SLOW VACCINE ROLLOUT PROMPTS QUESTIONS
County doesn’t know the total number of shots administered
With the prick of a needle, an elderly Chula Vista man was vaccinated against COVID-19 on Dec. 21, drawing cheers and applause from a room filled with health care workers.
Carlos Alegre had just become one of the first San Diegans to receive a vaccine that fights the novel coronavirus, raising people’s hope that the county, and the country, will emerge from the pandemic, perhaps by mid-to-late summer.
That hope still exists. But the vaccine rollout has not gotten off to a fast start. A new variant of the virus is helping push infections to record levels. And a postNew Year’s Eve surge could make things worse this week and shove greater San Diego’s overcrowded hospitals into crisis mode.
The situation is generating a lot of public anxiety, and many, many questions,
some which are answered here.
Q:
How many of San Diego County’s 3.4 million people have received a COVID-19 vaccine?
A:
No one has provided a precise tally. A county spokesperson said on Friday that 58,000 people had been immunized. But that might be an underestimate due to delays in reporting. And the figure does not include nursing home residents who have been vaccinated at those facilities by CVS and Walgreens. The pharmacies are leading a national vaccination effort that will involve more than 90 percent of California’s long-term care facilities.
The overall vaccination number also does not include San Diego County’s military community, which is among the largest in the U.S. The Navy has inoculated many front-line workers and staff, and has begun to immunize some of more than 105,000 active-duty uniformed personnel in the county. But for security reasons, the Navy is not disclosing the number of people who have been vaccinated so far. The VA San Diego Healthcare System has immunized nearly 3,100 people.
It is also unclear how many total doses of vaccine have been delivered to the county, hospitals, the military and other parties involved in immunizing people. No one is pulling the data together and posting it publicly — although that might change.
“When we have the data we will share the data,” said County Supervisor Nathan Fletcher. “We continue to push. It’s frustrating. We would like to know today exactly how many (doses) are here.”
Q:
Is it possible to pull such data together? A:
It’s being done in many other places. The state of Indiana’s main website reports how many people have received the first dose of a vaccine and the number who have been fully vaccinated, and it breaks out the numbers by county, age, gender and ethnicity. Ohio does something similar. So does the University of California San Diego. But California, despite its position as the center of the information-technology universe, doesn’t. Nor does San Diego County.
Q:
Is the vaccination rollout going better in other parts of California and elsewhere in the U.S.? A:
Generally speaking, no. About 2.3 million vaccine doses had been distributed throughout California as of Thursday, according to the Centers for Disease Control and Prevention. Less than a quarter of those doses (around 528,000) have actually been administered.
That echoes the situation nationwide. Leaders of Operation Warp Speed, the U.S. government’s bid to fast-track vaccine development and distribution, declared that 20 million Americans would be vaccinated by the end of December. It’s early January, and roughly 6 million people have gotten a COVID-19 vaccine. That’s less than 2 percent of the country. By comparison, Israel has vaccinated more than 17 percent of its population, according to a database maintained by Oxford University researchers.
The U.S. rollout has gotten off to a slow start for a variety of reasons, including the fact that it began during the holidays and the vaccines must be kept in supercold temperatures at every step of the shipping and storage process.
That could improve soon. Dr. Anthony Fauci, the nation’s top infectious disease expert, has said vaccinations are speeding up and could soon reach 1 million doses a day.
UC San Diego Health said Thursday that it is partnering with the county to immunize 5,000 people per day, starting today
Q:
Who has been getting vaccinated in San Diego County during the first three weeks of the rollout? A:
The focus is almost entirely on health care workers and staff and residents of nursing homes. They fall into the highest-priority group, known as Tier 1A. Several San Diego hospital systems — including UC San Diego Health, Sharp HealthCare and Rady Children’s — have vaccinated the majority of their staff and are beginning to administer second vaccine doses, as both the Pfizer and Moderna vaccines require a booster shot. CVS and Walgreens began administering vaccine in San Diego’s nursing homes the week of Dec. 28, though it’s unclear exactly how many people have been vaccinated through this program.
