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California/SCC vaccine inequitable allocations - Printable Version

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California/SCC vaccine inequitable allocations - M_T - 02-04-2021

If Santa Clara County's vaccine dashboard has accurate information, first doses are being inequitably allocated to health care entities in Santa Clara County by a factor of more than 3, depending upon whether someone is with Kaiser Permanente, Sutter/PAMF, or other.

Based on the Santa Clara County (SCC) dashboard data for January 20 - Feb. 2, the incremental number of 1st doses allocated in the County:
52,290 Santa Clara County (allocated to different groups in the county)  (1,046,500+ patients) (50.0 doses per 1000 patients)
           43,540 SCC Health  (300,000 patients) (145 doses per 1000 patients)
                   0 Stanford  (341,000 patients)     (0 doses per 1000 patients)
             1,400 El Camino Health  (140,000 patients)  (10 doses per 1000 patients)
              -975  HCA Healthcare (265,500 patients)    (<0 doses per 1000 patients)
             8,325  others  (? patients)
                    
 9,550  Kaiser Permanente  (600,000 patients)  (15.9 doses per 1000 patients)
13,500 Sutter(PAMF)   (427,000 patients)     (31.6 doses per 1000 patients)

80,650 total  (2,073,500+ patients;  Population is about 1.93M)

Patient numbers are derived from the SCC COVID-19 Testing dashboard, and are clearly estimates.

KP and Sutter get their doses state-wide from the state and then allocate to their facilities.  As I understand it, the county doesn't know those numbers, so the numbers have to be reported by KP & Sutter to the county.

The County refuses to provide vaccines to those that use Kaiser or PAMF/Sutter.



It appears that the 50 1st doses per 1000 patients (population) is double than the average for the state of California.
The CDC indicates that 485,800 1st doses were shipped to California for each of those weeks. Based on total CA population(39.5M), that is 24.6 doses per 1000 people.  However those doses have to be split among the counties and the multi-county entities (KP, Sutter, ...).

That much disparity seems unlikely.   Indeed, if the 1st doses sent to SCC were based on the full 1.95M population of the county, then SCC would have received 26.8 doses per 1000 people.

Something doesn't add up right.


RE: California/SCC vaccine inequitable allocations - Snorlax94 - 02-04-2021

The doses in SCC seem right on the national average.

The latest report is that 36.7M doses have been administered nationally.

At about 2M people, SCC is about 1/164 of the US population.

Based on its size, you’d expect about 224,000 doses administered and in the latest update about 236,000 doses have been given.

So, very close to the national average. I actually expected SCC to be significantly above the national average because I bet SCC has a higher proportion of healthcare workers, lower vaccine hesitancy, and one of the nation’s longest life expectancies (so more people 75+).


RE: California/SCC vaccine inequitable allocations - M_T - 02-11-2021

Santa Clara County has had online townhall meetings about COVID.  This week they are having smaller meetings in County Supervisor Joe Simitian's district for some of the communities in his district.  I listened in on one tonight.   There was someone from the county, and representatives of Stanford Health, Sutter, and El Camino Health.  I believe there was supposed to be someone from Kaiser but they couldn't make it.  Someone from Kaiser may be at other meetings this week.

These meetings are recorded and are available on Joe Simitian's web site.

Let me first say that these meetings have been very useful to me.  While I tend to be leery of political leaders pushing their agenda, I believe Joe Simitian has really used these to connect the constituency with those who know  what is going on. The Q&A part of this allows concerns to be raised and often explained.



In response to a question, the county rep indicated that the state has (up to now) been dividing vaccines so only 20% went to multi-county entities and 80% went to the counties.  This explains the large discrepancy between what is available through the county and what is available through Sutter and Kaiser.   In our county, about 50% of the population is with either Sutter or Kaiser.  Originally the concept was that Sutter and Kaiser patients would get vaccines from Sutter & Kaiser and everyone else would get vaccines from the county.  So, 50% of the population was getting only 20% of the vaccine, and the other 50% was getting 80% of the vaccine.    That got so bad that SCC adopted a No Wrong Door policy about Feb. 4 to allow anyone to get the vaccine at any provider.   However, I am seeing this same problem repeated in other counties.

I said "up to now".  A week or so ago, the state contracted with Blue Shield of California to do something with the distribution.  There were hints that something will be announced soon about major changes.  (The governor often announces these things on Monday.)   Amongst the changes expected is an implementation of age-based vaccination from here on out.


Another tidbit I picked up on is that the mass vaccination site at the Oakland Coliseum (due to start Feb. 16) will be using federal doses of vaccine, not state doses.  I expect that means that anyone can get vaccinations there.


The county rep indicated there were approximately 170K people in SCC in Phase 1-A.  That's 8.7M.
He also indicated that 73% (IIRC) of 75+ have been vaccinated, and 1/3 of 65+ have been vaccinated.  I'm not sure whether that was 1/3 of 65+ (as stated) or 1/3 of 65-74 (as possibly intended).
I suspect this meant "have had at least the first vaccination".

The census indicates 118,250 75+ and 266,825 65+ (ie, 148,575 65-74).
That indicates that 86,300 75+ have been vaccinated (about 32K haven't).
And either 88,000 65+ (ie, 86,300 75+ and 1700 65-74)
  or 49,000 65-74 and 86,300 75+ for a total of 135,000 65+ 
I suspect the latter.

Since there are 226,600 that have received at least one dose in the county, that means that roughly 90,000 have gotten the shots that are not 65+.  That's 4.6% of the overall population (5.8% of the 1.56M eligible (16+) population in SCC).



There is one known case of the South African variant in SCC.  Surprisingly, they seemed to think this case had been sufficiently isolated.  That must mean this was a traveler who was infected elsewhere and effectively quarantined when they came to the county.

I should have asked what percent of cases do they do genomic sequencing on, and why this one.