In Long Beach, port workers qualify for the front of the coronavirus vaccine line.
Statewide, Gov. Gavin Newsom wants 10% of vaccines guaranteed for educators going forward. But some counties began vaccinating teachers a month ago.
Some counties embrace the state’s conclusion that medical marijuana workers are health care workers and qualify for early shots; others do not. There’s a system operated by the state to make vaccine appointments, but myriad other appointment systems are used by counties.
Despite efforts to standardize California’s approach to vaccinating some 40 million people, its theme song could be Frank Sinatra’s “My Way.” But that’s expected to change in coming weeks as Blue Shield takes over “a statewide vaccine network to ensure the rapid delivery of current supply of the COVID-19 vaccine to Californians, consistent with the (state’s) COVID-19 Vaccine Allocation Guidelines,” according to the contract it struck with the state.
Change is coming. Bumps are expected. Local officials remain unclear on exactly how it will all play out and when. The state says it will have more information to offer later in the week.
“We’re also awaiting clarification, but in the meantime we’re continuing to book second doses and hopefully continue first doses in new tiers next week,” said Lisa Derderian, a spokeswoman for the city of Pasadena, which has its own health department. “Yesterday, we updated our COVID-19 vaccine web page to include an inquiry portal for childcare centers and K-12 education workers. We will join LA County in adding this group as eligible for vaccine beginning next week.”
So here’s a look at what to expect over the next six or so months as California moves, ever so tentatively, toward consistency. It’s drawn from state and county sources and data, as well as a panel from Keck Medicine of USC — Edward Jones-Lopez, an infectious diseases expert, and Felipe Osorno, executive administrator of continuum of care operations and improvement.
Q. Everyone keeps saying vaccine supply is the key issue. What’s going on with that?
A. A lot. On Wednesday, Feb. 24, the Food and Drug Administration said that a third and much simpler vaccine — by a branch of pharmaceutical giant Johnson & Johnson — is safe and effective. It requires only one shot, can be kept in refrigerators rather than specialized freezers (like the more cumbersome Pfizer and Moderna vaccines, which require two doses) and was 72% effective in a U.S. clinical trial. Experts will meet Friday to make a recommendation about its use to the FDA, whch is expected to move quickly after that to grant emergency use authorization. J&J hopes to have 100 million doses in circulation by the end of June.
Q. What about Pfizer and Moderna?
A. Both companies told Congress this week that they’re dramatically upping production and are on track to deliver 300 million doses — each — by the end of July. That’s enough for the adult population of the United States. Blue Shield’s contract with the state specifies that California should be administering 3 million vaccinations per week by Monday, March 1, and 4 million a week by April 30. While ambitious — it has taken two months to administer 7.7 million vaccines in the state — it would still take time to vaccinate California’s 30 million adults.
Q. So, things will be normal soon?
A. All things are relative. “We’re still a few months away,” said USC’s Jones-Lopez. “A major issue is understanding if the vaccines protect against infection and transmission. We know they prevent death in a very significant way — almost eliminating death — and are very protective against severe disease. Obviously, that’s an enormous advance. But if you’re exposed, if vaccinated, can you transmit to others who are not vaccinated? That’s not yet well known.” Most info on this right now is coming from the Astra-Zeneca vaccine widely used in Britain, “and the data emerging is very, very optimistic,” he said. “The overall picture emerging is that normality will come slowly and surely over several months. By June, a lot of important groups will be vaccinated. But for children — an important group to vaccinate to interrupt transmission — that will come later. By the beginning of the next school year, in September, I expect it to be very close to feeling back to normal.”
Q. How is Blue Shield going to affect the effort?
A. It will put all the counties on the same page, using the same criteria for eligibility across the whole state, presumably starting next week, said USC’s Osorno. “Hopefully, we will be able to go quicker than we have so far,” he said. There are plans for one website for figuring out when and where to get vaccinated, rather than the many in use, and “one of biggest focuses Blue Shield has in this partnership with the state is equity.” White Californians are getting vaccinated at much higher rates than Black and Latino residents, and Blue Shield is charged with turning that around. “There might be some hiccups as we transition,” Osorno warned.
Q. Will Blue Shield help predict supply?
A. Officials hope so. Right now, counties don’t know how much vaccine they’ll be getting from one week to the next. “We are hopeful that the transition to Blue Shield … will be able to support us in predicting vaccine availability 3 weeks at a time,” said Clayton Chau, director of the Orange County Health Care Agency. “This will be much easier for scheduling purposes when it comes to vaccination.”
Q. Who’ll be eligible when?
A. Seniors remain the highest priority: About 45% of those over age 65 still haven’t been vaccinated, according to state data. On March 1, front-line essential workers will become eligible, including teachers in schools and colleges, food and agriculture workers and emergency services workers. On March 15, eligibility expands to include those ranging in age from 16 to 64 with medical conditions such as cancer, diabetes and immune conditions. Hopes are high that supply will keep pace with the increasing number of people seeking vaccines.
Q. What about concerns over the virus mutating?
A. Much like flu vaccines are tweaked each year to address different strains, coronavirus vaccines can be re-engineered to battle new variants, experts said.
Q. Will there be other vaccines soon?
A. In the U.S., Astra-Zeneca hopes its vaccine will receive emergency approval in April, and Novavax is finishing up a Phase 3 trial and is expected to be next in the pipeline. “Together, all these efforts are likely to provide hundreds of millions of doses,” Jones-Lopez said. “It’s the only way we’re going to be able to control this virus. The immediate and most urgent need is to to give as many vaccinations as possible to as many people as possible, both in this country and in the world.”
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