California expands vaccine access to 16 and older. When could Sacramento supply meet demand?
Four months to the day after the first arriving batches of COVID-19 vaccines were administered in California, the state of 40 million people has opened eligibility for the jab to all ages 16 and older.
As the gates open, Sacramento County is still playing catch-up with its neighboring counties and the state in its campaign to mass vaccinate against the coronavirus and beat down the pandemic.
Thursday marked Gov. Gavin Newsom and the state health department’s deadline for providers to broadly expand access to the general population of adults and older teens.
The expansion effectively puts an end to months of frequently changing, often-confusing eligibility requirements that involved tiers and subtiers intermingled with age cohorts and essential worker groupings.
How quickly and easily a newly eligible Californian will be able to secure an appointment slot, though, continues to depend on several factors, including location, as demand is still expected to outpace supply in many parts of the state in the short term.
Sacramento, like Yolo and other nearby counties as well as UC Davis Health, has found in the last week or so that some blocks of appointment times would go unclaimed in online registration systems, according to county spokeswoman Janna Haynes.
However, Sacramento County found that posting about these openings to the neighborhood-based social networking site Nextdoor generates a rush of appointments, filling the clinics, Haynes said.
Haynes also said that when county partner Curative on Monday opened 16-and-older appointment slots for Thursday and Friday at the McClellan Park vaccination site, they were snatched up quickly.
Roughly 1.2 million of Sacramento County’s 1.5 million residents are 16 or older, according to U.S. Census data and county estimates.
But the local health office this week did not have a solid estimate of how many more Sacramento County residents would become newly eligible Thursday, Haynes said, because many people in their 20s, 30s and 40s already are getting vaccinations under different eligibility criteria, such as medical conditions or their occupation — or from acquiring leftover doses from clinics at the end of the day.
That said, the county does not expect to be able to keep up with initial demand, unless the Johnson & Johnson single-dose vaccine, which was paused Tuesday at the recommendation of federal health agencies due to a handful of reports of clotting, comes back online swiftly and the county’s weekly allotments also ratchet back up.
“The assumption is the next several weeks we will still not be able to meet the anticipated demand, but we are always hopeful that we will get higher allocations week to week,” Haynes said.
Allocation figures are still coming just one week in advance, with states’ totals shared by the Centers for Disease Control and Prevention on Tuesdays and then handed down from the state to counties and hospital systems later in the week.
California is slated to receive just over 2 million total first and second doses of Pfizer and Moderna next week, according to the CDC, compared to about 1.9 million this week. J&J allocation numbers weren’t released Tuesday due to the recommended pause.
Already, about half of Californians ages 16 and up have received at least one dose of a vaccine, state health data show. Some Northern California counties and hospital networks were able to move to 16-and-older ahead of schedule, in the past week or so.
Sacramento’s vaccination rate lower than neighbors
By the numbers, vaccine rollout in Sacramento County has consistently trailed California’s statewide rate as well as those of neighboring El Dorado, Placer and Yolo counties.
A reported, one-third of Sacramento County residents had received at least one vaccine dose as of a Wednesday update from the California Department of Public Health, with 21.6% fully vaccinated — trailing California’s overall rates of 39.1% and 23.3%, respectively.
In Yolo County, 40.6% are at least partially vaccinated and 25.6% are fully protected.
On multiple occasions earlier this year, local government and health officials have called the state’s direct allocation to the Sacramento County health office inadequate.
Local officials pointed out that despite the county making up about 4% of California’s population, the health office’s allocations for three consecutive weeks from late February through mid-March each represented less than 2% of the state’s total shipments, and were actually shrinking compared to earlier in 2021.
CDPH in early March began doubling allocations into socioeconomically disadvantaged neighborhoods, boosting allocations to ZIP codes in the lowest quartile of California’s “Healthy Places Index.” Sacramento County has 22 such ZIP codes; El Dorado and Placer counties each have none.
There have been other local hurdles, too, such as when Sacramento-based Sutter Health had to postpone and reschedule about 21,000 appointments in early March due to a dearth of state-allocated supply.
