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Update on Vaccine Issues and Policies from Supervisor Jeffries’ Office
February 4th, 2021
Thank you for contacting Supervisor Jeffries’ Office regarding your concerns about the COVID vaccination program. The process to date has been incredibly frustrating for everyone, and we sympathize greatly with the difficulties people are enduring. This has been a very fluid situation, with very poor communication coming from the State to the County, and apparently from the federal government to the State, making it hard to say anything with certainty. At the end of January, the Governor and his team announced another series of changes in both the COVID lockdown rules and in the vaccine priorities and processes, and we are still trying to interpret some of them here at the local level, so that we can keep constituents like you informed on what to expect. One thing we can say with confidence is that the biggest ongoing problem we are having is with the shortage of actual vaccines. We have approximately 800,000 people eligible in the current State tiers/phases, and have so far only received about 240,000 vaccines—and a little less than 100,000 of those have gone to County Public Health. Since each person vaccinated requires two doses, that means we can only serve half as many people.
The announcement by the California Department of Public Health suggests that they intend to take over the eligibility, distribution, and tracking of vaccines in the State, and that counties may be relegated to serving mostly those residents that receive health care from the County (Medi-Cal and indigent care), and helping with clinics in the hard to reach and under-served areas of the County. It is possible that the State is moving away from the mass vaccination clinics, and towards people receiving their vaccines through their own health care providers and pharmacies, as vaccines have been given historically. The recent announcement that the Governor has put Blue Shield and Kaiser in charge of the state distribution system seem to confirm that. Unfortunately, the State has still not told the counties exactly what our role will be, so we are awaiting further direction, and focusing on distribution to targeted populations.
That said, we have received many e-mails and calls on various vaccine issues. Here is what we know (or think we know) about the biggest issues of contention, in no particular order:
1) State Vaccine Registration System Complaints: The first week of mass vaccine registrations was a disaster at the State and County level. Our County website was completely overwhelmed, and if you were lucky enough to make it through to the State site to complete the registration, it was crashing and incredibly non-user friendly. We fired our web vendor, and developed a new website internally, and for the last mass vaccine registration, the County website worked nearly perfectly. Unfortunately, the County website really just links to the State website to actually register for a vaccination, and the State website was still terrible, dropping people, crashing, and making them repeatedly fill out the same information only to be told the appointment was already booked. Some people only found out later they were successful, but we did manage to book 10,000 appointments in 30 minutes. The State has announced it is launching a new registration site https://myturn.ca.gov/, which they promise will be more user friendly, and allow people to sign up for appointments as they come available. Unfortunately, that site will not be functional for people to register for appointments state-wide until “mid-February”, per the Governor. The County is also looking at utilizing an internal registration system, but we need to compare it with the State site, and ensure that it will communicate properly with the State site, as they are apparently requiring all systems to integrate with the new State database.
2) When Is the Next Vaccination Opportunity?: We are not sure when the next mass vaccination registration opportunity will be. Because we are “between websites” for registration, and waiting for further guidance from the State, Public Health has put a temporary halt to the mass vaccination registrations, and will focus on targeted vaccination clinics for seniors (we did 85+ last week, and are moving to 80+ this week), finishing the health care workers (Phase 1A), and those who need 2nd doses. We are hoping the new sites will allow for more appointment opportunities to register farther in advance, so we don’t have the same problem of 500,000 people competing for 10,000 slots at once. We will announce those registration opportunities (as will our Public Health Department) as soon as we are aware of how and when they will exist. In the meantime, up to now, private providers, hospitals, health systems, clinics, and pharmacies have been receiving a significant portion of the doses received “by the County”, and many of them have finished their first round of administering shots to their own health care workers and staff, and have begun to move on to their own patients and clients. Some (including Riverside Medical Clinic and Kaiser) are now actively reaching out to their eligible patients, mostly on an age priority basis. The VA in Loma Linda is also now offering vaccinations to eligible veterans. Some are also taking interest lists. This may be the primary model moving forward at the State level.
3) Priority Tiers for Eligibility: Riverside County has followed the State tiers and phases to determine who is eligible for the COVID vaccine. Based on the announcement at the end of January, everyone will now be subject to those eligibility rules State-wide, and the County will not have discretion in moving categories up or down. The CDPH press release says:
“Simplifying Eligibility: In simplifying eligibility beginning mid-February, the State will implement a Statewide standard under which health care workers, individuals 65+ and education and child care, emergency services and food and agriculture workers will be eligible to start making appointments to receive the vaccine, pending vaccine availability. These are the groups identified in Phase 1B, Tier 1. Future groups will become eligible based on age. This Statewide standard will move in unison across all 58 counties. This will allow the State to scale capacity up while also ensuring the vaccine goes to disproportionately impacted communities.”
