Santa Clara County has provided overdose of vaccine over the past month to a senior county official and dozens of other health care workers, raising new questions about providers’ discretion to vaccinate people with lower priority among a chaotic statewide deployment.
While Santa Clara County isn’t the only provider that has faced the problem, its options are raising eyebrows in part because the county has simultaneously taken a tough stance against other providers who deviate from normal protocols, recently cutting the vaccine at Good Samaritan Hospital because it improperly vaccinated Los Gatos teachers.
Since Jan. 11, the county has relied on a written plan that explains what to do with the excess vaccine, which must be used quickly once it begins to thaw. He asks to first offer the vaccine to those in Phase 1A, the highest priority, followed by those over 75, and then transport the vaccines to VMC’s Valley Specialty Center or Saint Louise Regional Hospital.
As counties across the state struggle to ethically manage additional day-to-day doses in the context of a general shortage, the protocol seems to give way to what happens next. At least twice, rapid-thaw vaccines have landed in the arms of county employees who are considered part of Phase 1B, including County Adviser James Williams and others who do not regularly come face-to-face with patients with coronavirus. Some of these employees, including Williams, are also much younger than those who now have priority for vaccination.
The largest group was vaccinated on Dec. 30, nearly two weeks before the county established written rules for additional doses, when county executive Jeff Smith authorized about 45 county employees working at the county center. county emergency operations to get vaccines that the county says were otherwise headed for garbage.
State guidelines give priority to health workers and those living in long-term care centers in Phase 1A, followed by those over 65, educators, food and agriculture workers, and emergency workers. of Phase 1B, of which EOC employees are part.
“By definition, they are not spaces known in advance. It’s not about appointments made, which was the only thing that one day was a much bigger number, “said Williams, who is in his thirties. “We usually talk about onesies, twosies or maybe a dozen.”
Around 4 p.m. on Dec. 30, Smith said he received a call because the Valley Medical Center employee health center had a batch of unused doses of Pfizer and there were no health workers nearby. high priority they needed it. With about 90 minutes left to administer the doses, Smith allowed those who were physically present at the San Jose emergency operations headquarters, including Williams, office workers, analysts and other support staff, to receive the first doses that afternoon. Williams said she was one of the “last people in line.”
At that time, about 6,000 health workers and county support staff had been vaccinated across the county.
“There wasn’t a group of people available at the hospital, so the emergency operations center staff seemed reasonable to me,” Smith said. “My thought process was, ‘Well, if there are no doctors, nurses and technologists available, we should go to the emergency services.'”
The state’s vaccination guidelines in December give some discretion to providers when it comes to getting off the list of priorities when vaccines are about to expire or people don’t show up for appointments. Health departments can “temporarily adjust prioritization” only after “intensive and appropriate efforts to reach prioritized groups at this time,” according to the California Department of Public Health, which did not respond to the request for comment. Friday.
However, exactly how these scenarios unfold in reality has caused confusion and heated debate. Last week, the county sanctioned Good Samaritan Hospital for offering teachers what the hospital said were excess vaccines, also under Phase 1B grouping. The county said the hospital’s actions included a number of “problematic” events in which teachers were offered vaccines at future dates, not just the excess vaccine.
Phase 1B county workers only received vaccines on the day they were available and only except for other options, Smith and Williams said.
In another instance, on January 12, Deputy Director of Emergency Management David Flamm alerted emergency operations personnel, public health personnel and other 1B workers of a log link to sign up for the same day’s appointments “approved by the county leadership,” according to the email obtained by this news organization.
Flamm said Friday that it was the only time he was asked to send this email and that vaccines seemed accessible in several places. “DON’T SHARE !!!!!” the email told recipients and added, “If you can’t get vaccinated today, we anticipate that there will be additional days in the coming weeks when this opportunity may arise.”
“With all the vaccination operations underway, it seems to me that there is always a bit of a delta between those administered and the cancellations, or any other amount of problems, so I just anticipated that this could happen again,” he said. dir Flamm.
In all, there have been cases of “at least a couple” of 1B workers receiving vaccines in addition to the Dec. 30 group, but with far fewer numbers, Smith said.
“We were in a situation where we had a shortage of vaccines, a challenge with the interpretation of state regulations, a lot of people who would like to have the vaccine, and we tried and still try to focus initially on health care. Professionals and agents “It’s a situation of using it or losing it.”