San Francisco Chronicle - (Sunday)
Vaccine supply vexation
Kaiser says it hasn’t been allocated enough doses for members
Kaiser Permanente, which serves the largest share of the state’s health insurance market and runs a vast hospital system, has received a disproportionately small share of vaccines from the state, according to the company and elected officials.
That leaves some of its older members out of luck while seniors with other providers stand a better chance of getting a shot, a dynamic highlighting inconsistencies in the state’s distribution of limited resources.
Across California, Kaiser is still prioritizing vaccines only for members over 75, even as other health care providers and the state’s mass vaccination sites are now open to Californians over 65. In Northern California, the state has given Kaiser 269,500 vaccines — too few to cover its members over the age of 75, let alone its health care workers. When the state changed to ageprioritized guidelines a month ago, supply didn’t keep up, the company said.
“The supply we received did not increase aligned with our coverage of 25% of the state’s population,” a Kaiser spokesperson said. “We have been working with the state to address this, and over the last couple weeks the allotment we have received has increased. We expect the allocation to continue to increase.”
The issue has been stark in Santa Clara County, where Kaiser received less than 10% of vaccines despite serving about 30% of the population, Dr. Rakesh Chaudhary from Kaiser said during a town hall this week.
Santa Clara County Supervisor Joe Simitian said that at one point, Kaiser didn’t have enough vaccines to inoculate its health care workers as eligibility opened to the public and got at least 4,000 doses from the county to fill the gap. Last week, Kaiser had to cancel more than 5,000 vaccine appointments because it didn’t get a promised shipment of doses. The county public health department said inequitable supply was the reason it changed its guidelines two days later to a “no wrong door” policy that offers vaccines to anyone eligible regardless of their health care provider — meaning that Kaiser patients 65 and up can get vaccinated elsewhere.
Darrel Ng, a spokesman for the California Department of Public Health COVID19 Vaccine Task
Force, said he could not comment on allocations to any specific provider and did not answer why Kaiser had received a disproportionately small supply.
Last week, the state reallocated an additional 150,000 doses to Kaiser, with 50% going to its members and 50% going to disproportionately affected populations, Ng said. Kaiser said thanks to that reallocation, it was able to provide vaccines to anyone over 65 at Moscone Center.
“The No. 1 factor in the lack of vaccines for any state, county, health system or provider is the extremely constrained vaccine supply overall,” Ng said.
California has so far administered 5 million doses — a fraction of the roughly 17 million needed to give to all health care workers and Californians over the age of 65. For the first four to six weeks of the vaccine rollout, allocation was based on populations of health care workers, then readjusted for those over 65 a month ago, Ng said.
The state has been giving 80% of its vaccine supply to counties and 20% to multicounty entities, including Kaiser, Santa Clara County officials said Thursday. Sutter Health and UCSF Health, which also get doses directly from the state, opened up vaccinations to people over age 65, even though they don’t yet have enough vaccines for everyone eligible to receive one. Kaiser has not yet done so for that age group, but expects to receive a larger share next week.
“The state distribution system, it just somehow missed the mark,”
Chaudhary said last week. “I know we have a lot of members that are worried and frustrated. I share that frustration.”
Santa Clara County health officials said Palo Alto Medical Foundation, run by Sutter Health, experienced similar, scant vaccine allocations from the state, though that system is offering vaccines to those over 65.
Sutter declined to provide upon request specific data on its allocations compared to the proportion of patients and health care workers. To date, the health system has administered more than 200,000 doses. “The type and amount of vaccine allocation we receive from the state changes each week, requiring careful and highly complex coordination to make sure the appropriate type and number of doses get to the right place at the right time while working to meet incredible demand,” said Sutter spokewoman Monique Binkley Smith.
UCSF, which also gets supply directly from the state, has received 59,750 doses — nowhere near enough to vaccinate its eligible patient population, spokeswoman Kristen Bole said. So far the health system has vaccinated around 13% of its patient population over 65 and 85% of its health care workers. The city supplemented the health system’s vaccine supply at the City College site when UCSF was running out, she said.
For some older adults, getting a vaccine in the Bay Area has felt like taking part in a game of chance.
Stella Walker, 90, who was diagnosed with lung cancer last year, kept calling Kaiser and receiving the same message — there weren’t enough vaccines. A friend told her she could book an appointment at a countyrun site in Rohnert Park. She got one — but she’ll have to wait until March 3.
“I didn’t know whether Kaiser was going to come around,” said Walker, who otherwise praised the health system providing her cancer treatment. “I’m really shocked they had no room and no appointments available.”
Berkeley residents and Kaiser members John Culver, 70, and his wife, Janine Bajus, 68, agreed to wait given the limited vaccine supplies, but watched as some of their younger friends started receiving shots through Stanford Health Care.
“Suddenly this is just a big freeforall. That was the point I began to feel very frustrated,” Culver said. “At a certain point, we just became fatalistic.”
They finally got their first doses through Berkeley’s city health department Thursday. Culver questioned why a small city managed to get vaccines for his age group while Kaiser couldn’t, fueling his concerns about inequity for others.
“It seems very disorganized and chaotic. and it depends on what health system you’re in, it kind of depends a little bit on who you know, it depends quite a bit on where you are,” he said. In Mountain House in San Joaquin County, just across the county line from Alameda County, Kaiser member Misty Van Atta has tried through the state, county, Safeway and CVS to try to get shots for her parents, ages 70 and 73, to no avail. Her father is partially paralyzed and uses a wheelchair after a stroke.
Van Atta lives with her parents and her 8yearold son, heightening their anxiety about the virus. Her son is now receiving counseling because of pandemic fear, she said.
“He’s terrified that if we go out to the grocery store, if we accidentally bring something back, he could kill his whole family,” she said. “Everybody is frustrated.”