Mass COVID vaccinations will begin next week

County officials detail challenges of rollout so far

Adventist Health Sonora on Thursday announced plans to begin vaccinating people 75 and older for COVID-19 at the Mother Lode Fairgrounds beginning late next week, while the Tuolumne County Public Health Department is ready to start doing the same as soon as enough supplies become available from the state and federal government.

County officials involved with public health and emergency services held a virtual meeting with The Union Democrat on Thursday to discuss and answer questions related to rollout of the vaccine since the first shipment arrived in mid-december, including challenges they had to overcome related to staffing, supply uncertainty, and changing rules for distribution.

“The logistical nightmare that is occurring with intake, contact tracing and making sure people are getting their second dose is just mind boggling,” said Dore Bietz, county Office of Emergency Services coordinator.

Nevertheless, the county’s small public health team that includes five nurses have worked with health care partners in the community to distribute and administer all of the first 765 Pfizer vaccine doses earmarked for Tuolumne County that arrived Dec. 16.

The vaccine made by Pfizer requires two shots spaced 21 days apart to be effective, while the one made by Moderna requires two spaced 28 apart.

There were 159 people as of Thursday who received a first dose of the Pfizer vaccine out of the initial 765 who still needed to receive a second dose, though they are being administered each day.

Bietz said the county’s initial batch from Pfizer was mostly doled out to Adventist Health Sonora, skilled nursing facilities and other long-term care facilities because health care workers and nursing home residents were the initial group that the California Department of Public Health Department

said could receive the vaccine under Phase 1A.

All of those who received the vaccine must be tracked and reported to the state by the public health staff, on top of coordinating vaccination clinics, administering doses, and daily duties related to contract tracing and investigating COVID-19 cases in the midst of a surge.

“It's not just making it available, but we have to have the qualified staff to administer the vaccine,” Bietz said. “Public health is multi-tasking between contact tracing and the vaccination.”

The hospital and other qualified health care providers, including both Me-wuk tribal clinics and some pharmacies, have also signed up to receive supplies of vaccine directly through CVS and Walgreens as opposed to through the county Public Health Department.

Providers that receive the vaccine directly had yet to respond to a survey sent out on Thursday by Rebecca Espino, director of the county Health and Human Services Agency, asking to report the number of doses they've received of each of the vaccines and how many people they've given their first and second shots.

Espino said the providers are required to report information to the state to help ensure the proper people are receiving the vaccines, but not the county.

Some of the reasons Espino gave for why the county lagged behind some other surrounding counties in moving on from Phase 1A and into Phase 1B, in which people 65 or older will be eligible, is due to having a larger population of health care workers and people in general. Adventist Health Sonora alone employs more than 1,500 people.

“That doesn't include all of our paramedics, all our EMTS and other folks who fall in tier 1 (of Phase 1A),” she said.

The hospital said in the announcement for mass vaccination clinics beginning late next week that it had given more than 1,150 shots to health care workers over the past three weeks and on schedule to soon have vaccinated all long-term care residents in its Sierra Care Center, Units 6 and 7, which reported several cases and two deaths from the virus late last year.

Espino said the county also recently received 700 doses of the Moderna vaccine and will have administered 100 doses by Friday to in-home supportive services and other home health workers, who fall under tier 2 of Phase 1A, and is withholding an additional hundred for the second shot due to uncertainties about supply.

The remaining 500 doses will also be administered Friday at a closed clinic to those people in tier 2 of Phase 1A that have signed up, which requires 22 qualified nurses to give all of the shots. Espino said 800 workers responded to sign up when they put out the word about the clinic.

While the county plans to move onto Phase 1B next even if all those in Phase 1A haven't received shots, the limiting factor is the current slow and inconsistent trickle of supply for such mass vaccination clinics.

However, there's hope that the new administration under President-elect Joe Biden will speed up the distribution of vaccines in the coming weeks after he takes office on Wednesday. He's indicated a desire to send out all the vaccines currently in the federal stockpile and use the Defense Production Act to beef up supplies.

County Supervisor Ryan Campbell, who serves as director of the Office of Emergency Services, said the slow pace of vaccine distribution has impacted cities and counties throughout the state (see story on page A2 for more information on that).

Campbell also said another challenge has been the changing guidelines from the federal government that lead to change in the state's requirements for counties to follow, which forces them to quickly adjust any plans they already had in place.

“Local governments are at the end of a long chain of distribution decisions being made at the state and federal level, so there are decision makers outside of the county making decisions that we then have to implement,” Campbell said. “Where the rubber meets the road is with public health.”

“We need the public's help to understand, and I know we can't say be patient, but be compassionate that we are all going through this together and collectively we're going to get through this,” Bietz added, “Things are happening outside of our control.”

Adventist Health Sonora, meanwhile, has been working to procure more vaccine doses that will be provided at no cost to county residents who meet the current distribution criteria.

Though anyone 65 or older meets the criteria of Phase 1B, the hospital is starting first with the roughly 6,000 people in the county who are 75 and older. Getting through that group will allow them to more quickly move onto people 65 to 74, the hospital said. There are 13,700-plus county residents 65 or older, according to census data.

Calaveras County announced on Wednesday that it has more than 10,000 residents 65 and older, but only a “few hundred” doses on hand and 100 expected to arrive next week.

Adventist Health Sonora said on Thursday that Tuolumne County who are 75 and older will be invited to verify their age, county of residence and schedule an appointment for their vaccination as soon as the clinics can be set up, staffed and supplied.

The hospital said appointments will be available in the next few days, and it will announce when a schedule is ready.

When all Tuolumne County residents eligible for Phase 1B vaccinations have had the opportunity to receive vaccine doses, and as vaccine supply increases, clinics will then be available for people who are designated as Phase 1C.

“We are eager to see the community vaccinated as quickly as possible,” Michelle Fuentes, the hospital's president said, “and ease the strain that COVID-19 has put on our families, businesses and healthcare team.”