As state and federal officials expanded eligibility for the vaccine this week, local health officials in the Bay Area are desperate to get more doses to meet the demand of those who were already eligible.
Since Contra Costa County began allowing all residents age 65 and older to sign up for vaccination appointments, according to new guidelines released by U.S. and California health authorities, it has received a thousand sol · hourly bids, sufficient to meet your weekly dose allocation in 12. hours. The website of Sutter Health, a health care provider that vaccinates people in several counties, crashed Thursday under such a high demand for vaccination consultations. To make matters worse, a federal stockpile of second-dose vaccines that had been taken into account in the planned supplies was depleted, launching “chaos” into an already rocky deployment, in the words of a Santa Clara County official. .
Contra Costa County has used half of the vaccine doses allocated so far, but it is not for lack of evidence. About 36,000 shots have been fired and the other 36,000 are already counted with reserved appointments in the coming days and weeks. 33,000 more will arrive soon.
“The county is not just sitting on those other 36,000 doses,” said COVID-19 Chief of Operations Dr. Ori Tzvieli, at a press conference Friday morning. “We are rapidly accelerating our efforts to vaccinate as many people as possible. We want to get shots in the arms. … But the mitigating step is really the amount of vaccine we are assigned.”
By the end of next week, the county expects to administer 3,600 shots a day and increase that capacity to 5,800 a day next month. In Santa Clara County, officials are increasing the number of vaccines to the first phase of recipients, from 3,000 administered on Monday to 6,000 scheduled for administration on Friday.
Dr. Jennifer Tong, chief associate physician at Valley Medical Center, warned that it is only a small portion of the need.
“The biggest constraints we have right now is the availability of the vaccine,” he said.
To date, the county has administered 32,352 first doses and 6,594 second doses of approximately 170,000 assigned. In addition to two mass vaccination sites at the county fairgrounds in downtown San Jose and at a Berger Drive complex north of San Jose, a high-capacity location will be added to Mountain View. An offer from the San Francisco 49ers to use Levi’s Stadium as another such venue is still being examined by the county.
If there were more doses in Contra Costa County each week, Tzvieli would re-evaluate the need for a mass vaccination site. But with the limited amount available, its twenty or more smaller places in the county are proving more effective, he said. Two more will open next week in Richmond and Antioch.
“It’s about supply,” Tzvieli said. “If I had an extra 20,000 doses, I’d organize it into a three and nothing, but now I don’t have any.”
Santa Clara County Attorney James Williams said they also continue to struggle to find out how much vaccine capacity there is in the county, in large part because the hospital systems that provide care to most patients in South Bay, Kaiser and the United States Palo Alto Medical Foundation, are receiving dose vaccines directly from the state. Federal vendors, such as CVS, Walgreens and VA, are also out of their data reach.
“We don’t have full visibility of what they’re doing,” Williams said.
Williams noted that expanding the state of vaccine eligibility to residents age 65 and older does nothing to increase the available supply of vaccines, which is why the county has set its own age limit for vaccines. 75 years. At least 300,000 Santa Clara County residents are at least 65 years old.
“The reality is that we don’t have nearly that much vaccine to administer,” he said. “We’re seeing demand exceed supply and exceed basic capacity for things like programming.”
Contra Costa County officials said they expected to vaccinate the 77,000 residents aged 75 and over “in the coming weeks,” but in the meantime have opened appointments for anyone 65 and older. For now, however, most of the shots on a given day are still in front of health workers and those over 75 years of age.
Williams also said officials were discouraged by Friday’s revelation that there was no alleged dose reserve.
“We learned this morning that this stock does not exist,” he said. “This throws into chaos expectations around vaccine delivery.”
He hopes the promise of a truly nationally coordinated vaccine deployment promised by the incoming Biden administration will reverse what he calls abdication by the Trump administration, which said it devoted resources to a futile attempt to overthrow Biden elections in the face of a pandemic the death toll is approaching 400,000 in the United States.
“This has really distracted the energy of the federal government from its first and foremost job of protecting and caring for everyone in the United States,” Williams said.
But the new administration will face a one-generation challenge of inoculating hundreds of millions of Americans in the coming months with hard-to-administer vaccines. Even beyond the extreme storage and transportation requirements, healthcare professionals need to be trained on how to deliver the vaccine, and then additional staff are needed to monitor recipients for the next 15 minutes in case of allergic reactions. Everything must be achieved in a safe and socially distant way.
“To top it off,” Tzvieli said, “all of this is being built as we face the biggest increase in the pandemic, which is already extending our limited resources.”