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Great Variation in Counties’ COVID-19 Vaccine Distributions

California has increased its immunization rate overall, but vaccine distribution still greatly varies between counties. Some have nearly one-third of their residents vaccinated, while others are at just 5 percent.

(TNS) — California is pushing shots into arms at a much faster clip than it was just a month ago — closing in on the national average, with vows to accelerate even further — but the pace of COVID-19 vaccinations varies greatly from county to county within the Golden State.

A Southern California News Group analysis of state data found that smaller counties with fewer people and less complicated logistics are leading the pack in vaccinating their residents: Little Mono, with 14,526 residents, ranked No. 1, managing to vaccinate one out of every three residents. On its heels was tiny Alpine, population 1,209, getting shots into 27 percent of its residents.

But inoculation pace is not a simple function of size. Some big counties appear better than others at getting the job done:

  • San Diego weighs in at No. 9 of California's 58 counties. Even though it has the state's second-highest population, with 3.3 million people, it has managed to vaccinate 15.2 percent of them.
  • Orange — almost identical in population to San Diego, with 3.2 million residents — has vaccinated 12.9 percent of its population, landing the No. 21 spot.
  • Massive Los Angeles, with 10 million people, has vaccinated 12.3 percent, coming in at No. 23.
  • Riverside, with 2.5 million people, was No. 39, with 9.4 percent vaccinated.
  • San Bernardino, with a population of 2.1 million, was No. 41, with 9.2 percent vaccinated.
  • In last place, at No. 58, was Kings County, with just 5 percent vaccinated
The differing rates reflect complicated variables, as well as the state's still-shaky data-gathering system, officials said. How many people are in priority groups within a county's borders dictates how much vaccine they get. There's also the ease — or difficulty — of scheduling appointments, the availability of transportation to vaccination sites, the willingness of people to embrace the shots, and, most importantly, the scarcity of vaccine itself, as demand far outpaces supply.

"The issue for vaccinations is an issue of available supply nationwide," Gov. Gavin Newsom said Wednesday. "The issue of scarcity is real."

Newsom acknowledged the state has fallen behind, especially on the effort to ensure densely populated communities of color and others hardest hit by the coronavirus, are not overlooked.

"We are falling short of our goals of making sure we are truly being equitable in the distribution of this vaccine," Newsom said at a briefing in the Central Valley, where preparations are underway for the eventual distribution of the vaccine to agricultural workers.

"Our commitment to equity is not rhetorical. It's real," Newsom said, adding that equity metrics on the rollout are due out later this week, and will show the state is, indeed, lagging.

He also said several testing sites operated by state partner OptumServe are being converted to vaccination clinics across California — with a goal of reaching residents in hard-hit neighborhoods. That, in tandem with new mass vaccination sites at Oakland's Alameda Stadium and Cal State Los Angeles joining the array of community sites, will open up vaccine distribution to the most vulnerable, Newsom said.

But as with most vaccine pledges from public officials, it all came with a caveat: getting enough vaccine in the first place.

On Wednesday, L.A. Mayor Eric Garcetti announced the Dodger Stadium vaccine center would close Friday and Saturday because it expects to run out of vaccines.

A Better Measure?

In Riverside County, spokeswoman Brooke Federico said the better measure of distribution efficiency is how much vaccine received is actually in people's arms.

Statewide, just shy of 66 percent of vaccines delivered have made their way into arms, according to state data. And while county-by-county data is not yet available from the state, Southern California counties report doing much better than the state average.

Riverside County has administered 86 percent of the doses it has received, Federico said. San Bernardino and Orange counties say they both have administered 89.5 percent; Los Angeles is at 82 percent.

Officials warned that the state's data-gathering has many holes and that vaccination may well be under-reported. Orange County, for example, tracks the ZIP codes of those vaccinated, but when it uploads data to the state system, the ZIP codes are stripped out, said Supervisor Lisa Bartlett.

"The state data has to get scrubbed, cleaned up," Bartlett said, fearing that such errors could impact how much vaccine counties are allocated in the future.

Vaccine Calculations

Counties don't get vaccine supply based on simple, total population, Federico said.

Instead, allocations are based on how many people are in priority groups in each county. That means even counties with identical total populations would get different amounts of vaccine based on how many folks over 65 they have, how many health care workers they have, how many nursing home residents they have.

To illustrate: San Diego County has a health care and skilled nursing facility workforce of 352,174, while Riverside County's workforce in that category is 113,614. San Diego got 13.3 percent of the state's early vaccine supply, while Riverside got 4.3 percent.

The calculations will change as vaccine is offered more widely. Now that people 65 and older are eligible, Riverside County has 387,429 people in that priority group, and will get an allocation much closer to San Diego's: 6.19 percent starting on Feb. 16, Federico said. San Diego County, with 496,742 eligible, will get 7.94 percent.

Orange County has more people over 65 than San Diego, and will be getting more supply as well, said Clayton Chau, director of the Orange County Health Care Agency.

Complicating comparisons, said San Bernardino County spokesman David Wert, is that each county also is vaccinating a large number of residents from other counties. "That's because, besides seniors, the only eligible sectors are employment-based, and a sizable number of health care, emergency, and education workers get vaccinated where they work, not where they live, and those are often different counties," he said.

Clearly, the numbers are a work in progress, and will be more meaningful after vaccinations have been available to the general population for a while, Wert said.

Vaccine Distribution Funnel

Another detail escaping most people is that counties aren't providing the bulk of vaccinations.

Large, independent health systems have received some 70-80 percent of the vaccine supply and give the shots directly, said Andrew Do, chairman of the Orange County Board of Supervisors. Frustrated people — told it's not their turn yet by their health providers — then turn to the county seeking shots, he said.

Moderna and Pfizer are scaling up production, and Johnson & Johnson's vaccine candidate is slated to go before the Food and Drug Administration for emergency use authorization on Feb. 26. Quick approval is expected, and the company has vowed to have 100 million doses available by June.

Things are ramping up quickly. A month ago, California trailed the nation, vaccinating just 1,981 of every 100,000 residents. The pace has picked up considerably, with nearly 4.8 million doses administered, or 12,109 per 100,000 residents. That's very close to the national average of 12,810, according to data from the Centers for Disease Control and OurWorldInData in London.

"I hope I'm waking up a month from now and we have plenty of vaccine — and I'm not getting any more arrows shooting in my back," Chau said. "I'm very confident we have the capacity, the infrastructure, that will help us respond to the need."

(c)2021 The Orange County Register (Santa Ana, Calif.) Distributed by Tribune Content Agency, LLC.

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