Sacramento County has administered a little more than 835,000 total doses through Tuesday, according to CDPH. That’s about 53 doses for every 100 residents, 10% below California’s overall rate of 59 per 100. Yolo residents have received over 144,000 doses, or 64 per 100; Placer County has had 250,000 doses, or 63 per 100; and El Dorado has administered about 109,000, or 57 per 100.
The 10% gap between Sacramento County and the statewide per-capita rate is significant, but it has decreased from a deficit of close to 17% in late February, daily updates to state health data show.
Placer County on its local COVID-19 data dashboard shows vaccination rates broken down by age groups. In the county of 400,000 people, 77% of residents 65 and older are at least partially vaccinated, dropping to 47% for ages 50 to 64, 38% for 35 to 49 and 18% for 18 to 34.
A ‘gluttony’ of vaccine doses?
In a mid-March interview with The Bee, Yolo County health officer Dr. Aimee Sisson predicted that ramping up of supply would lead to “a fairly sudden shift from what we’ve had since December, of scarcity, to gluttony” in the near future.
“All of a sudden we’re going to have a very different problem, which is, ‘Are we going to have enough providers?’” Sisson said.
When exactly the shift to “gluttony” may happen could vary by region in California, and will likely depend on several factors aside from supply allocation increases.
One critical demand variable will be communities’ uptake rates.
In a March 2021 Public Policy Institute of California poll, 21% of those surveyed said they are unlikely to or definitely would not get the vaccine. Hesitancy figures vary among different demographic groups. Among Black Californians in the PPIC survey, 29% said they did not want to get the vaccine, compared to 5% of Asian Americans.
Political partisanship is also a factor: 39% of Republicans in the recent survey said they would definitely or probably not get the vaccine, compared to 19% for independents and 10% for Democrats.
Another important inflection point will be the timing of vaccines being authorized for use in children under age 16. Pfizer, the only vaccine authorized for emergency use in juveniles ages 16 and 17 in the U.S., applied last Friday for emergency use authorization for ages 12 through 15.
California expanded access to include the 50-to-64 general population on April 1.
Yolo County opened to 16-plus this Tuesday, two days early. Sisson said the county hadn’t expected to expand access early but was driven by waning demand, with some appointments for the 50-and-older age group going unfilled last week.
“These safe and effective vaccines are too precious to leave sitting in freezers,” Sisson said in a prepared statement Tuesday.
Placer County on Sunday opened appointments at its county-run clinic at The Grounds in Roseville to the 16-plus crowd.
‘Go go go go’
Prior to the pause, J&J allocations to California had been minimal due to a supply issue involving a U.S. manufacturing plant. As a result, the state’s federal allocation of J&J vaccine plummeted, from about 570,000 doses last week to 67,000 this week — just 4% of federal supply for the week, Newsom pointed out on Twitter, leaving the vast majority of supply flow up to Pfizer and Moderna.
Sacramento County, in turn, saw its weekly allocation from the state drop from 30,000 total doses of all three available vaccines back down to about 20,000. J&J shots fell to 1,700 doses this week, down from 12,000 last week.
Because of its low proportion, the J&J pause represents a far smaller logistical headache than a pause on Pfizer or Moderna would have caused.
But it also provided a clear illustration of just how rapidly things can change in the vaccine campaign.
Early Tuesday morning, the Food and Drug Administration recommended a pause in the use of J&J. Within a couple of hours, a south Sacramento clinic that had planned to give 4,000 J&J doses at Luther Burbank High School swapped those for first doses of Pfizer’s two-dose vaccine.
More than an hour before the 9 a.m. start to the clinic, the county and clinic administrator Equivax announced that the change would limit supply to those who made appointments in advance, and that the clinic could no longer accept walk-ins.
“We made a 5 a.m. pivot to get that done, and we got it done,” said Dr. Rusty Oshita, an emergency physician helping run the Burbank High site
Then at 11:30 a.m., Sacramento City Unified School District announced on social media that the Burbank High clinic would indeed open up for walk-ins because there were still extra shots available.
Shortly before noon, Mayor Pro Tem Angelique Ashby tweeted: “Luther Burbank has extra vax shots available for walk in until 2pm today.
“Go go go go.”
This story was originally published April 15, 2021 at 5:00 AM with the headline "California expands vaccine access to 16 and older. When could Sacramento supply meet demand?."
