COVID-19 vaccine

The Tuolumne County Public Health Department received its first batch of the Pfizer COVID-19 vaccine on Dec. 16.

In an effort to speed the rollout of the COVID-19 vaccine to people most at risk of dying, California state officials on Wednesday announced that people 65 and over will be eligible to receive the vaccine sooner than had previously been planned.

Under new guidelines from the California Department of Public Health, people in Phase 1A of the state's tiered system — health care workers and nursing home residents — are still eligible to receive vaccines. After those people are given vaccines, seniors 65 and older will be in the next group.

The state is setting up system to let people know if they are eligible to receive a vaccine, and if not yet eligible, to register for a notification via email or text when they are, Newsom's office announced. That system is expected to launch next week.

A second phase of that system will help counties, cities and others run mass vaccination events at stadiums, fairgrounds and other locations. It will allow eligible members of the public to schedule vaccination appointments at those events. In addition to mass vaccination events, people also will be able to go to their doctor or pharmacy to receive the vaccine as more becomes available from the federal government, Newsom's office said.

"There is no higher priority than efficiently and equitably distributing these vaccines as quickly as possible to those who face the gravest consequences," Newsom said in a statement. "Individuals 65 and older are now the next group eligible to start receiving vaccines. To those not yet eligible for vaccines, your turn is coming. We are doing everything we can to bring more vaccine into the state."

The change in policy comes one day after the Trump administration announced it was reversing course. The Centers for Disease Control on Tuesday began recommending that states expand access to Covid-19 vaccines to everyone 65 and older to speed up vaccine rollout.

The Trump administration had promised that 50 million doses would be administered nationwide by the end of January through Operation Warp Speed, its vaccine program. But through Tuesday, it had delivered only 25 million doses nationwide, and just under 9 million shots had been given, according to the CDC.

The federal government's priority system, ranked by occupation and risk, and California's similar system, have been widely viewed as too cumbersome and slow.

As of Monday, California had shipped 2.46 millon vaccine does to city and county health departments, and to large health care providers like Kaiser Permanente, Sutter Health and Dignity Health. But only about one third of those — 816,673 vaccine doses — had been administered statewide.

"With our hospitals crowded and ICUs full, we need to focus on vaccinating Californians who are at highest risk of becoming hospitalized to alleviate stress on our health care facilities," said Dr. Tomás Aragón, director of the California Department of Public Health and State Public Health Officer. "Prioritizing individuals age 65 and older will reduce hospitalizations and save lives."

There is no question that older Americans have been hit hardest by the pandemic. Of the 31,102 deaths in California since the disaster began last year, 75% have been people 65 and older, and 94% have been people 50 and older, according to state statistics.

And it has not been spread evenly through California. Through Wednesday, 66% of the state's total COVID deaths have occurred in just five of California's 58 counties, all of them in Southern California — Los Angeles, Riverside, Orange, San Diego and San Bernardino.

The nine Bay Area counties have accounted for just 10% of the statewide deaths — 3,148 — even though they have 20% of the state's population. Of the nine Bay Area counties, Santa Clara has the most deaths, with 986, followed by Alameda with 763, Contra Costa with 392, San Mateo with 268 and San Francisco with 235.

Expanding the pool of people who can get the vaccine also is expected to raise new challenges.

In Florida, after Gov. Ron DeSantis issued an executive order Dec. 23 saying anyone 65 and older could get the vaccine, along with health care workers, counties launched online registration websites. But they crashed due to a flood of interest. Phone lines set up for appointments were jammed. And seniors sat all night in lawn chairs and cars outside hospitals, some of which announced they were administering the vaccines on a first-com-first-served basis.

On Tuesday, the Santa Clara County Board of Supervisors voted 5-0 to require large health care providers to produce written plans and timelines for COVID-19 vaccine distribution by Feb. 1.

What's driving the change? A growing number of Americans are frustrated over the existing criteria, which they believe are too limiting, said bioethicist Art Caplan of New York University's Langone Medical Center, who has been tracking state trends.

"People are seeing too few vaccines in a tiny number of arms. There is disappointment with the slow rollout," he said.

Secondly, people aren't convinced that there aren't enough supplies to handle a much larger group, especially with new vaccines by AstraZeneca and Johnson & Johnson debuting in February.

With more vaccines on the way, "we should get ready for that," he said. "We've seen how slow it is to set up things for distribution. So people are saying: 'Get going. Prepare. Get ready.'"

There's the perception that logistics, not limited supplies, are the problem, he added. By opening up more sites — such as civic centers, baseball stadiums, Walgreens lobbies — the state could accommodate more vaccines.

Finally, Californians are watching others get vaccinated, and feel left behind, he said. "People are saying 'I see other people getting vaccines in Florida or bribing their way to get them, and I'm 65 too or I'm high risk — so do something."

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