As SLO County COVID death toll rises, state gives confusing direction on vaccine rollout

Good news: Californians over 65 are now eligible for the COVID-19 vaccine.

Bad news: Eligibility doesn’t actually mean you can get the shot.

As of now, there is only enough vaccine available in San Luis Obispo County to begin vaccinating residents over 75, and the county opened that population to begin receiving shots as of Monday.

But there isn’t even enough for them; the county will be able to give approximately 4,000 first doses next week, but there are approximately 26,500 people 75 and older in our county.

The lack of available vaccine is due to many factors that are way beyond local control.

Here’s one: The county is required to hold enough doses in reserve to provide the necessary second shot to people who have already gotten their first one.

That’s not an arbitrary decision; when the county receives vaccines, they are designated as first or second doses and, according to county Public Health spokesperson Michelle Shoresman, “must be administered as such.”

Public Health Officer Dr. Penny Borenstein has asked for permission to use some of the second doses as first doses, Shoresman said, and has gotten some guidance from the state on the topic of converting second doses to first doses.

“We are looking at this guidance and seeking clarification from the state as well as evaluating our local data so that we can best implement it here,” Shoresman said via email. “Our goal is to continue to give out as much vaccine as possible.”

Freeing up second doses wouldn’t make a huge difference in San Luis Obispo County right now; Borenstein said Wednesday that there were just over 7,000 second doses on hand.

Still, that could get more shots in the arms of a significant number of people who are at highest risk of becoming seriously or fatally ill from COVID.

And it would make more of a difference in the future if counties don’t have to hold back as many doses in the reserve.

Policy on doses

Keeping second doses in reserve was the policy early on, but that’s been revised by the federal government.

Both the Trump and Biden administrations are now saying that vaccine production is speeding up, allaying the fear that there will not be enough vaccine available for second doses.

Under the circumstances, the state Department of Public Health should be encouraging counties to vaccinate as many people as possible, as quickly as possible.

Instead, there’s confusion as to where the state of California stands in regard to the two-dose regimen.

We emailed the California Department of Public Health Press Office on Thursday for clarification on whether counties can go ahead and use all available doses and got this response:

“Received your inquiry and are working on it but don’t know if we’ll be able to meet your deadline.”

That’s ridiculous, and we have the governor to blame for that.

Shouldn’t he have clarified the guidance on holding back doses before expanding eligibility to people 65 and over?

Instead, he threw county health officers under the bus by offering something they weren’t prepared to deliver.

Medical opinions

It’s past time to stop hoarding vaccines, which is the recommendation of a growing number of medical experts.

One is Robert M. Wachter, dean of the Department of Medicine at UCSF.

He initially supported the recommendation that two doses be delivered within a month. No longer.

“It’s time to change the plan; namely, we should give people a single vaccination now and defer their second shot until more doses of vaccine become available,” he wrote in an op-ed in the Washington Post.

He also wrote that clinical trials of both the Pfizer and Moderna vaccines “showed that the first shot had a substantial benefit beginning around 10 days afterward.”

A Jan. 6 update from the Centers for Disease Control includes this information: “There is no maximum interval between the first and second doses for either vaccine. Therefore, if the second dose is administered >3 weeks after the first Pfizer-BioNTech vaccine dose or >1 month after the first Moderna vaccine dose, there is no need to restart the series.”

The Food and Drug Administration, however, is sticking to its original advice on the 3- and 4-week dosing schedule.

“We have committed time and time again to make decisions based on data and science,” the agency said in a Jan. 4 statement. “Until vaccine manufacturers have data and science supporting a change, we continue to strongly recommend that health care providers follow the FDA-authorized dosing schedule for each COVID-19 vaccine.“

Note the word “recommendation.”

Each state — and each county — should have the ability to determine the best course of action, based on their circumstances.

Right now, the situation in San Luis Obispo County — as in much of California — is dire.

COVID-19 is now the leading cause of death in our area; as of Friday, 128 people have died of the virus here.

Our county Public Health Department is to be commended; it’s administered about 57% of the doses it was allocated, compared to only 31% statewide.

But that’s not enough, and the fault lies with the state.

It’s raised expectations that the vaccine will be available, and now it’s failing to give clear direction to the counties.

Newsom should make it clear that counties can use all available doses now, even if it means second doses may be delayed.

Lives may depend on it.

How to sign up for vaccine alerts

To receive email alerts on the latest changes with vaccine distribution, sign up on the county’s “subscribe” page, www.emergencyslo.org/subscribe and click the box for “vaccine updates.”

This story was originally published January 14, 2021 at 3:06 PM.