Vaccination pace? Depends on county
Santa Clara lags in inoculating residents, while Contra Costa opens eligibility to more people
They are separated by about 30 miles, but Santa Clara and Contra Costa counties have suddenly become worlds apart in their quests to vaccinate residents against COVID-19.
Contra Costa County flipped a switch this week, opening up vaccine eligibility to anyone 50 or older who lives or works in the county. But Santa Clara has been canceling appointments for already-eligible older and highrisk residents and engaging in high-profile battles with both the state and now Kaiser Permanente that appear to be contributing to its woes.
As of Tuesday, Contra Costa County had at least partially vaccinated 36.3% of its population, while Santa Clara had vaccinated only 28.2%. Contra Costa’s total includes 79% of those ages 65-74 and a whopping 96% of residents over 75, while Santa Clara has vaccinated 64% of those 65-74 and just 69% of those over 75.
What’s behind those numbers is where it gets messy.
For months, a vaccine supply crunch has slowed the rollout of COVID-19 vaccines across the country. In recent weeks, Santa Clara County has been highly vocal in its opposition to the state’s plan to turn over its vaccine supply chain to private health insurer Blue Shield. While most big private health care firms, such as Kaiser or Stanford, signed contracts to shift their vaccine pipeline to Blue Shield, most of California’s counties have continued negotiating for more control, which has slowed the transition and heightened tensions with Gov. Gavin Newsom’s administration at a crucial juncture.
The result: Breakdowns in
communication appear to be leading to costly misunderstandings.
When Santa Clara County recently ran low on doses, it without warning canceled thousands of appointments for second shots for residents who were Kaiser patients, sending the health care giant into a frenzy to find more vaccine and rebook enraged residents.
In an interview Tuesday, Marty Fenstersheib, Santa Clara County’s head of testing and vaccine, defended the county’s move. He said state health officials originally told the county to set aside second doses of the Moderna or Pfizer vaccines for returning patients — but then they switched course, telling the county instead to use all its vaccine supply each week for either first or second shots.
“We never got anything in writing to change that,” Fenstersheib said.
So Santa Clara County said it used what it had on hand to focus on low-income, vulnerable residents, which the state failed to include in a special program to set aside vaccines for hard-hit communities.
That caused problems because the county didn’t get enough vaccine to cover all residents returning for their second doses, including Kaiser patients who had booked appointments through county clinics. As county officials looked at vaccine inventory, it appeared as though Kaiser was stockpiling vaccine, Fenstersheib said. So, the county decided to send Kaiser patients to Kaiser to get those vaccinations. Unlike Santa Clara County, Kaiser had signed a contract with Blue Shield and said it received different instructions for what to do with its vaccine supply — specifically that it should set aside supply to cover second doses.
The state’s public health department did not respond to a request Tuesday for comment about how counties should handle their vaccine supply.
Kaiser, however, shot back an extraordinary storm on Twitter saying it was filing a complaint with the U.S. Department of Health and Human Services and accusing Santa Clara County of being “grossly misleading” in its explanation of what happened.
“Santa Clara County has created this issue for itself and thousands of its vaccine patients by not accounting for second doses,” the health care giant said, accusing the county of targeting Kaiser members for cancellation.
“We want to assure everyone we will take care of our members who have been affected by the county’s action,” Kaiser continued.
In a statement Tuesday, Kaiser said it was now having to “direct some of our upcoming first dose vaccine supply away from future first dose appointments. So the actions by Santa Clara County have significant implications and will delay first dose availability for members and non-members unless we receive additional supply to make up the shortfall.”
Fenstersheib said Santa Clara County is now moving back to hanging on to second doses and expects a boost in supply soon. “April seems like the magic month,” he said.
By comparison, Contra Costa County seems to be swimming in vaccine. John Gioia, a Contra Costa County supervisor, said the county’s vaccine supply has been boosted by the federal government because the county has a number of what are known as federally qualified health centers receiving vaccine through a national program.
“That puts us in a better position because those doses are on top of what we get from the state,” Gioia said.
Contra Costa County, he added, has “tried to balance” getting first doses into arms while holding back enough supply to administer second doses “so we don’t have to cancel appointments.”
At a meeting of the county’s board of supervisors Tuesday, Santa Clara County Executive Jeff Smith said his county has pushed to get more vaccine through the same federal program but faced “a lot of competition.” Still, he said, the county did not anticipate in the future needing to transfer more patients to Kaiser.
Smith, who used to work in Contra Costa County, also took a jab at his former employer, suggesting its move to vaccinate all of its residents 50 and up, regardless of their health, “contradicts the state regulations.”
Santa Clara County distinguished itself from Contra Costa on Tuesday when it moved into the state’s less restrictive orange reopening tier, joining San Mateo, San Francisco and Marin, while Contra Costa and Alameda stayed in the red tier. And while Santa Clara County insists its been focused on making sure its most vulnerable residents get vaccines, Gioia said his county too has been wildly successful in vaccinating almost all of its at-risk elderly.
“Every county is different,” Gioia said.