California Vaccine Rollout Beset by Stockpile Shortage, Logistical Challenges

State and county health officials in California face considerable challenges with storing and administering Covid-19 vaccines, a task that experts say should not distract from equitably distributing doses to those most vulnerable. 

After receiving the first dose of Moderna’s Covid-19 vaccine on Friday, Ana Giron, who works at a dental clinic in Pasadena, California, leaves the distribution site. (Courthouse News photo / Martin Macias, Jr.)

LOS ANGELES (CN) — After receiving her first dose of Moderna’s Covid-19 vaccine Friday at a distribution site nestled between palm trees of a Los Angeles park, health care worker Ana Giron finally brushed away some of the stress and anxiety she’s carried since the start of the pandemic.

Giron, who works at a dental clinic in Pasadena, waited 20 minutes for the first of two required doses, but she’s waited months to take this step towards immunization for a virus that has killed nearly 360,000 Americans to date.

“I’m at least a little bit hopeful that this will help us,” Giron said in an interview with Courthouse News. “I have underlying health conditions, too, including diabetes, so I’m feeling good about it. This has been a very stressful time.”

The nation’s decentralized rollout of the two Covid-19 vaccines approved for use — made by pharmaceutical companies Pfizer and Moderna, respectively — has brought hope that society will return to some semblance of normalcy this year.

But distribution of the vaccines, which in California is done in several phases and prioritizes first doses for health care workers and people at risk of becoming severely ill from the virus, has lagged considerably.

Nationwide, about 6.7 million Americans have received a vaccine dose according to the Centers for Disease Control and Prevention, far below the Trump administration’s plan to immunize 20 million people by the end of 2020.

President-elect Joe Biden has promised to speed up distribution, announcing Friday he’ll release almost all available doses in the U.S., a move that follows experts’ advice to get the first dose into as many Americans’ arms as possible.

Even before taking office, Biden has set a goal of immunizing 100 million Americans in his first 100 days. 

The CDC has projected that close to 90 million people will be vaccinated by March, still under one third of Americans and far less than the 70% officials say is needed to reach herd immunity.

California’s Vaccine Rollout 

In California, where nearly 29,000 have died from Covid-19, vaccine rollout has been beset by a number of issues that bring into focus challenges that come with such a gargantuan effort. 

Administering doses quickly and efficiently has been a challenge: California has received just over 2 million vaccine doses but only administered about 652,000 of them as of Jan. 8.

Vaccine doses are also lower than anticipated, with officials estimating they won’t have enough doses to immunize “most” residents of its 58 counties until the summer. 

California joined five other states this week in a letter demanding the Trump administration release a vaccine stockpile — reportedly 50% of the country’s supply — that it’s chosen to reserve for the required second dose for individuals who received a first shot.

Lags are also tied to ultra-low temperature storage requirements for the Pfizer vaccine, a shortage of vaccination sites and staff to administer doses and a delay in setting up systems to track who is immunized and where they live. 

Kiran Savage-Sangwan, executive director of California Pan-Ethnic Health Network, told Courthouse News the hiccups in vaccine distribution aren’t a surprise given the unprecedented circumstances officials are working in.

Still, Savage-Sangwan believes California needs to ensure people understand and trust vaccinations and work to make doses more rapidly available to communities with histories of inequitable access to care.

“We also need to be thinking about who’s getting it and how to ensure equity,” Savage-Sangwan said of vaccinations. “We should be prioritizing those who have the highest risk of getting seriously ill or dying. In low-income communities of color, people should be getting it immediately.”

Savage-Sangwan is part of California’s Community Vaccine Advisory Committee, one of two groups advising state health officials on how to equitably distribute vaccines.

The group said in its meeting Wednesday that officials need to help people understand when they’ll be eligible for vaccinations and provide necessary vaccine storage equipment to community health centers that people are familiar with or have used for regular Covid testing.

