Californians age 65 and older can start getting vaccinated right away after the state on Wednesday agreed to a major expansion to its coronavirus immunization efforts, partly in hopes of quelling a raging surge that continues to squeeze hospitals.
The announcement came on the heels of federal guidance Tuesday that states make vaccine doses available to a wide swath of older adults, who are most at risk of becoming seriously ill, needing hospitalization and intensive care, and dying.
But while some Bay Area counties began immunizing the new group immediately, other counties and health care providers said they will not be able to implement the new guidance until they receive more vaccine doses.
Gov. Gavin Newsom also has come under political pressure to speed up the state’s lagging vaccination efforts, which have been mired in part by complicated rules about who will be eligible to get the next doses, and when. Opening up vaccines to a large population of people who are easily identified at least simplifies things, public health experts said.
The need to get more people vaccinated is urgent: Though hospital and intensive care numbers have stabilized somewhat in California over the past week, many counties are still carrying an enormous patient load, and deaths from COVID-19 are climbing. More than 450 Californians are dying every day from COVID-19.
Immunizing older adults won’t have an immediate impact on the surge, but it could help alleviate some of that pressure within a few weeks, public health officials said.
“The vast majority of patients that are being hospitalized are older persons, and also the ICU admissions and the deaths are happening with older persons,” said Dr. Tomás Aragón, the state health officer and director of the California Department of Public Health, during a vaccine advisory committee meeting that was called last-minute Tuesday evening. “The way that we’re going to impact the surge is by prioritizing the older age groups.”
Dropping the age to 65-plus, down from the 75-plus it had been previously, adds 3 million Californians to the 8.5 million already eligible to be vaccinated in the next group, known as tier one of Phase 1b. This group continues to include essential workers such as teachers and grocery store workers.
“This was the right thing to do,” said Dr. Robert Wachter, chair of the UCSF Department of Medicine. The state’s earlier plans to offer the next round of vaccines to more narrowly defined groups based on risk of exposure and serious illness was understandable but overly complicated, he said.
“We tried to be very elegant and targeted in our choice of prioritized groups. And in doing so we created something that’s just too complicated to work in a situation like this,” he said. “It was well meaning. But at the end of the day, the most important question is how do we get vaccine into arms as quickly as possible, and with particular focus on those at greatest risk of getting sick and dying.”
Now, Wachter added, the state faces a new dilemma: “a very, very large group of eligible people who are going to be clamoring for their vaccines.”
California has fallen behind almost every other state in its pace of vaccinations, ranking 44th out of 50 states and the District of Columbia as of Wednesday, according to the U.S. Centers for Disease Control and Prevention. California has administered 2,256 doses of vaccine per 100,000 people, while states leading the effort have vaccinated more than twice that.
It is unclear how the newly expanded eligibility will play out across the state, where there is great variation in how much progress individual hospitals and nursing homes are making with vaccinations.
San Francisco on Wednesday began vaccinating people 65 and older who are in the county health system that serves people who are uninsured, on Medicaid or on the city health care plan.
Not every county in California is ready to start offering vaccines to the expanded group, as many are still working their way through the first phase of health care providers and staff and residents of long-term care facilities. But some counties say they are close to finishing up the first phase and are eager to offer vaccines to more residents.
The state said it will launch next week an online and phone system where residents can check if they are eligible for vaccines and, if they are not yet eligible, register for an email or text notification when they are. The system will help counties and cities run mass vaccination events, the state health department said.
Santa Clara County health officials said Wednesday that they would begin immunizing people age 75 and older immediately, but would have to delay offering doses to those age 65 to 74 until they get more vaccine supply from the state.
Dr. Jeff Smith, the Santa Clara County executive, told the Board of Supervisors on Tuesday that the county had asked the state for 100,000 more doses and was told they would only receive 6,000. “That’s not going to be enough,” Smith said. “Our real limiting step at this point is access to the vaccine.”
San Mateo County is still focusing on vaccinating health care workers and residents and staff at long-term care facilities. Most county residents will get vaccinated by their primary care provider, officials said.
“When will I get my vaccine? That’s a situation that’s evolving minute by minute, day by day,” Dr. Anand Chabra, San Mateo County Health section chief of mass vaccination, said Wednesday during a vaccine update. “We expect that vaccines will primarily be (received) from your primary care provider, particularly if you belong to a large health system like Kaiser, Sutter or someone connected with a hospital system.”
Other Bay Area counties, including San Francisco and Contra Costa, similarly say they will rely on the large providers like Kaiser and Sutter to vaccinate most of their residents, and that county clinics or hospitals will vaccinate the remaining population who are uninsured.
“Until there is official guidance from (the state) and we have capacity to expand vaccination to this significantly larger population, Sutter Health will continue to prioritize community 1a and those 75+ due to their significantly higher risk,” said Sutter spokeswoman Monique Binkley Smith. The health system plans to start vaccinating patients 75 and older this week.
Kaiser did not immediately respond to questions Wednesday about how the new state guidelines will impact their plans to notify and vaccinate their patients who are 65 or older. Kaiser has said it will notify its members by email, conversations with physicians and other modes of communication.
While waiting for public health authorities and large providers to push more vaccines to vulnerable populations, some doctors have started making aggressive efforts to push out doses.
Dr. Rebecca Parish, who runs a private practice called Comprehensive Wellness in Walnut Creek, became so frustrated with the slow rollout of vaccines that she decided to work with local nonprofits to set up a drive-through vaccination site this weekend.
She said patients have called her in frustration about the lack of information and the difficulty getting access to vaccine. One 83-year-old woman was in tears, unable to navigate Rite-Aid’s online registration and unable to reach anyone at the store, she said.
Parish said local politicians are “disengaged” and don’t understand how lack of vaccine availability is affecting people. “They’re not feeling the urgency we’re feeling in health care,” she said, adding that with 3,000 people dying a day, in the United States, sitting on vaccines was “unconscionable.”
She said more than 100 volunteers will be on hand to help seniors with appointments to get vaccinated Saturday and Sunday. Nonprofits Lamorinda Village and Lamorinda Spirit Van are pre-registering people 75 and older for the Pfizer shots. She expects the event to administer the 500 doses she says she’s getting from the county health department over two days, at which point, she’ll ask for more doses.
San Francisco Chronicle staff writer Emily Fancher contributed to this report.