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California Phase 1A, 1B & 1C vaccination guidelines
#1
California's guidelines for vaccinations in phase 1A and 1B are published at the CDPH.
  Santa Clara County reinterpreted those (inaccurately, in my opinion) and published SCC's interpretation on their website.  For instance, SCC added all staff at all medical facilities to 1A differently than the state's document which specifies persons at risk of exposure, while the CDC described that part of group 1A as healthcare workers (with direct or indirect exposures).

California's guidelines broadly follow the CDC recommendations for Phase 1A - 1C.

Those in group 1C (65yo, 16-64 with comorbidities, and "essential" workers)  can expect their first dose to be between April through August, if there is enough vaccine.
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#2
Gov. Newsom announced changes on Monday Jan 4 to who is in phase 1B and 1C in California. (I missed these changes until Saturday) Primarily this accelerated the older population relative to some of the essential workers. For the older groups, the requirement for co-morbidities was dropped.

Community Vaccine Advisory Committee's latest meeting was January 6 (3 hr video [www.youtube.com]/watch?v=yjIf6iowt3o  See 31:30;  slide deck).  This shows the changed recommendations for phase 1B and 1C.  These are now posted at the CDPH.

Public Comment can be submitted here:  COVID19VaccineOutreach@cdph.ca.gov

The next meeting is January 20 (every 2 weeks).

Note that California phase 1B Tier One is basically equal to CDC phase 1B, while California phase 1B Tier Two is mostly similar to CDC phase 1C (as adopted Dec. 22 by CDC) except for adding prisoners & homeless.    Hmm..... perhaps renamed to sound like they are doing it faster?

I'm adding population counts (from Dec. 23 meeting slides).  For the work sectors, not all are at risk of exposure, but the number is the estimated total size in California. I'm adding my estimates of dates for first doses based on my understanding of expected ship dates (OWS schedule),


1A:  (~2.5M; cumulative 2.5M; Dec - late Jan 1st doses (vaccination dates, not distribution dates). Jan. 10: 2.3M distributed to CA)
  • Healthcare workers
  • LTCF residents
1B Tier One:  (<8.5M;  cumulative 11M; mid Jan - late Feb 1st doses)
  • Individuals 75 and older (2.6M)
  • Those at risk of exposure at work in the following sectors: education & childcare (1.4M), emergency services (1.1M), and food and agriculture (3.4M)
1B Tier Two: (<7.5M; cumulative 18.5M; late Feb - late Apr? 1st doses (hole in March))
  • Individuals 65 -74 years of age (2.5M+1.0M)
  • Those at risk of exposure at work in the following sectors: transportation and logistics(1.1M); industrial, commercial, residential, and sheltering facilities and services (2.1M); critical manufacturing (0.5M)
  • Congregate settings with outbreak risk: incarcerated(0.2M) and homeless (0.1M)
1C:  (13M??; cumulative 31.5M???;  Currently only about 25M first doses purchased for California )
  • Individuals 50-64 years of age (?)
  • People 16-49 years of age and have an underlying health condition or disability which increases their risk of severe COVID-19 (<10.0M?)
  • Those at risk of exposure at work in the following sectors: water and wastewater(0.02M); defense (0.06M); energy(0.1M); chemical and hazardous materials (0.2M?); communications and IT (0.3M); financial services (0.6M); government operations / community-based essential functions (0.9M)
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#3
I chased down the 2.5M people for the 1A group that were quoted above (Slide 24 of CVAC mtg #4, Dec 23)

The number comes from 2.5M healthcare workers minus 0.4M not at risk plus 0.4M residents in LTCF.

This number indicates that  2.5/39.5 = 6.3% of the CA population are health care workers.
This stands in stark contrast to Florida where there are about 500K healthcare workers for 21.5M people, or 2.3%.



In my opinion, California's Community Vaccine Advisory Committee got its head stuck in the Critical Infrastructure vise.  The slides for meeting #3 (Dec 9) when they were setting up phase 1A never mention older people or LTCFs as members of 1A.  Their numbers were not considered.
Age was only mentioned in relation to essential workers.

If you go back to CVAC  Meeting #2 (Nov 30), you will see in slide 16 and 17 that the CVAC was not going to include LTCF residents unless the CDC ACIP committee included it.  In this meeting, the estimates were 2.4M healthcare workers minus 0.4M at no risk, and 0.4M LTCF residents.

