California prioritizes those over 50

The decision reflects recognition elders are more at risk if they get the virus

California is changing its COVID-19 defense strategy to offer the vaccine earlier to a broader segment of the elder population, protecting the most medically vulnerable populations.

Elaborating on guidelines outlined by Gov. Gavin Newsom earlier this week, on Tuesday during California’s community vaccine advisory committee meeting, Dr. Robert Schechter unveiled criteria that elevate people in two groups: ages 50 and 64, and 65 to 74 years old.

The timing of this next step has not yet been announced and the state’s coronavirus vaccination program for first priority workers and residents is lagging so far.

“Very soon, as the supply increases over the next weeks, be expecting a formal announcement of when (the next phase) is in effect,” said Schechter, chief of the Immunizations Branch of the California Department of Public Health and cochair of the state’s drafting guidelines workgroup.

Of the 2 million doses of COVID-19 vaccine that have been administered to health departments in California, about 490,000 doses have been administered. The state is enlisting dentists, pharmacy technicians and other health care providers to expand its delivery of shots. Another 1 million doses should be arriving in the state soon.

“There has been a slower ramp up than hoped,” the state’s acting Public Health Officer, Dr. Erica Pan, told the vaccine advisory committee. “We continue to get better with every step.”

California counties are still vaccinating health care workers at highest risk — those in direct contact with COVID-19 patients or the virus’s infectious particles. And the vaccination program to inoculate residents and staff of nursing homes and assisted living facilities — also in the highest priority group — is just getting started.

Alameda County estimates that it can complete this group, called identified as phase 1a, by the end of January, but the timing is dependent on vaccine supply and participation rates. San Mateo County expects phase 1a to continue through the end of February. Other counties did not offer their timelines by deadline.

As the state struggles with a nightmarish surge of new cases and deaths, the group assigned with setting guidelines has updated and refined the list of who is next in line.

People at least 75 years old are still grouped at the top of phase 1b —just below phase 1a — so they’ll get a vaccine before it’s available to the general public. This group, categorized as tier 1, also includes workers in education and child care, emergency services and food and agriculture.

What’s changed is access for people ages 50 to 74. Seniors ages 65 to 74 years old have been elevated to the next in line, phase 1b, tier 2, along with workers in transportation/logistics; industrial, residential and commercial sheltering facilities; critical manufacturing; incarcerated and homeless people.

Next come people ages 50 to 64. This group, classified as 1c, also includes people ages 16 to 49 with an underlying medical condition or disability. Workers in defense, energy, IT, water and wastewater, chemical and hazardous materials, communications, financial services, government operations are also in this priority group.

The move reflects many emotional appeals made by residents who wrote to the state committee. Since Oct. 1, 65% of those hospitalized and 80% of those who died of the coronavirus were 61 or older.

“Hospitalization and ICU use are driven by the older population as is the death rate. Prioritizing the elderly would decrease the burden on statewide hospital systems, particularly in critical care areas, and sharply decrease the death rate. This in turn would improve normalization of business, large and small,” San Carlos vascular surgeon Dr. Walter Kwass wrote.

“I worry everyday about my husband,” who is age 65 with heart disease, said Deborah Biederwolf of Emeryville, a nurse at Alta Bates Summit Medical Center. “I’m writing you with concerns about the priority on who receives the vaccine.

Tuesday, the state also outlined what high- risk conditions will give Californians a boost in line. They are: cancer, chronic kidney disease, chronic obstructive pulmonary disease, heart conditions, organ transplant, obesity, pregnancy, sickle cell disease, smoking and type 2 diabetes mellitus.