California is one of the slowest states in the nation when it comes to rolling out coronavirus vaccines, data from the Centers for Disease Control show — even as virus cases surge, overburdened hospitals turn away patients and record numbers of people die.
South Dakota was more than twice as speedy as California at pushing shots into people’s arms as of Tuesday, Jan. 12. It had vaccinated 5,451 of every 100,000 residents, ranking No. 1 among all 50 states, Washington, D.C., and Puerto Rico.
The Golden State trailed far behind, at No. 44, vaccinating just 1,981 of every 100,000 residents.
While an enormous state like California faces complicated logistics, two other large, heavily populated states are also vaccinating people far more quickly than is California. Both New York and Texas eclipsed California’s pace by some 50 percent (shots in 2,979 of every 100,000 arms in New York and 2,938 of every 100,000 in Texas). Those states ranked No. 18 and 21, respectively.
Even Louisiana and Puerto Rico, not particularly known for efficient infrastructure, are doing better than California.
“Part of the process that we’ve set up here in California — really thoughtful, trying to focus on risk and exposure and equity — has led to some delays in getting vaccine out into our communities,” said Mark Ghaly, secretary of the California Health and Human Services Agency, on Tuesday, Jan. 12.
Gov. Gavin Newsom said that “We recognize that the current strategy is not going to get us where we need to go as quickly as we all need to go” at a briefing Monday, Jan. 11.
Newsom was one of eight governors who implored federal officials last week to quit holding back half of available vaccine doses — meant to ensure that each person already vaccinated gets the second, required shot a few weeks later — and release it so as many people can get it as soon as possible.
President-elect Joe Biden said he intended to do just that when he takes office next week, confident that Pfizer and Moderna can produce enough new vaccine to cover the required second doses in the required timelines. But on Tuesday, the Trump administration beat him to it, agreeing to release all doses over strident objections of the Food and Drug Administration and many experts.
Dangerous gamble?
That’s a profound and perhaps dangerous wager, some say.
“It’s like the gambler at the casino who lost 10 bets in a row on the roulette wheel and says he’s finally due for a win,” said Andrew Noymer, an epidemiologist and population health scientist at UC Irvine. “You’re not ever due for a win. Has Lady Luck really been smiling on us lately?”
Each first dose, Noymer said, is a promissory note on the second. “To push it all out and wait for the feds to deliver the second dose is making an all-in bet that either the feds will deliver, and/or that a delay is OK,” he said. “That six weeks between shots, instead of three or four, is OK. And that’s not been tested. It hasn’t been trialed and hasn’t been authorized and the manufacturers aren’t crazy about it, which tells you a lot.”
The FDA, which approved the vaccines for emergency use, has registered similar, strong objections.
“We have committed time and time again to make decisions based on data and science,” the FDA said in a statement. “Until vaccine manufacturers have data and science supporting a change, we continue to strongly recommend that health care providers follow the FDA-authorized dosing schedule for each COVID-19 vaccine.”
But many others see wisdom in moving more swiftly, saying that pushing vaccine out and sticking to the required timelines for second shots are not mutually exclusive things.
“Releasing all the vaccine now makes sense,” said David Eisenman, a professor at UCLA Fielding School of Public Health and director of the UCLA Center for Public Health and Disasters. “It needs to be in the hands of states and local governments. But that alone isn’t going to solve the fundamental problem, which isn’t that there hasn’t been enough vaccine, but that there hasn’t been enough vaccination.
“Hospitals run 24/7. Nurses work 24/7. Doctors work 24/7. We really need to be administering it 24/7, but most jurisdictions aren’t doing that,” he said. “Public health departments, in the decades after 9/11, did exercises in mass vaccination because of feared bioterror attacks. We had written plans and chosen sites. I’m not sure why it’s not happening now.”
Ramping up to 24/7 operation requires resources, though, and those have been too slow to trickle down to the people who must hire extra staff to do the vaccinating.
Rapid ramp-up
So far, 2.83 million doses have shipped to California, and 783,000 have made their way into arms. That’s less than one-third of the state’s current allocation.
To speed up the pace, Newsom is “sending an urgent call across the spectrum” for thousands more professionals to administer vaccines, including dentists and pharmacists. He set a goal of 1 million new vaccines to be administered by the end of this week — essentially, more than doubling the tally so far.
Mega-vaccination sites called Super PODS — for “point of dispensing” — are swinging into action, including at Disneyland in Anaheim, Dodger Stadium in Los Angeles, Petco Park in San Diego and CalExpo in Sacramento.
The California Department of Public Health also has loosened rules for who can line up for shots. After “appropriate efforts” are made to reach the reach highest priority groups — health care workers and long-term care workers and residents — health departments and providers can offer shots to folks in lower priority groups. Teachers and school staffers will be able to be vaccinated soon, Newsom said.
“The Governor’s office has convened meetings with leaders across the public and private health care system and received commitments to cooperatively accelerate the pace of vaccine administration,” said Darrel Ng, a spokesman for California’s COVID-19 Vaccine Task Force, in a statement. “Progress has been immediate. On Friday, more than 65,000 doses of COVID-19 vaccine were administered in California — the highest ever daily total and more than Monday and Tuesday of last week combined.
“The health system is ramping up. We expect this progress to continue.”
Retail outlets join effort
CVS and Walgreens also have started vaccinating residents and staff at nursing homes and assisted-living facilities under contracts with the federal government.
“Certain states that I know have put a great deal of effort into coming up with their priority groups, watching how we keep a keen eye on equity, have been in same place as California is, and we look forward, with additional vaccine, to accelerating and really doing more in this space than we’ve done,” Ghaly said.
Still, people like UCI’s Noymer worry. Pushing out all doses and hoping that enough new vaccine will materialize in time to give people their second injections on time is “setting up an unforced error,” he said.
“I don’t want to hear stories eight weeks from now about how no one could have predicted that the second doses wouldn’t arrive on time. Frankly, people think that because of the change in administrations, everything is going to be hunky dory. But whatever is causing delays isn’t going to change overnight,” he said.
Updated 2:56 p.m. 1/12 with comment from Ghaly
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