4) Difficulties for Seniors 75+: Trying to compete with half million people for limited appointments on a computer has been very challenging for many of our most senior (and most vulnerable) community members, particularly those without family nearby to assist. During the pause in mass clinics, the County has focused on this population, including senior only appointments that can be scheduled by phone through our 2-1-1 system. The county now has almost 100 operators for this service. The 2-1-1 call center has had appointments set aside for this population as they come available—but even with the increased staff, wait times have been as long as two hours (Hint: Call early in the morning). The County is also now enlisting the Office on Aging and DPSS to assist in making these appointments, and reaching out to high risk individuals that are already within our County system. Last week’s 85+ clinic appointments went extremely well, and we filled 20,000 slots without any issues with the system crashing. This next week we expect to have 30,000 appointments available for those 80 and over.
5) Second Doses: Many people have now had the first dose, and are in need of scheduling their second dose. There has also been a problem with determining which vaccine is available for a second dose at each site on the existing registration site. Officially, you can receive that second dose after day 21 with the Pfizer vaccine and day 28 with the Moderna vaccine, but the CDC says that you can wait as long as 42 days without concern, so you do not need to panic if you cannot get your second dose exactly three or four weeks from the initial dose. Up until now, the State has recommended against holding back sufficient vaccines to offer second doses, preferring that counties prioritize getting as many people their first doses as possible. We also have been unable to schedule appointments more than a week ahead, because of the ongoing lack of supply of vaccines, making it impossible to schedule a second appointment three and four weeks in advance. Many of the private distributors and providers did reserve second doses for those they were vaccinating, which is one of the reasons the statistics show so many doses undistributed. Moving forward, the new registration systems are both expected to make registration easier for those who need their second dose, logging which brand of vaccine was received, and tracking “due dates”, so that second doses can be more easily scheduled. The county is also hosting clinics and appointment slots specifically for second doses, and notifying those who received their first shots from the County through email and phone calls in the week before their 21/28 day window opens for their second dose. If you received your first dose somewhere other than the County clinics, we encourage you to work with that provider.
6) Vaccines for Educators: Teachers and educators are part of the Phase 1B, Tier 1 that the State says are currently eligible in every County, but to date there have not been any focused teacher vaccination clinics hosted by the County, as teachers are in a tier with many other classifications. It is hoped that in the new State-directed system, school districts will be able to work with private health care providers to get their employees vaccinated.
7) Hoarding Vaccines?: While the County dashboard on the vaccine website shows just over half of vaccine doses received are actually being distributed, the doses received by Public Health, has been distributed as fast as they have been received, and we have no meaningful backlog. Some of the private providers have been withholding half their vaccines in order to have the 2nd doses available for everyone that received a first dose, and some are just not utilizing the state portal to report their progress on dispensing the vaccines. Our Public Health team has been manually contacting the private providers to check on their progress, and trying to determine which of them are actually failing to distribute vaccines effectively, so that we might be able to adjust future distributions accordingly. Riverside County is now well above the state average in the percentage of vaccines we have received that have been administered, and have the highest ratio of received to administered in Southern California.
8) Skilled Nursing Facilities: The federal government contracted with CVS and Walgreens to vaccinate residents of skilled nursing facilities and other long-term care residences nation-wide, including California. While they are a month behind what the Trump Administration had initially set as a deadline, CVS and Walgreens claim they are “on schedule based on program parameters.” They have told County Public Health that they are almost entirely complete with dispensing first doses in Riverside County, but we are still working to identify facilities that may not have been covered by the federal contract.
I hope this answered as many of your questions and concerns, at least to the best of our ability with the information we have today, but you can keep updated on the County’s vaccine website: https://www.rivcoph.org/COVID-19-Vaccine.
Announcements are also regularly posted on the RUHS Public Health Facebook page. We are as frustrated as anyone with the communication and the process to this point, and will continue to work hard on behalf of our constituents to improve both of those things, so that we might move on to a post-COVID crisis world as quickly as possible.
Chief of Staff
Supervisor Kevin Jeffries
Riverside County Economic Development Agency has developed a website for businesses in need of assistance from the local, state, or federal government as a result of the various quarantine and isolation policies:
RESOURCES FOR IMPACTED EMPLOYEES