Savage-Sangwan told Courthouse News the state should also consider moving from a phased distribution plan to a “place-based” one, or a plan that brings vaccines to areas hit hardest by Covid-19.

“I don’t think a phased approach is the problem,” Savage-Sangwan said. “The issue is ‘Are these the right phases?’ Having it be industry-based is complicated and confusing.” 

The Golden State has the nation’s highest total of people infected with SARS-CoV-2, the novel coronavirus that causes Covid-19, with more than 2.5 million cases. 

As of Jan. 7, health departments statewide have reported 73,862 positive cases among health care workers and 276 deaths.

On Thursday, California told local health departments and providers to expand vaccine eligibility by offering doses to community health and testing site workers, public health field staff and dental clinic and pharmacy personnel.

More than 586,000 health care workers in California have received the first dose of a Covid-19 vaccine, according to state data. 

The new guidance also says once demand has subsided from the first priority group, doses should be allocated to people age 75 and older, childcare workers, staff in emergency response and food service and educators.

Melissa Powers, an educator whose Orange County school currently offers limited in-person instruction, told Courthouse News she’ll jump at the first chance to be vaccinated.

“I’ll absolutely get it,” Powers said of the vaccine. “Right now, it feels like I’m risking my life to teach. I want to be able to teach in person.”

Socially distancing a class of 26 students is impossible and waiting for a vaccine that can ameliorate the problem has been frustrating, Powers said.

“It’s been very slow and it’s been very disappointing,” Powers said. “It’s ridiculous for a state as technologically advanced and as smart as California, that it’s going too slow.”

Vaccine Distribution In Los Angeles County 

Health care industry workers who’ve been on the frontlines of the Covid-19 pandemic wait in line to receive a vaccination at a distribution site in Lincoln Park in Los Angeles, California on Friday. (Courthouse News photo / Martin Macias, Jr.)

At the vaccination site in Los Angeles’ Lincoln Park, Deirdre Shipstead proudly held up her immunization card after receiving her first dose of the Moderna vaccine, saying that getting vaccinated shows “people give a damn.”

Shipstead, who works at an addiction recovery clinic in Malibu, told Courthouse News she wants to be able to treat her clients face-to-face. 

“It’s important to give the care we give in such a way that my clients feel confident and safe,” Shipstead said. “This pandemic has kicked everybody in the ass. Everyone’s nerves are frayed.”

Los Angeles County, where about 1 in 5 people being tested for Covid-19 are currently testing positive, is the largest from a cluster of Southern California counties that has received about 256,000 doses from the state, the largest quantity of any region. 

The area includes Orange, San Luis Obispo, Santa Barbara and Ventura counties.

Still, there aren’t enough vaccine doses currently available to immunize even half of the county population by spring, Dr. Paul Simon, chief science officer at LA County’s Department of Public Health, said Friday.

“We advocate for as much vaccine as we can get,” Simon said in a press conference. “But there’s no mechanism in place to get more than our share. Existing supplies are not sufficient if you want to vaccinate 70% or 80% of the population over the next months.”

At least 151,772 doses of the Pfizer and Moderna vaccines have been administered as of Jan. 6, including 6,151 given as second doses, according to county data.

The county said in a statement Friday it opened 19 vaccination sites this week and will open 75 more by next week.

In an emailed statement, the California Department of Public Health said the special container the Pfizer vaccine is shipped in, if unopened, can maintain its ultra-low temperature of -70° C for up to 10 days. 

“The vaccine must be brought up to at refrigerated temperatures (2-8° C) to reconstitute and be administered,” the statement said. “The Moderna vaccine also requires cold storage but not at the ultra-cold level required by Pfizer.”

Simon said the county is working to add more vaccination sites and increase the supply of ultra-low temperature freezers that can store the Pfizer vaccine. But that task, along with the effort to increase vaccine stockpiles, is not easy to complete.

“This is a massive and complex logistical undertaking,” Simon said. “There aren’t a lot of those freezers around.”

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