In a continued race to vaccinate residents quickly and stay one step ahead of the mutating coronavirus, health officials from Santa Clara and San Mateo counties are urging patience and a renewed effort to follow safety guidelines.
Both counties are struggling to receive adequate COVID-19 vaccine doses from the state to meet the needs of currently eligible groups. On Tuesday, health leaders expressed concern about what will happen when the state opens eligibility to all adults ages 16 and older on April 15. As the counties seek to reach a 70% to 80% population vaccination rate to attain herd immunity, they also face the reality that some people won't choose to be vaccinated — or might give up trying to secure an appointment.
Anticipating frustration from the public, Santa Clara County Supervisor Joe Simitian on Tuesday urged staff to find ways to encourage people who don't find a vaccination appointment right away to "please keep trying."
Health leaders in both counties said the number of doses that have been administered is rising, but new COVID-19 cases in the past two weeks are continuing at the same pace. Health leaders are hopeful that people will keep following protocols for mask wearing and social distancing to prevent another surge in infections.
They are also in a race against time before the virus further mutates and potentially renders the vaccines less effective, county health staff told their respective Boards of Supervisors on Tuesday.
The variants currently in Santa Clara County that are on the Centers for Disease Control and Prevention's "variants of concern" list include the United Kingdom B.1.1.7, which is 50% more transmissible and causes more severe symptoms than the original strain; the South Africa-originated B.1.351, which is 50% more transmissible; the Brazil-based P.1; and two variants originally found in California, B.1.427 and B.1.429, which are about 20% more transmissible, county Health Officer Dr. Sara Cody told the Board of Supervisors on April 6.
"I think it's really the variants that threaten to undo the progress that we've made," she said. "The good news is that so far, the vaccines that we have deployed are performing well against these variants. But we just have to continue to be watchful because, of course, it's the virus's job to evade — whatever it is that we put up. And so the goal here is to vaccinate as many people as quickly as possible, particularly in communities that have been hardest hit, where the virus has amplified most prominently over the pandemic."
An additional 300,000 county residents will be eligible for the vaccine starting April 15, said Dr. Marty Fenstersheib, the county's COVID-19 testing and vaccine officer.
"As all of us know, the vaccine allocations continue to be inadequate. We hope they will improve over the coming weeks. But clearly, our eligibility and our demand far exceed our current supply and in fact we are probably only using about a third of our capacity, given that limited supply," he said, referring to the vaccination sites the county has developed.
Countywide, 40.3% of people ages 16 and older have received at least one dose of the vaccine and 25% have completed their vaccinations, he said. The county's allocation, which includes distributions to community clinics and other county health care entities, received nearly 72,000 vaccine doses this week compared to 58,670 last week. The number excludes retail pharmacies, Kaiser Permanente and Sutter Health/Palo Alto Medical Foundation, according to county health data.
Broken out by provider, during the week of March 31-April 4, the approximate numbers of doses administered were as follows: Kaiser, 37,000; retail pharmacies 29,000; Stanford Health Care, 14,000; Sutter/PAMF, 3,000; County of Santa Clara Health System, 44,000; El Camino Health, 2,000; other county health care entities, 4,000; and community clinics, 3,000, according to a county data chart. The numbers have more than doubled for Kaiser and tripled for Stanford and the retail pharmacies from a month ago.
In San Mateo County, health officials also continue to face a shortage of doses. They were forced to curtail their mass-vaccination events at the San Mateo County Event Center to just one this week, which was "very disappointing," Health Chief Louise Rogers told the Board of Supervisors on Tuesday morning.
The county is making considerable progress on its goals to vaccinate the most vulnerable groups and communities through more targeted events. Dr. Anand Chabra, the COVID-19 mass vaccination section chief, said 48.6% of the county's eligible population have been vaccinated; 39.8% of vaccinated residents live in places that fall in the lowest quartile of the Healthy Places Index. The county has recorded inoculations among more than 65.6% of people of color, 29.1% of white residents and 5.3% of unknown race. The county has also vaccinated 83.8% of residents ages 65 and older and 87.4% of those who are 75 and older, he said.
But "we still do not have sufficient supply to meet the demand," he said.
Of more than 101,000 first and second doses managed by the county, 91.4% have been administered or distributed. The county plans to hold six targeted-community, first-dose vaccination events this week in highly impacted communities and several second-dose events. One first-dose, mass-vaccination event for 4,100 people will take place at the San Mateo County Event Center and 4,400 people will receive second doses, he said.
Last week, all San Mateo County jail inmates were offered vaccines, resulting in 325 adults and 13 juveniles receiving shots. Newly booked inmates are being offered vaccines as they enter the facility, he said.
The county also has vaccinated more than 300 residents and staff at homeless shelters. Last week, 120 unhoused homeless also were vaccinated.
"We've seen enormous progress in reaching out with the vaccine to all the corners of our county, and we still have a ways to go," Rogers said.
The county expects to have offered all adults vaccinations by early summer. Vaccinations for children are not likely to roll out until early 2022, however, Rogers said.
"We're really at a point of transition. This is not over yet. It's not going to be over in the near future, but we are going through transition and a hopeful shift in the coming months as more adults are vaccinated," she said.
Both counties' health officials offered a carrot of sorts: the possibility that if people remain patient and continue to maintain social distance, wear masks and follow other health protocols, the counties could soon move into the state's Blueprint for a Safer Economy's least-restrictive "yellow tier." (The state announced it would eliminate the tiers altogether on June 15 if it maintains a sufficient vaccine supply and hospitalization rates stay low.)
There are a few hopeful signs. To move into the yellow tier, counties must have been in the previous orange tier for three weeks and then meet a set of factors, including a low adjusted case rate and a testing-positivity or "community transmission" rate. The state lowered the threshold for the adjusted case rate on Tuesday after reaching a vaccination goal of 4 million people living in its lowest vaccine equity quartile, which represents the 25% most vulnerable communities. To move into the yellow tier, a county must demonstrate that it has a testing positivity rate and adjusted case rate of less than 2% for two consecutive weeks prior to moving to the less-restrictive tier.
Santa Clara County has a testing positivity rate for this week of about 1%. Its ranking in the state's lowest Healthy Places Index census tracts based on testing positivity rate is just above 2%, Cody said. The county has an adjusted case rate of 2.4%.
San Mateo County has a COVID-19 positivity rate of 0.8% and a rate of 1.4% in the lowest Healthy Places Index census tracts. The adjusted case rate is 2.4%, Rogers said.
Find comprehensive coverage on the Midpeninsula's response to the new coronavirus by Palo Alto Online, the Mountain View Voice and the Almanac here.