Anyone hoping to be vaccinated at one of the COVID-19 mass-vaccination centers in Santa Clara or San Mateo counties is likely to be turned away if they have a primary care physician, Santa Clara County staff said on Tuesday.
The clarification comes at a time when people are inundating health care providers with requests for vaccination appointments and all providers, including the two counties, are facing highly limited supplies. The counties aren't set up to take on the patients of large health care providers such as Kaiser Permanente, Sutter/Palo Alto Medical Foundation or Stanford Health Care, Santa Clara County staff told the Health and Hospital Committee on Jan. 19. Clients of other health care facilities will need to get their vaccinations through their providers, Santa Clara County Executive Jeff Smith said during Santa Clara County's Health and Hospital Committee meeting on Tuesday afternoon.
Committee Chair Supervisor Joe Simitian noted that the decision would be distressing to some county residents, who would likely feel entitled to the vaccines since they are county taxpayers. But with four health care providers serving more than three-quarters of patients, the county would be quickly overwhelmed and would be unable to serve its core clients, many of whom are low and very low income.
The county receives its allocation of vaccines once a week, Health Officer Dr. Sara Cody said. On Jan. 19, it received a total of 29,350 vaccines from the state, which includes doses for people having their first shot and for those who are now ready to receive their second injection. The federal government hasn't communicated in advance to allow counties and health providers to prepare, she said.
"As far as being able to plan ahead, it's impossible," she said.
County health leaders said they also have limited information from the other health care providers, since different entities receive their allotments separately from the state. Others, such as CVS and Walgreens pharmacies and the Veterans Administration, get their allocations from the federal government.
The Santa Clara County Health System has administered 42,306 first doses and 7,517 second doses out of 77,775 total doses as of Jan. 19. The county currently has 27,747 appointments scheduled within the next seven days, according to the county's COVID-19 vaccine dashboard.
Kaiser Permanente in Santa Clara County has received 12,650 first doses and administered 12,333 doses. It received 6,975 second doses and administered 3,206 second doses as of Jan. 19. It currently has 5,400 patient appointments scheduled.
Stanford Health Care has received 25,700 first doses, administered 20,704 and received 8,775 second doses, having administered 9,864. Stanford has only 200 patients registered for vaccinations in the next seven days. The larger numbers of administered doses above allocations may be due to the county providing a few thousand doses from its stockpile to cover health care workers at facilities that received a small allocation compared to their size, county officials said.
Palo Alto Medical Foundation, however, has failed to report any of the data, Cody said. Those numbers are required under a county health order, which requires medical facilities except for those under federal jurisdiction to submit their data on allocations, vaccinations and appointments. If facilities don't follow up on a timely basis, they could be subject to fines and penalties, county staff said.
Health officials have had informal conversations with Palo Alto Medical Foundation and recently approached them more formally.
"We've told PAMF they need to produce the data now," Cody said, emphatically.
(Update: PAMF has now reported the data to the county. As of Jan. 21 the medical center reported it has been allocated 14,800 first-vaccine doses and administered 7,365 doses. It has received 9,500 second doses and hasnot administered any at this time. PAMF also scheduled 7,154 appointments in the next seven days.
Simitian said the large health care providers are going to be the drivers of vaccinating the population.
"The Big Four serve 85% of the population," he said. Kaiser is responsible for about 30% of patients in the county; Sutter/Palo Alto Medical handles 21%; 17% are cared for by Stanford and its affiliates; and 15% are clients of the county, he said.
"If the county's position is that it can't accept the responsibility to give Kaiser and Sutter patients vaccines, we need to work with them to get vaccines to their patients. It's incumbent to push on them," Simitian said.
There has been much confusion over who is eligible for the vaccines, he noted. California health officials have opened up vaccine eligibility to anyone age 65 and older. Santa Clara County has approved vaccinations only for those who are 75 and older in the state's Phase 1B and health care workers who are covered under the state's Phase 1A protocols. San Mateo County said it would vaccinate people who are 65 and older earlier this week, but has since said it currently does not have enough vaccine doses to do so.
Few health care providers are going that far, however. Kaiser, which previously announced it was making the vaccines available to a limited number of people 65 years and older, has now scaled back to those who are age 75 and older, Smith said.
County leaders said they will soon be opening a mass-vaccination center at the Mountain View Community Center, which will soon be taking appointments, but once again, it isn't open to patients with primary care physicians. Patients of county medical centers should receive their vaccines through their providers.
Santa Clara County isn't the only county facing vaccine shortages, Cody said.
"Every (health officer) in the state is hampered by the short supply. In general, the big challenge across the state is supply. There's not enough supply from the (federal government) to the state and not enough from the state to the counties," she said.
California Health and Human Services Secretary Dr. Mark Ghaly said in a separate press conference on Tuesday that the state is pushing to vaccinate another 1 million people by this weekend. The state would likely announce its updated guidance in the next 24 hours based on federal guidelines, he said. He is also hopeful that more vaccines will be forthcoming after the incoming Biden administration takes over on Jan. 20.
Find comprehensive coverage on the Midpeninsula's response to the new coronavirus by Palo Alto Online, the Mountain View Voice and the Almanac here.