California Counties, Lawmakers Call For More Organized, Better-Funded COVID-19 Vaccine Rollout As Cases Continue To Climb

California is facing a serious supply-and-demand problem as it attempts to administer the COVID-19 vaccine to the state’s nearly 40 million residents. While people anxiously await their turn to receive a shot, counties are scrambling to figure out when more vaccines will be available and how they can distribute them quickly and safely. 

Governor Gavin Newsom has publicly acknowledged that the rollout is happening more slowly than expected, due to hold-ups with supply from the federal government, the paperwork necessary to certify doctors to give the vaccine and confusion around whether counties can vaccinate multiple priority groups at once.

A bipartisan coalition of 47 lawmakers published a letter Wednesday calling on Newsom to better communicate the timeline for when counties can expect to receive new doses. 

“We are all aware of the limited amount of vaccines that have been made available to the states,” the lawmakers wrote. “But we believe that we need to plan for a more effective and efficient roll out of these vaccines so we can further improve the public health of Californians and start rebuilding our state.”

In the letter, legislators asked for:

• A reliable forecast for vaccine quantity for the next four weeks
• Updated forecasts at least weekly
• Authorization of nursing students, retired medical professionals and firefighters to administer shots
• Expand the use of the National Guard for vaccine administration

Assemblywoman Cottie Petrie-Norris (D–Laguna Beach), the primary signee, said the vaccine “is doing none of us any good just sitting in a warehouse,” and that California has been too focused on plans to administer the vaccine rather than actually getting it out.

“There really is a tradeoff between speed and precision, and I think what we’ve seen so far has been some analysis paralysis,” Petrie-Norris said. “And it’s a really good time for us to stop talking about it and just start getting it done.”

To date, California has received roughly 2,860,000 vaccines and administered about 889,000, or about 31% of them. Nationally, slightly more than one-third of doses have been administered.

Federal officials announced this week they would stop holding back doses to be able to have supplies for the second round of shots. They’re now encouraging states to use all their doses, and to vaccinate everyone age 65 and older. 

Newsom announced this week that counties should prioritize vaccinating the elderly in hopes of preventing deaths and hospitalizations, while also continuing to immunize health care workers. 

Counties say they’re still getting through the first tier of the first phase of vaccine distribution — health care workers, long-term care facility residents, emergency health workers, dentists and other health providers.

Local health leaders say part of the delay has to do with the time it takes for the state to approve people to administer the vaccine. Other challenges include not being able to plan ahead for incoming doses, and the particular handling instructions and reporting requirements associated with both the Pfizer and Moderna vaccines. 

County health departments say they can’t begin mass outreach campaigns, schedule people for appointments or plan community vaccination clinics until they have a sense of what’s coming down the pipe.

“It makes it very difficult to plan,” said Colleen Chawla, president of the County Health Executives Association of California and Alameda County Health Care Services Agency Director. “Because we have to go in order of specialized populations, we also have to outreach to them and make appointments and let them know that they can come in when it’s their time.”

Chawla’s organization and other groups representing county leaders also wrote a letter to the governor this week asking for more support during the vaccine rollout. They specifically asked for $400 million in state support to help cover:

• Costs associated with facilities, security, vaccinators, data entry staff and clinicians
• Mobile ‘strike teams’ to reach long-term care facility residents, farmworkers and other groups
• Outreach to people in underserved areas

The letter also asked for:

• $280 million for COVID-19 testing
• $440 million for contact tracing and non-congregate housing solutions to protect vulnerable people
• $50 million in ongoing General Fund dollars for public health infrastructure

In his proposed budget released earlier this month, Newsom included $2 billion to expand COVID-19 testing in California, plus $473 million to improve contact tracing and $372 million for vaccine distribution.

Chawla said they’re requesting money in addition to that proposed funding, in hopes that it will be available immediately rather than on the other side of the budget approval process.

“We are in the midst of this right now and this is a crisis at this moment,” she said. “So these funding requests are for our next six months of operation.”

She says staffing is a major issue as county health departments are trying to deal with a vaccine rollout on top of a surge, needing to carefully reprioritize staff from contact tracing and testing to immunization.