Meeting 3 indicates  2.5M Healthcare Workers (slide 31).
GACH Healthcare Workers 733,857  (General Acute Care Hospital)
Healthcare Workers 1,338,750
MCE Healthcare Workers 477,873  (Multi County Entity -  Kaiser, Sutter Health, etc.)
Total 2,550,480


Immediately after meeting #3, announcements were made that dentists were considered to be part of phase 1A.  "Dentist" does not appear in the slides for the meeting, nor do the 2.5M healthcare workers seem to include the 36,000 dentists.

California didn't provide any organized mechanism for vaccinating LTCF until a December 28 announcement of California joining a federal program for CVS & Walgreens to provide vaccinations to 856 nursing homes.  At that time, it was estimated that it would take 3-4 weeks to complete.

The CDPH database of Licensed Healthcare Facilities indicates 2577 Long Term Care facilities (1209 Skilled Nursing Facilities, 1104 Intermediate Care Facilities (mostly < 20 beds; one 1450 beds).

That database does not include all places that provide assisted living facilities.  As an example, Sunrise in Palo Alto is not listed, but it is listed in SCC's list of LTCFs.
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#4
Updating my earlier numbers (with 65+ moved)

CA Population: 39.5M
 0-15:  7.9M
16-49:  18.5M
50-64: 7.3M
65-74: 3.4M
75+:    2.6M
Eligible population (16+): 31.6M

California population numbers for each group below are from CA Vaccine plan  and other planning documents.
Double the numbers for doses needed.

Phase 1-A : 3M  9.5% of eligible population (Originally estimated as 2.5M people (300K Long Term Care residents & staff; 2.2M "front line" health care) 
   Roughly late January to have enough 1st doses

Phase 1-B Tier 1  8.5M  27% (8.5M was before 65-74 added)   11M, 35%   Total 11.5M - 14M or 36% - 44%
  75+: 2.6M   Census says 2.4M.  2.1M is a better estimate (2.4M - 300K LTCF)
  65-74:  2.5M   Census says 3.4M  3.1M is a better estimate (3.4M - 9.5%)
  Education & Child Care: 1.4M
  Emergency Services: 1.1M
  Food and Agriculture: 3.4M
At current production levels, the last of this group get first doses around April 1.

Phase 1-B Tier 2  3M  9.5%  Total:  14.5M-17M or 46%-54%
  Critical Manufacturing: 0.5M
  Facilities & Services: 1.1M
  Transportation & Logistics: 1.1M
  Incarcerated: 0.2M 
  Homeless: 0.1M 

Phase 1-C:  12M   38%   Total: 26.5M-29M or 84%-92%.
  50-64: 4.9M  (7.3M pop - 33% in prior phases)
  16-49 high risk: 5M   (40% of 18.5M 16-49 - 33% in prior phases)
  Chemical 0.2M
  Communications and IT 0.3M
  Defense 0.06M
  Energy  0.1M
  Finance  0.6M
  Govt  Ops, Community-Based  0.9M
  Water and Wastewater  0.02M

Everyone else:  2.6M - 5M
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#5
M_T,

Do you have any clues as to what rate eligible people are getting the vaccine in CA? I have only seen anecdotes.
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#6
At this point, the vaccination numbers are a mixture of phase 1A and phase 1B Tier 1 (65+), so it is hard to tease out the numbers.  We didn't have clear numbers (that I know, anyway) for the first vaccinations at the end of phase 1A.  It is also hard to understand delays in rolling the shots out.

It is clear that although the vaccines were in short supply, there were a lot of first doses that sat at vaccine administration sites (hospitals, etc.) in December. 

The best I can say is that California originally predicted 2.5M  people in phase 1A, but now estimate 3M.    We are now seeing phase 1A second doses being given (3 or 4 weeks after early January).  Just under 500K people have gotten 2nd doses in CA.  That's just 25% of the originally estimated phase 1A.  (I believe very few of the 300K LTCF people in phase 1A have gotten their 2nd shots -- not because they refused them but that CA didn't get them to them.)

The US originally predicted 21M in phase 1A.  4.7M have received 2nd doses (meaning 1 doses by about Jan. 1).  Again about 25%. 

