VACCINE DISTRIBUTION WIDENS IN SOUTH BAY, LAGS IN EAST
Now entering its fifth month, San Diego County’s coronavirus vaccination campaign has broadened considerably from its earliest days when supply was limited to health care providers and seniors. Today, vaccination maps show thousands more doses being administered in a much more diverse range of places.
But, while the effort to reach communities with less access to health care resources has had a striking effect in the South Bay, efforts have been slower to bloom to the east. The county health department’s latest vaccine allocation reports indicate that those living in its east region, which stretches from La Mesa, Lemon Grove and Santee out past Pine Valley, have accounted for just 12 percent of those vaccinated so far.
Eastern communities have the lowest per-capita vaccination rate at 436 people receiving at least one dose per 1,000 residents. The Coastal North County region has a similar rate — 438 per 1,000 — but contains far fewer ZIP codes with disadvantaged neighborhoods than the east region does.
San Diego began reserving doses for its disadvantaged neighborhoods on Feb. 17, and a special state pro
gram doubled down on equity allocations in early March, linking accelerated progress in the state’s reopening system to delivery of millions of doses in areas with the least-equitable access to health care resources.
At the moment, though, that focus on equity is showing up strongest in the south, even though 13 ZIP codes, especially a pair in El Cajon and Spring Valley, said to contain disadvantaged populations hit hard by the pandemic are in the east.
County records show that the southern region now has the highest percapita vaccination rate in the region with 599 people having received at least one dose per 1,000 residents. Out east the rate was 442 per 1,000 through Thursday. That’s the lowest of the county’s six regions.
The difference is most stark comparing the south to the east in terms of people age 65 and older who have been vaccinated. The number is 99 percent in the south but 78 percent in the east.
Overall, though, San Diego has done well with the big picture with the highest vaccination rate in Southern California, according to the latest data from the California Department of Public Health. Northern counties, including San Francisco and Santa Clara, have continued to outpace those closer to the border.
Nick Macchione, director of the county health and human services agency, said late last week that he is both proud of the vaccination efforts seen in the south and cognizant of the fact that there is more work to be done in the east. Vaccination participation, he added, is bound to increase as everybody comes to know somebody who has had their shots.
“Many, they see how their neighbors, their friends, are getting vaccinated and doing well, how our cases are coming down,” Macchione said. “We’re not going anywhere, and we’re going to make sure we get to every single San Diego resident, and that includes every single East County resident.”
It’s clear that the vaccination effort in the southern part of the county has accelerated at a dramatic pace since mid-February.
In March, said Dr. Suzanne Afflalo, a juggernaut of a community health activist who has doubled down on serving her community since retiring from Kaiser Permanente, it was possible to get hundreds of doses, allowing her to begin working her voluminous contact list and holding tailored vaccination events — many of them in churches — in some of the region’s most disadvantaged neighborhoods.
These days, she said, it has been possible, working with the county and UC San Diego, to get thousands of doses for such events. And there is much less conversation around the trustworthiness of vaccines in general.
“I don’t find myself having to convince anyone like I used to,” she said. “I just have to find them appointments.”
She added that working with the county and UC San Diego, she has been able to keep doses off the main My Turn scheduling system, reserving them for those who live in the hardest-hit areas, relying on text messages and phone calls to let people know where to go and when to arrive.
“We started working with community centers, faithbased organizations and churches months ago to reach the people we need to reach,” Afflalo said. “It started off small, but I think we’ve come a long way.”
Some, such as Mohammed Tuama, director of Newcomers Support and Development, a refugee assistance and outreach group based in El Cajon, noted that similar targeted vaccination efforts have so far not been common in the parts of East County with the most disadvantaged residents.
He said many of the Arabic-speaking people he interacts with in the community have not had vaccination-focused outreach from messengers they trust, and said that this fact likely has something to do with vaccination rates in East County, at least among the diverse community of immigrants in El Cajon and other cities in the area.
“We have never seen any invitation or flyer for vaccination in our language,” Tuama said. “I haven’t seen it, none of our communities have.”
That’s not to say that the county’s public health department has ignored Arabic. There are dozens of educational materials on COVID-19 free for anyone to download on the county’s website. But, as yet, none are advertising the kinds of events that Afflalo and many others have been putting together down south.
Plenty of county cash has been spent supporting grassroots community groups and some, such as the San Diego Refugee Coalition, are tasked to reach out to these groups directly using “trusted messengers” drawn from the very communities that vaccination efforts seek to reach. All told, the county has spent $4.6 million through February on such groups, though the coalition, a subcontractor, is small enough that it was not broken out as a separate line item in the larger list.
Dalia Mohammed, an outreach worker with License to Freedom, a nonprofit that works to end domestic violence and is part of the coalition, said she has met regularly with members of local Kurdish and Iraqi communities during the pandemic. She said the relationship started in 2020 with sharing health information translated into Arabic and Kurdish and has evolved gradually into helping many make appointments through the often-confusing My Turn scheduling system.
One of the most valuable things she did to build trust in the vaccine, she said, was to get herself vaccinated at the Petco Park superstation. After seeing her talk about the experience in a local television interview, Mohammed said, many checked in with her to see whether she suffered any serious reactions.
Many, though, still view the vaccine with suspicion, especially as it is the government asking people to get vaccinated and refugees, especially those who have arrived recently, have learned to distrust state-backed programs in the places they emigrated from.
It also does not help, advocates said, that the Johnson & Johnson vaccine, revived Friday, was suspended. Many were already hearing from unreliable sources that the vaccine was not well enough tested.
Still, Mohammed added, no one working for the coalition has had trouble coming up with volunteers when appointments are available. A vaccination clinic held two weeks ago in City Heights, she said, was very well attended, with 1,500 doses administered, no appointment necessary, to those in East County ZIP codes with predominantly Arabic-speaking neighborhoods.
“When the opportunity is given to us, when there is a website that says, ‘oh, they’re taking 200 people,’ we get those people there,” Mohammed said. “When they say they’re taking walkins, believe me, we send enough people there that they can’t take any more.”
A key difference between the south and the east, coalition members said, has been Project SAVE San Diego. The initiative started with a pilot effort in National City, Chula Vista, Imperial Beach and San Ysidro and has since expanded to Southeast San Diego, making extra doses and vaccination workers available to community organizations. This is the program that has helped Afflalo get the doses she needs to do her outreach.
But SAVE, which stands for Scheduling Assistance for Vaccine Equity, is only now expanding to the eastern parts of the region. Coalition members said that a contract was just signed last week to bring a mobile vaccination operation contracted with the county to an as-yetunnamed church in East County. The van should begin operating on Saturdays.
Tuama said another effort is also under way to host a vaccination clinic catering to Arabic speakers in the community room at the El Cajon Police Station.
Political affiliation could also have something to do with the somewhat-lower vaccination rates in East County. Many national news organizations have recently observed that states with a predominance of registered Republican voters correlate with lower overall vaccination rates.
A survey conducted in late December and early January in San Diego County found that 31 percent of Republican respondents said they were “unlikely” to get vaccinated while only 9 percent of Democrats said the same.
An analysis of voter registration records obtained in November indicates that about 37 percent of residents living in the east region are registered Republican, roughly tied with inland North County for the largest concentration of conservative votes in San Diego County.
The difference is visible on the local party Twitter feeds recently with Democrats promoting the move to vaccinating anyone age 16 and older on June 15 and the Republicans letting that date pass unremarked. A request for comment on its stance on vaccination was not returned Friday.