Vaccine unlikely for most until ’21

Newsom: ‘Unrealistic to expect’ mass availability this year; high-risk people top priority

Even if COVID-19 vaccines are authorized for use in the next couple of months, the vast majority of Californians likely won’t see their turn for shots come up until well into 2021, Gov. Gavin Newsom said Monday in an announcement intended to temper potentially positive news with “sober reality.”

“When we talk vaccinations, don’t anticipate or expect that you’ll be able to go down to a pharmacy anytime this calendar year and get a vaccination,” he said in a news briefing.

“We hope that’s the case, but based on all the evidence, all the data that we have been provided, and the expertise we have been able to glean … it is simply unrealistic to expect.”

A detailed vaccination distribution plan submitted to federal authorities Friday and publicly released Monday outlines how California officials plan to tackle the hefty task of distributing millions. of doses of a COVID-19 vaccine to residents and who gets treated first.

Under the plan, vaccinating California’s nearly 2 million health care workers will be top priority after the state independently validates the vaccine’s safety and efficacy. Next, state officials will expand distribution to people at high risk for severe illness or death from COVID-19 and other front-line essential workers.

Nonessential workers and the majority of Californians who aren’t considered high risk will fall last on the state’s priority list and should expect to wait months after the first vaccines are issued.

The governor’s announcement comes as the number of confirmed coronavirus cases surpassed 40 million worldwide on Monday, with California reporting more than 875,000 cases and nearly 17,000

deaths.

But in a favorable sign of California’s progress toward slowing the spread of the virus, the state’s sevenday average of new cases has dropped below 3,000 for the first time since midJune and daily COVID-19 deaths continue to fall. Still, Newsom said Monday that the state does “not yet” have plans to impose quarantines on travelers coming from nearly two dozen other states where the virus is surging.

Limited quantities of a vaccine — initially authorized under an Emergency Use Authorization from the U.S. Food and Drug Administration

rather than through traditional channels — are expected to become available in late November or December, though large quantities are not expected until at least the middle of 2021.

But before distributing a vaccine to the public, California will independently review its safety and efficacy — an additional screening on top of the federal approval, Newsom announced Monday.

Amid polarizing views on the nation’s response to the COVID-19 pandemic and the federal government’s efforts to speed up the development of a vaccine, a Scientific Safety Review Workgroup — made up of 11 California scientists and chaired by Dr. Arthur L. Reingold, the division

head of epidemiology and biostatistics at UC Berkeley — will offer an analysis independent of the federal agencies’ before approving its public distribution.

Dr. George Rutherford, an epidemiologist at UC San Francisco, called Newsom’s independent review plan “a sign of the times” given some of the mistrust of the federal government and concerns that vaccines’ approval and distribution are being rushed for political reasons, including President Donald Trump’s desire to bring good news in time for the Nov. 3 election.

“We need a large portion of the population immunized — 70%-80% of the population — so if this is what we need to make that happen and it helps dispel

mistrust and doesn’t add time to the distribution, then I think it’s great,” Rutherford said.

Once approved, the state will allocate the vaccines directly to large multi-jurisdictional entities, such as health care providers and systems with locations in multiple counties, and then to local county and city public health departments. They in turn will be tasked with vetting and enrolling vaccine providers and then providing them with doses of the vaccine.

Newsom estimated there could be 45 million doses available across the nation by the end of the year “on the high end.” Of those, California would receive 12%, or about 5 million, which would just about cover two doses for all the health care

workers in the state.

Because the initial supply of vaccines is expected to be limited, Newsom said it’s even unlikely that most patients and workers in long-term care facilities will be vaccinated by the end of the calendar year.

“I understand the prevailing winds where people are pushing optimism because we’re desperate for it … but the sober reality is the expectation should not and cannot be this calendar year for the overwhelming majority of us,” the governor said.

Mass distribution won’t come until 2021 at the earliest, Newsom said. But as forwhen?

“It simply depends on who you talk to,” Newsom said. “Those who are more optimistic say Q1 (January to March), those who are more realistic the middle of 2021 and those who on the spectrum of being a little more pessimistic are looking at Q3 (July to September) of 2021.”

Part of that uncertainty comes down to unique challenges posed by the two leading vaccine candidates, Pfizer and Moderna: Each requires storage on dry ice — which the state is already planning to stockpile — at temperatures between 20 and 70 degrees below zero Celsius. On top of that, each vaccine requires two doses, administered 21 days apart, adding another potential complication.

The state is in the process of surveying health systems and acute health care facilities to gauge their storage capacities.