San Francisco Chronicle - (Sunday)
Haney seeks more vaccine in poor areas
Tenderloin, Treasure Island are left behind, S.F. supervisor says
California has given San Francisco steadily more COVID19 vaccine doses since California started an equity program this month directing 40% of the state’s supply to the lowestincome ZIP codes. But the city’s two qualifying neighborhoods have yet to receive any benefit from the influx of lifesaving shots, says the supervisor who represents them.
California allocated 62% more vaccine doses to San Francisco’s hospitals and its public health department by the third week of March compared with the first week — 42,640 doses compared with 26,260 — according to a Chronicle review of records. Within that, the public health department received 5% more doses by the third week: 16,260, up from 15,450.
But Supervisor Matt Haney says the lowincome Tenderloin neighborhood and Treasure Island, which include the 94130 and 94102 ZIP codes on the state’s priority
list, have seen no uptick in vaccine availability so far.
“At the end of the day, there are two neighborhoods still being left behind, despite the fact that they’ve been prioritized by the state,” Haney told The Chronicle.
“The fact that there isn’t a dropin site in the Tenderloin in light of the extra doses being provided for this neighborhood is entirely unacceptable,” he said. “And Treasure Island does not have access to clinics currently, despite the fact that these extra doses have been allocated for three weeks. So where were the doses for these ZIP codes for the last three weeks?”
The answer to that question sheds light on the flexible nature of the state’s equity program, developed by Gov. Gavin Newsom’s administration to get vaccinations to the people who need them most. The targeted ZIP codes on the equity list are essentially recommendations, according to the state.
“Counties receive vaccine doses, and they decide where to allocate them within their county. To the extent a ZIP code (on the equity list) is not getting doses — those decisions are being made at the county,” said Darrel Ng, Newsom’s spokesperson on vaccine issues.
The San Francisco Department of Public Health publicly tracks the doses it administers in each neighborhood and says on its website that it prioritizes older people, those at risk of severe disease and health care workers. The state’s equity program is not mentioned.
California hands out vaccine supply each week to the health department and, also in San Francisco, to UCSF, Kaiser and Dignity Health. Nearly half of last week’s doses went to Kaiser’s mass vaccination site, and 38% — the 16,260 shots — went to the health department. Kaiser said it is “reaching out to residents in the identified ZIP codes” but provided no details.
The health department says it uses its allocation to serve the city’s “most vulnerable communities.” In all, the department has administered 57,065 doses in 38 neighborhoods since it began vaccinating people.
BayviewHunters Point has received the largest portion: 13.53%. Next are the Mission (10.47%), the Excelsior (8.94%) and the Sunset/ Parkside (6.13%).
Fifth is the Tenderloin, which has one of its three ZIP codes, 94102, on the state’s equity list. The neighborhood has received 5.91% of the health department’s doses, but it’s not clear if they have been concentrated in the lowerincome 94102 area.
Treasure Island — all of which is within the 94130 ZIP code on the equity list — has received 0.27% of the city’s doses. It’s third from last, just above two of the wealthiest San Francisco neighborhoods, the Presidio (0.12%), and Sea Cliff (0.07%)
On Thursday, the city announced that eligible residents from eight ZIP codes can drop in for shots without appointments at Southeast Health Center and San Francisco General Hospital. Both the Treasure Island and Tenderloin ZIP codes from the state’s equity list were included in the Thursday announcement.
Haney, however, said the hospital is “very far from Treasure Island and the Tenderloin,” and that “language and (lack of ) technology” might prevent residents of those neighborhoods even from learning about the availability. “We have to keep barriers as low as possible,” he said.
San Francisco isn’t relying on the state’s equity list, which “did not account for the fact that many of our neighborhoods, like the Mission for example (include) extremely lowincome census tracts,” said a statement from the city’s COVID Command Center.
The exclusion of many lowincome areas is at the heart of strong objections by a number of Bay Area officials to the way California created its equity list. The state relied on its Healthy Places Index, which combines dozens of economic and social measures to score ZIP codes for priority attention. A Chronicle analysis found that just 2% of the people prioritized for vaccines under this approach live in the Bay Area.
San Francisco’s COVID Command Center said that nearly 80% of its doses go to organizations that serve prioritized people, “which take into account income levels, crowding” and groups with little access to health care.
The rest are offered to people over age 65 “with digital and language barriers to appointments,” a group with the highest risk of hospitalization and death from COVID that still has “significant gaps” in access to vaccines, the COVID Command Center’s statement to The Chronicle said.
The Command Center also cited its use of mobile units to take vaccines into underserved areas.
Haney said the mobile units are too small, and that dropin vaccination centers are what’s needed for Treasure Island and the Tenderloin.
“I absolutely believe this is the county’s responsibility,” he said. “They are getting additional doses for the explicit purpose of equity distribution — but I’ve no evidence of expanded access.”
The state’s equity list included eight other Bay Area ZIP codes. In Solano County: 95625, 94535, 94512, and 94590.
In Alameda County: 94601, 94621 and 94603. And in Contra Costa County: 94801, which includes Richmond.
The Contra Costa County health department has been prioritizing appointments for Richmond residents, vaccinating about 35% of the nearly 30,000 people in the 94801 ZIP code, said spokesperson Scott Alonso.
Bela Matyas, Solano County’s health officer, said his county has targeted lowincome Vallejo, which includes 94590, but not the other ZIP codes in the county that are on the state’s list.
One of those ZIP codes covers Travis Air Force Base — “which is responsible for vaccinating their own,” Matyas said, and the others are very sparsely populated.
“There is a genuine disconnect between what the state says they’re doing and what’s real,” he said. “We are aware of our poorest communities and have been very aggressively targeting not just that ZIP code but all those we believe are impacted by health equity issues.”