Marin supply of vaccines falling short
Doses arriving in county slower than promised
Coronavirus vaccines have been arriving in Marin County at a slower pace than initially promised by the state, the county’s public health officer said Tuesday.
“What is driving the pace of our vaccine administration is the supply of vaccines,” said Dr. Matt Willis.
The first doses arrived in Marin on Dec.16. The following week the county was promised two boxes of the Pfizer vaccine, each containing 975 doses, but received only one box. The county received only 100 doses of the Moderna vaccine last week, far fewer than it was expecting. The previous week it received 3,100 Moderna doses.
Willis said he expects to receive a total of 2,500 doses of vaccine this week and the same amount each week for the foreseeable future.
So far, Marin has received 12,778 vaccine doses, a combination of the Pfizer and Moderna products. Laine Hendricks, a spokeswoman for the county, said that by the end of last week, 6,100 vaccinations had been administered in the county. Hendricks said the county expects to administer 5,476 vaccinations this week.
Willis said the pace of vaccinations in Marin and throughout much of the state has been slowed by strict adherence to a tiered system for determining who is vaccinated first.
Marin County is in phase 1A of administering the vaccine. This phase limits vaccinations to health care workers and employees at nursing homes, but it divides these workers into three categories or tiers.
Employees at skilled nursing centers and acute care hospitals are in tier one. Employees at primary care clinics, federally qualified health centers and urgent care centers are in tier two. Employees at specialty
clinics, dental clinics and pharmacies are in tier three.
“We’ve got these very fine slices around different sectors, even within health care, that we’re being expected to follow,” Willis said. “It’s really difficult to manage only vaccinating people in phase 1A tier one completely before moving into phase 1A tier two. That has had some unintended consequences in terms of delaying the overall process.”
Willis said that in an effort to speed up the process, Marin has decided to allow anyone who qualifies for phase 1A to be vaccinated regardless of which tier the person is in.
He said other factors have also influenced the pace at which vaccinations have occurred. For example, the eligibility of people being vaccinated has to be certified and they have to be registered through a state computer portal, which keeps track of when they need to receive their second dose. Both the Pfizer and the Moderna vaccine require two doses for maximum effectiveness.
In addition, doctors and primary care clinics that
want to administer the vaccine to their patients must go through an approval process. The only entities authorized to receive vaccine shipments and give shots are the county’s public health department, Marin’s hospitals and certain CVS and Walgreens pharmacies.
The federal government has partnered with CVS and Walgreens to have the two chains send their pharmacists to long-term care centers to administer the vaccine.
Campbell O’Connor, a Walgreens spokesman, wrote in an email that Walgreens began administering vaccines to residents and staff at nursing homes and assisted living centers on Dec. 21.
“We will continue to expand vaccinations to nearly 3 million residents and staff at 35,000 long-term care facilities that have selected Walgreens as their vaccine provider as states finalize their distribution plans and receive vaccine allocations,” O’Connor wrote.
Willis said, “That is probably siphoning off a significant number of doses from the federal level. We don’t have visibility on how many
doses are coming in right now through our pharmacies, which is a blind spot for us. We’ve asked for that information.”
Despite the federal government’s partnership with the pharmacies, Marin County chose to use its initial vaccine allocations to vaccinate employees at local skilled nursing centers.
“We didn’t want to wait for CVS and Walgreens because we don’t have a lot of visibility in that process,” Willis said. “It might have been weeks before that was available. We wanted to get protection as early as we could.”
Eighty- five percent of the coronavirus deaths in Marin have occurred among nursing home residents. Willis said the vaccine has now been offered to employees at all 13 of the county’s skilled nursing centers, with an acceptance rate of more than 75%.
“That is going to go a long way towards preventing further outbreaks in skilled nursing facilities,” Willis said.
He said the pharmacies have vaccinated residents at two Marin long-term care centers so far.
Phase 1B of the vaccination program is expected to begin at the end of January or early February. During that phase, priority will be given to residents 75 years and older, teachers and other educational workers, food and agricultural workers, other “to be defined” essential workers, and people ages 65 to 74 with underlying medical conditions.
Briefing supervisors on the pandemic response on Tuesday, Willis said the public shouldn’t expect the state mandated stay-at-home order to be lifted this week. The entire Bay Area came under the order after the availability of intensive care unit beds in the region fell below 15% on Dec. 17.
As a result, Friday is the earliest the order could be lifted, if the Bay Area’s ICU bed capacity rises to 15% or above by then, according to the state’s edict. That is unlikely, however, since the regional ICU bed availability stood at 7.9% on Monday.
Otherwise, the order will be lifted when the California Department of Public Health’s four-week projection of the Bay Area’s ICU bed capacity is greater or equal to 15%.