the county.”
Not unexpected given that Cody is in charge
dan, i was reading about folks like dentists, physical therapists and folks like me, working in small business in support of healthcare. we are a segment that may have a tendency to fall thru the cracks, even though we are in close contact with our clients, who are the most vulnerable. we may totally miss the immunizations if we aren’t pro active enough to make some calls and send notes to city, county, state federal contacts we may have.
i do agree, however, that, as you said, “Whatever is done needs to be done quickly and without bureaucratic red-tape.”
The headline of the article i poste dabove says:
“Coronavirus: Santa Clara County boosts vaccine effort amid slow rollout”
But, in the article Cody says:
“Overall, the initial rollout has been “encouraging,” she said, and the county was “thrilled with the partnership of all the health care systems to stand up vaccinations.””
and
““I’m not a logistics person but even I can appreciate how complex this is,” Cody said.”
Maybe part of the problem is Cody– shouldnt county health get someone that knows something to make sure the vaccine rollout moves quickly.
I hope this is not another example of Cody sidestepping state guidelines