San Mateo County’s latest vaccine numbers show some inequities in who is getting the first doses, but county officials say it’s too soon to draw conclusions from local data as they work toward getting shots into the arms of the most vulnerable. 

The majority of the 63,000 individuals vaccinated locally are white, female and under the age of 65. That reflects the demographics of health care workers, who were first in line for shots due to their high exposure and risk of contracting COVID-19, County Health Information Officer Preston Merchant said. 

“The data you see on our site is reflective of the people who work in health care,” Merchant said. “But, as we get further into the 65-plus group and have more vaccine available, you’ll see those numbers start to shift more favorably toward people at the highest risk.”

Local health care providers are the main source of the local vaccine distribution, with Sutter Health, Kaiser Permanente, Dignity Health and other large systems, responsible for more than half of vaccines administered to date. CVS and Walgreens, through a federal program to reach long-term care facilities, make up 1.2 percent of all vaccines distributed in the county. 

Meanwhile, San Mateo County is the third-largest distributor, giving more than 8,000 vaccines to those covered under its public health plan. The county is responsible for reaching anyone eligible for a vaccine but unable to get one through a major provider. It has also helped establish mass vaccination sites to speed up distribution for hospital systems receiving the most doses.

County health leaders say they have plans to reach those county residents who are now eligible but may be struggling to access current sites, but that vaccine supply is still a barrier. Health Chief Louise Rogers said at last week’s county Board of Supervisors meeting that the county Health Department hopes to partner with local pharmacies and neighborhood clinics to reach residents in their own communities. She said that finding the right vendor to help provide doses for mobile sites will be key, especially for reaching rural populations like high-risk farmworkers on the South Coast. 

“With farmworkers, just as with testing, we really believe we’re going to have to bring the vaccine to them,” Rogers said.

Last week, the state announced that health insurance company Blue Shield will be taking over vaccine distribution to improve efficiency. Some worry that agreement may come at the cost of an equitable distribution. Merchant said it’s unlikely.

“That doesn’t affect our on-the-ground plans,” Merchant said. 

Neighboring Contra Costa County may serve as an example for how to get vaccines to the most vulnerable residents first, even while supply constrains distribution.

The East Bay county has given out vaccines to more than 11 percent of its residents, most of whom are white and female like in San Mateo County. But its distribution to older residents appears to have been more successful, with more than half of those vaccinated being 65 or older. 

Contra Costa County officials say it comes down to the county’s proactive approach to distribution.

“We directly contact vulnerable patients of the county-operated health system (such as Medi-Cal and Contra Costa Health Plan members) who live in heavily impacted areas when they become eligible – we do not wait for them to fill out a form,” Public Information Officer Scott Alonso wrote in an email to the Review. “Our mobile outreach teams bring vaccine directly to residential facilities for older adults and low-income senior housing.”

Contra Costa County officials don’t have a way of measuring whether the vaccine is being distributed equitably. They do, however, have public vaccine data broken down by city to help keep track of which neighborhoods are getting left behind so they know where to target. Low vaccination numbers in low-income areas of color have prompted the Health Department to distribute vaccines to clinics hosted by trusted community partners in those neighborhoods, in addition to several mass vaccination sites in areas hardest hit by the virus.

“We know that specific communities within our county, particularly the Latinx community and people living in the western and eastern parts of the county, have been disproportionately affected by COVID-19,” Alonso wrote. “Therefore, vaccine access in these communities is very important.”

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