These are totals, not per week.  Remember, Pfizer 2nd dose is 3 weeks later;  Moderna, 4 weeks later.
So, today's numbers (Jan 28) of 2nd doses represent Pfizer doses given through about Jan 6 and Moderna through Dec. 31.
Total 1st dose distributions by Dec. 21: Pfizer: 5M ;  Moderna 6M
Total 1st dose distributions by Dec. 28: Pfizer: 7.6M; Moderna 8M
Total 1st dose distributions by Jan. 4:  Pfizer: 9.7M; Moderna 10.1M

Someone probably has done surveys of phase 1A vaccination rates but I haven't seen it.  I expect, for instance, Stanford Hospital knows how many of its staff has taken a first dose.  That may be a different percentage than, say, healthcare staff at some skilled nursing facility.

It is an entirely different question about the rate of vaccination demand in the general population, and among them, the demand by different age groups.
And, of course, the anti-vaxxers in Marin County (CA) and in rural Louisiana may be very different.



Stanford hospital might be a good example for which  I have data.  There was early data on their distribution.  Their current information is available .

The early posting indicated about 15K healthcare workers.  Current posting indicates about 15K (Santa Clara + Alameda counties) have gotten both vaccinations.
The early posting indicated about 30K total population.  Current posting indicates about 25K have gotten at least one dose (of 29K doses received).

The 15K of healthcare workers were in phase 1A.  But I don't know the justification for the other 30K.  It may have been improper for the state or county to give them enough doses to cover everyone at Stanford Medicine.  (Maybe things like this is why the state raised the estimated Phase 1A from 2.5M to 3M.)
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#7
A bunch of news articles indicate 40% or so of health care workers are choosing to not vaccinate. However, it's only news if the number of people who decline is high. Therefore, it probably doesn't mean much.

I am not finding out how to post a link so I will post the link text:

https://www.miamiherald.com/article248483530.html

https://www.miamiherald.com/news/coronav...26355.html

https://abc7.com/la-county-covid-vaccine/9450876/

https://www.washingtonpost.com/local/nur...story.html
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#8
There are 3 ways to reply. 
(1) One is the "Reply" button with the Cartoon Quote image in it at the bottom of each message (with Edit, Delete, Reply, Quote, Report" buttons.  That should give you the full editor with all the buttons for doing things like links.

(2) There is the black "New Reply" button below the last post

(3) Finally, there is the "Quick Reply" form at the bottom of the page.  That doesn't give you any of the buttons for doing things like links.  You are still able to enter Bbedit-style tags like this, but without the spaces
    [ url=https://www.miamiherald.com/article248483530.html]Half of Miami’s COVID front line passed on vaccines.[ /url]
After you've entered some text, if you click on "Preview Post", you get the full set of buttons including for links.
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#9
I'll point out that I personally don't consider hesitancy to take the vaccine as a sign of ignorance.

The vaccine is even newer than the disease. We've had maybe 6 months experience with the vaccine, which isn't a lot. As I mentioned on the old board, I remember thalidomide. I think caution and careful weighing of the risks are appropriate.

I also mentioned that I have a relative who is a medical researcher & head of a university department that was leery of the vaccination approval process. He's very conservative in his use of medicines, requiring evidence of benefit. But he saw the results of the trials and was convinced. He has gotten his 2nd vaccine now, and his wife will be getting her 2nd shortly.

For those of us in high risk groups (certainly 65+, and I believe those 50+ and 18-49 with the extended set of underlying conditions, or similar), it seems a no-brainer. The risk of the disease is so great compared to the risk of the vaccination.

One of the conundrums is for young females that are or may be considering being pregnant in the near future. The two current vaccines weren't tested on pregnant volunteers. However, pregnancy is listed as one of the underlying conditions that increases ones risk of poor outcome from COVID. The CDC approved the vaccines for pregnant women.
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#10
Agreed. It always seems to come down to weighing two risks, both of which are unknown.

I wonder how I will advise my children, 19 and 20, when their turn in line comes. Low risk for them if they get the disease. In the best case scenario, the risk of getting the disease to being with may be lower because so many others are vaccinated. Plus, with a longer life expectancy a neurological disorder like Guillain-Barre syndrome somehow seems even more tragic.
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