Q:
How long will it take to vaccinate the people in that first group, and who is eligible to get immunized next?
A:
The county says it will take several weeks to finish with 1A. Then it moves on to 1B, which focuses on older people and on essential workers who are more likely to be exposed to the virus — people like firefighters, police officers, grocery workers, bus drivers and teachers.
That next phase will heavily focus on people 75 and older — a very vulnerable demographic. As of Friday morning, 1,211 of the 1,738 people who have died of COVID-19 in San Diego County were 70 or older. The county is home to about 200,000 people who are 75 or older.
This group also will focus on educators and child care workers, as well as emergency service and food and agricultural workers.
Then things move to Tier 2, which includes the nearly 275,000 people in the 65-to-74 age range, along with hundreds of thousands of people in the transportation, industrial, commercial, residential, critical manufacturing and sheltering facilities sectors.
Other states have already begun vaccinating some older residents outside nursing homes and non-health-care workers in phase 1B, including Texas and Nebraska. There’s actually no requirement that states completely finish phase 1A before moving on. In fact, the CDC’s vaccine advisory committee has discussed how states can ramp up one phase while winding down another, and the state of California has said vaccine doses that would otherwise be wasted can be administered to people in the next phase.
Q:
Can people in 1B register in advance to get the vaccine?
A:
Not yet, but supposedly at some point. “We will have (that feature) before we get into Tier 1B,” said Nick Macchione, director of the county’s Health and Human Services Agency. “A place where everyone can register and know when their turn’s up, that they get notified and where to go.”
Other places, such as New Jersey and parts of Ohio, already allow people to pre-register for the vaccine.
The county has said that, once eligible, San Diegans will be able to get vaccinated through their existing health care providers, local pharmacies, community clinics or vaccination sites run by the county.
Q:
Who comes after that?
A:
Group 1C includes the roughly 600,000 people who are in the 50-to-64 age range, and people 16 to 64 who have an underlying health condition or disability that increases their chances of developing severe COVID-19. Vaccinations also will go to people working in the wastewater, defense, energy, chemical and hazardous materials, communications, IT, financial services and government operations sectors.
Q:
Will officials prioritize who gets the vaccine first in these various sectors? A:
Yes. The CDC has advised that vaccination at each stage be prioritized for those individuals at greatest risk of exposure to the coronavirus or developing severe disease. That’s been true during phase 1A as well, with health care workers in closest contact with COVID-19 patients being the first in hospitals to get vaccinated.
Q:
What if a person isn’t at great risk but they perform a crucial job? For example, would a 21-yearold person who is doing key repairs on a warship at a local defense company get a vaccination before a healthy 51-year-old accountant in the same firm?
A:
So far, the state hasn’t provided a detailed breakdown of how to divvy up doses beyond phase 1A. And with demand exceeding supply, clear guidelines on how to allocate vaccine equitably will be key to preventing further chaos and confusion.
Q:
When will people who don’t fit into any of these tiers — the general public — get vaccinated? A:
The county says it’s likely to be spring, which begins on March 20. But it’s unclear what time of spring the immunizations will begin.
Q:
How many people in the county and in the nation have to be vaccinated to slow the spread?
A: That’s the big question, and CDC estimates of how much of the population needs to get vaccinated or recover from natural infection to achieve herd immunity range from 55 percent to 82 percent. Fauci has said we might reach that point by the summer, but we won’t know until we get there, says San Diego State University epidemiologist Corinne McDaniels-Davidson.
The arrival of a new, more infectious strain of the coronavirus certainly doesn’t help, as even more people will need to be vaccinated to control the pandemic.
“It’s going to take more time to reach that community immunity level,” McDaniels-Davidson said. “We’re in for a really devastating year, especially in the f irst six months, if things don’t slow down.”