Anyone 65 or older is now eligible to get a vaccine in California, so why have so few people in that age group actually gotten the vaccine? Local health care providers and county leaders all say the same thing: there simply aren’t enough vaccines to go around.

“We are in a textbook rationing situation,” San Mateo County Health Officer Dr. Scott Morrow wrote in his latest statement. “We have more demand than supply. … We all want to go faster, but until this supply issue is ameliorated, we won’t be able to.”

The first countywide vaccination numbers were released Tuesday morning, tallying 48,826 county residents vaccinated as of Monday, with nearly 10,000 individuals having received both doses. That accounts for just 6.4 percent of the county’s population, and falls far short of the 6,000 per day needed to get a critical mass of county residents immunity by summer.

The problem is supply. County Health Chief Louise Rogers reported last week that the county itself has received enough vaccines for just 25,800 residents to date, and local health providers are also reporting low numbers of vaccines received.

Sequoia Hospital, part of Dignity Health, has administered just 3,000 to 4,000 doses to date, Sequoia’s Chief Medical Officer Dieter Bruno said on Monday. Kaiser Permanente leaders said the health system has gotten enough vaccines for just 2.5 percent of its 12.4 million members nationwide. After announcing last week it would vaccinate members 65 and older, overwhelming demand and meager supply has forced Kaiser to focus only on those 75 or older after health care workers and staff at long-term care facilities.

“We understand and apologize for the frustration some of our members have encountered with availability of vaccination appointments,” a Kaiser statement reads. “What is limiting appointments is the very limited supply of vaccine.”

It’s not just low supply plaguing the local rollout. It’s inconsistency and a lack of clear information about what is to come.

A Kaiser spokesperson said this week that the health care group is struggling to schedule appointments amid volatile supply, and is now reaching out to eligible patients in place of self-registration. At San Mateo County, which is responsible for vaccinating those within its health plan or those uninsured, County Section Chief of COVID-19 Mass Vaccination Anand Chabra said some weeks just 100 doses arrive from the state, while others it’s closer to 10,000. Chabra said 95 percent of vaccines received in the county get out the door and into arms the next day, but it’s no easy feat.

“Having that kind of range makes it really hard to plan,” Chabra said. “It does make the vaccination clinic and setup more complicated if you don't know what to expect.”

This week, San Mateo County partnered with Dignity Health to get vaccines into the arms of more health care workers and seniors. The three-day event is expected to get 4,300 shots into arms. But the site’s capacity is even greater, able to vaccinate someone every five minutes, if only enough doses were available.

“We believe we can reach 3,000 (a day) if we have the doses,” county Manager Mike Callagy said.

Further complicating the supply problem last week was a batch of Moderna vaccines that were put on hold due to safety concerns after adverse reactions were reported at one site in Southern California. While the suspect vaccines were eventually released, Kaiser and Sutter were each forced to hold back an undisclosed number of doses until they were deemed safe by the California Department of Public Health. County officials say they did not receive any doses from the batch put on hold temporarily.

The supply problem is not just local. President Joe Biden’s goal of hitting 100 million shots in 100 days might fall short because of supply constraints, and California State Epidemiologist Erica Pan said the state is getting just 300,000 to 500,000 doses of the vaccine each week.

The good news is that in San Mateo County, there is very little vaccine waste, Chabra said, estimating two to three doses go unused for every thousand.

“We don't even want that,” Chabra said. “Sometimes, mistakes do happen. That said, it is a huge priority not to let those doses go to waste.”

At this week’s vaccination event, the county began tapping a waitlist to ensure those doses get in arms. On Saturday, around a dozen standby residents got their vaccines.

There is no shortage of health care workers, protective equipment or volunteers to staff sites, county officials said. And the several new vaccines on the horizon, including the one-dose

Johnson & Johnson vaccine, offer a glimmer of hope. But state science officer Julianna McCall said the state isn’t anticipating a new vaccine before March.

“We would ask your absolute patience going into the eleventh month of this pandemic,” McCall said.

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