Doses for lowincome areas
Vaccinations: State wants highpoverty ZIP codes to receive 40% of supply
California will shift to a coronavirus vaccine system in coming weeks that allocates 40% of vaccine supply to its lowestincome residents, a move state officials said would begin to address a growing disparity in who gets shots.
The changes, announced late Wednesday and expected to take effect next week, could double the amount of vaccines going to lowestincome communities, the state said.
It will not affect who is currently eligible to get vaccinated — health care workers, people 65 and older, education and child care workers,
food and agriculture workers, and emergency services workers.
Rather, once the new system begins, eligible people in the state’s 447 lowestincome ZIP codes will get 40% of vaccine supply and appointments reserved for them. About 8 million residents who live in those 447 ZIP codes are eligible for the vaccines. Officials said other ZIP codes probably won’t get fewer doses than they do now, but may get a smaller portion of increased supplies going forward.
The changes seek to smooth out what has been an uneven distribution of vaccines that has benefited wealthier residents more. About 17% of total vaccines administered so far have gone to people in the lowestincome areas, compared with 34% that have gone to people in the highestincome areas, California Health and Human Services Secretary Mark Ghaly said Thursday.
State officials released the list of ZIP codes Thursday showing that many of the locations are in the Los Angeles region and the Central Valley. In the Bay Area, there are 10 ZIP codes that include parts of San Francisco, North Richmond, Vallejo, Fairfield and Oakland.
The areas are not defined formally by race and ethnicity but take into account income, education level, housing and health care access, which collectively align closely with race and ethnicity. As a result, communities that are primarily Latino, Black, and Asian and Pacific Islander are expected to receive additional vaccines.
It is not yet clear how the new state strategy will affect allocations to Bay Area health departments. Health officials for San Francisco and Marin counties said they are waiting to hear more information from the state on that question.
The state will provide singleuse codes to counties, health care providers and community organizations that work directly with the lowestincome residents, such as faithbased groups. Those organizations, in turn, will share the codes with individuals. The codes can be used to book vaccine appointments on MyTurn, the state online vaccine appointment system. This is similar to how the state has issued appointment codes to teachers.
At the end of March, the state may text the codes directly to individuals who have registered on MyTurn. But until then, the codes will be distributed through the counties and community groups.
Counties and large health care providers that operate in multiple counties will have to demonstrate that at least 40% of their doses are administered to the lowestincome residents.
The new system may result in some areas — those that are not in the lowestincome areas — getting a smaller increase in vaccine supply.
“Targeting a scarce resource to certain ZIP codes ... is going to mean some communities don’t get as much of an increase as others,” Ghaly said.
“But we expect all communities will be able to get at least as much (vaccine) as they’re getting now, and some will be getting more.”
State data shows the virus correlates closely with income — case rates are twice as high among households earning $40,000 to $60,000 compared with households earning $120,000 or more — so vaccinating the lowestincome, hardesthit residents is key to curbing overall transmission and easing pressure on hospitals.
About 40% of COVID cases and deaths have been concentrated in communities that make up less than 25% of the population, Ghaly said. Those communities are in the lowestincome areas that the state is now targeting to accelerate vaccinations.
“Getting vaccines distributed to eligible residents in these areas is critical,” he said.
Dr. Alicia Fernandez of UCSF, who works with community groups with ties to Black and Latino residents to address vaccine questions, said she applauds the state’s shift to focus vaccine allocation on ZIP codes.
“I think that’s a very good idea,” she said. “I think that a focus on place, in addition to age and other considerations, will help us reach some of the
most vulnerable.”
She added that the policy change is “a good first step” but that additional steps will have to be taken so that once vaccines reach the poorest ZIP codes, residents don’t face other barriers to accessing them.
State officials also announced changes that will tie counties’ ability to reopen further to the state’s ability to get the lowestincome residents vaccinated.
About 1.6 million vaccine doses have been administered to residents in the lowestincome communities. Once that number hits 2 million statewide, the requirement for counties to move from the purple tier to red tier will be loosened — the case rate can be up to 10 cases per 100,000 people, instead of 4 to 7 cases per 100,000 people. Ghaly said he expects that to happen in one to two weeks.
And once 4 million doses have been administered to the lowestincome residents, counties can move from the red tier to the orange tier by reporting 2 to 5.9 cases per 100,000 people, instead of 1 to 3.9 cases per 100,000 people.