San Diego Union-Tribune (Sunday)
Some have found a way to get to head of line to get vaccinated
San Diegans look for any way to get dose early, from waiting in line outside vaccine centers to volunteering
Just after 9 p.m. Friday, two people wearing masks and UC San Diego IDS slipped through a guarded gap in the gate blocking the entrance of the vaccination super station near Petco Park and turned to address a throng of about 100 people waiting in the dark, their breath fogging in the chill night air.
Scheduled appointments finished for the day, there were about one dozen doses of coronavirus vaccine left over, just what the group had been hoping for, some of them having queued up midday under ponchos and blankets as winter rain deepened sidewalk puddles.
But the ad-hoc line, which followed K Street east, turning the corner at 14th, did not set the pecking order on this night. Edgar Rodriguez, a UCSD practice manager and vaccination worker, made it clear that age, not order of arrival, would dictate who got through the gate and who went home.
“Sixty-four? Anyone else?” he yelled, moving to a few who raised their hands. He carefully checked the dates on their driver’s licenses before calling for 63-year-olds to raise their hands, granting a last bit of luck to a 59-year-old man before word crackled over the radio that there were no more doses left. It was a frustrating moment for Cynthia Monaco, who said she had waited, third in line, since noon Friday on the off chance that a few doses might come available. Thursday, many in line said, had zero extra doses to offer. Soon to celebrate her 65th birthday, Monaco did not wait for herself but for her sister, 56, who has Type 1 diabetes and multiple sclerosis.
“She’s very high risk, so I called her and said, ‘I want you to get down here at 7 and you take my seat in my camp chair that I’ve been sitting in all day,’” Monaco said. “She’s not healthy enough to be out here all day.”
But there was not quite enough to make it to age 56.
Her sister, who declined to provide her name, did not make it through the gate, standing disappointed, her hands resting on a walker, by her sister’s side.
“Everybody’s saying if you’re in line, you are the first person in that line, you might get one,” she said. “For them to change the entire scope of things and now it’s oldest down to the youngest, that’s not right.”
And so it is at the moment for
those who are not yet part of the group prioritized for coronavirus vaccination which, at the moment, includes those age 65 and older, health care workers and residents and employees of skilled nursing centers.
The situation is just the latest wrinkle in what has been a somewhat arbitrary rollout of the vaccine that offers the best hope yet of avoiding infection and escaping the never-ending shutdowns that have devastated whole sectors of the economy.
Since the first doses began arriving at hospitals in mid-december, there has been a steady grumble about who is getting access to doses after front-line health care workers and nursing home workers.
UC San Diego’s Petco location has received broad attention for its ability to vaccinate thousands by appointment every day, its crews of workers and volunteers working under white awnings rain or shine and deep into the evening hours, shepherding an endless stream of vehicles whose drivers managed to secure appointments.
When handling thousands per day, it is inevitable that, sometimes, a few doses will be thawed but unused when the gates close at 7:45 p.m. No-shows and other factors can leave a tiny margin of vaccine that needs to be used quickly before it expires. Similar situations have been recently reported at other mass vaccination clinics, including those in Los Angeles, and state guidance specifically allows centers to take actions like the one that unfolded at Petco Friday night in order to ensure that no doses are wasted.
Vaccination operations in San Diego County are required to make an effort to prioritize those next on the official prioritization list, such as law enforcement officers and teachers, when they have extra doses, but there is a limit to any operation’s ability to pull in such workers on a moment’s notice.
There has also been a little slack in the vaccine supplies sent directly to hospitals and health systems which, after vaccinating workers closest to the bedside, have used remaining doses to inoculate workers who say they wish to volunteer, assisting front-line workers who have been spread thin as the number of incoming COVID-19 cases has surged.
At Scripps Health, the organization confirmed in an email, the ranks of volunteers included some members of its board of trustees who, it said, “assist in governance and in support of operations.” Others on the board, Scripps added, received doses under Tier 1B of the vaccination prioritization schedule.
“Just like the rest of our volunteers, they received vaccinations at the end of our health care vaccinations and as Tier 1B was opened,” the Scripps statement said.
Scripps, and all health providers, are also vaccinating their own patients aged 65 and older, by appointment when supply is available.
The state has also allowed anyone licensed to give shots to get the vaccine under a “vaccinating the vaccinators” in hopes that they will later volunteer their services to help expand inoculation capacity when more doses arrive.
Those who say they will volunteer, if they have the right qualifications, get to the front of the line, though following through on such promises appears to be on the honor system at the moment.
Both Scripps and Rady Children’s Hospital said they have refused to vaccinate donors who may feel some entitlement to a spot closer to the front of the line.
The public has little visibility into the vaccine-allocation system. Individual vaccination records are considered health records not subject to public records act requests.
Only San Diego County, through the San Diego Immunization Registry that it manages, has the kind of access to confidential vaccination records.
With the exception of U.S. military and Veterans Administration, vaccinators are required to record each dose in the registry, an electronic repository that allows health providers to quickly receive a patient’s full vaccination history without the need to take a look at yellow paper vaccine cards.
Asked Tuesday whether the county was looking for evidence of inappropriate vaccinations in the registry, Dr. Wilma Wooten, the region’s public health officer, said no.
“We do not have the capacity, by and large, to look at individuals, by and large, by what classifications they’re in,” Wooten said.
According to the county, an occupation category was added to the registry in October 2020. Today, only 9.6 percent of registry records have occupations listed, meaning that significant additional research would be necessary to spot possible vaccine line jumpers.
With managing myriad pandemic-related tasks, from sorting through the thousands of new positive case notifications that arrive daily to setting up new vaccination stations, it is easy to see, that the public health department has been running full steam for nearly one year now.
Despite state guidelines, knowing who’s eligible to get a COVID-19 vaccine has often been messy.
Case in point: The state’s highest-priority vaccination group, mostly made up of health care workers and nursing home residents and staff, includes “laboratory workers.”
When the first supplies of vaccine arrived, there were questions about whether the large contingent of lab workers among the 68,000 employed by San Diego’s burgeoning biotech industry qualified.
Many of these companies are represented by Biocom, a statewide life science trade group based in San Diego. The organization’s president and CEO, Joe Panetta, says the county later clarified that only employees who do coronavirus research or work with clinical samples are eligible for the vaccine.
Biocom, UC San Diego, Scripps Research, the Salk Institute and the J. Craig Venter Institute all told the Union-tribune that they have informed their members about the clarification, which is also noted on the county’s COVID-19 vaccine page. Some biotech employees told the U-T that they were turned away at vaccination sites after being asked whether they do COVID-19 research.
“You’ll probably find if you talk to some of the companies that a few workers … were actually able to go and get vaccinated,” Panetta said. “That was cleared up very quickly.”
Deciding who needs to be vaccinated first has sometimes even become zoological.
Though the folks working at San Diego Zoo and Safari Park are not yet in the group designated for vaccination,
Lisa Peterson, executive director of the Safari Park, confirmed that most have already rolled up their sleeves, getting access on grounds that inoculation protects the wildlife they care for.
“I believe at this point, that between the (Safari) Park and the zoo, I think everybody’s had their first shot,” said Peterson, noting that these veterinarians fall into the same vaccination category as health care workers. “We’re grateful to the county for allowing us to be able to push our team forward so that we can protect the wildlife that’s in our care.”
The Safari Park’s gorilla troop has tested positive for the coronavirus, but, in general, only a small fraction of the more than 6,500 animals at either facility are thought to be susceptible to the coronavirus.