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State and Local Officials Frustrated by Inequities in COVID-19 Vaccine Distribution

Orange County is currently (as of February 14) hospitalizing 790 COVID-19-positive patients; 257 of them are in Intensive Care Units (ICUs), a drop from over 400 ICU hospitalized patients just two weeks ago. St. Jude Medical Center will not confirm the number of COVID-19 patients currently being treated there, but a California government site shows a hospital corresponding with St. Jude’s location treating 97 COVID-19 positive patients at this time. Countywide, the availability of ICU beds has risen from a low of 70 on January 20 to 130 on February 12. Six months ago that number exceeded 400 available beds.

With a population of 142,824, Fullerton has recorded 10,750 known COVID-19 cases, a rate of over 75 per 1,000 residents, the 10th highest in the County. There have been 228 Fullerton residents who have died from it, or 1.6 per 1,000 residents—a rate exceeded only by four other cities in OC. Health professionals remain concerned about a possible rebound of infections and hospitalizations due to the ill-advised mixing of households at Super Bowl parties.

While testing is still a priority for the Orange County Healthcare Agency, much of their attention is focused on vaccinating as many individuals as possible in California’s Phase 1A categories, which include those age 65 and over, residents of long-term care facilities, and a wide range of healthcare workers. On Feb. 11 California updated the State’s Vaccine Allocation Guidelines to include the Phase 1B categories of Food and Agriculture Workers, Education and Childcare workers, and Emergency Service providers, but the guidelines are based on available supplies, which are too low at present to cover everyone in these sectors. The Orange County Health Care Agency (HCA) still shows the County vaccinating just Phase 1A individuals.

In a recent virtual “Breakfast Club” meeting hosted by Sharon Quirk-Silva, who represents the 65th District in the California State Assembly, HCA Director and County Health Officer Dr. Clayton Chau noted that there were over 200,000 healthcare workers of some sort in the County. He explained that when the State issued its new eligibility list he consulted the OC’s COVID-19 Vaccine Taskforce who decided to continue focusing all efforts for the following two weeks on seniors and heath care workers and evaluate their progress at the end of that period. OC’s Board of Supervisors approved the approach, although it meant not immediately expanding access in OC to the workers in the 1B category. Dr. Chau said the decision to remain focused on seniors was based on the statistics that showed that 72% of ICU beds were occupied by seniors in the recent COVID-19 wave and that 75% of those who died from it were over the age of 65. He said that ICU patients are evenly split between Whites, Latinos, and Asians, but did acknowledge that for patients under the age of 65, the majority who die are Latino.

Dr. Chau also reiterated his priority to address ethnic inequities in vaccination distribution. Overall, OC has administered more than 450,000 doses of either the Pfizer or Moderna vaccines, both of which require two doses to achieve maximum immunity. However, the County’s reliance on an online app and website called Othena, developed especially for the purpose of registering individuals for vaccine appointments, has resulted in Black and Latino populations receiving fewer vaccinations in proportion to their percentage of the population in the County. Latino populations in particular have suffered far higher amounts of infections and deaths from COVID-19 because many live in higher density housing with more people per household making infections more likely. They are also less likely, as a group, to be able to work from home, where they might avoid workplace transmissions of the virus. Additionally, language barriers also exist in some households, lessening the likelihood that they are aware of preventative health measures.

According to the HCA’s own data (https://coronavirus.egovoc.com/vaccines-administered-oc), Latinos make up only 11% of the total number of persons who have received at least one vaccine dose, while Whites make up 46%, Asians 26%, and Blacks 1%. Of those age 65 or older who make up 58% of those vaccinated so far, Whites represent over half at 57%, while Latinos drop to only 9%, Asians drop to 11%, and Blacks 1%.

Source: Orange County Health Care Agency.

During a February 12 press conference organized by Assemblywoman Sharon Quirk-Silva entitled “Vaccine Distribution for underserved communities in Orange County,” elected officials from Fullerton and neighboring cities gathered at the Richman Community Center to call for concentrating more resources on reaching the most vulnerable populations who are, not surprisingly, also the poorest and the least likely to have access to digital apps to make appointments, as well as being less likely to be aware of the vaccination opportunities, or  even to have health insurance (although the vaccines are free).

Fourth District OC Board of Supervisors Vice Chair Doug Chaffee, whose district includes Fullerton and Anaheim, also spoke during the press conference. Chaffee acknowledged technical problems with the Othena app and website, which debuted a month ago as a scheduling tool for vaccine appointments. The app crashed on its first day, and was not available in languages other than English, serving as a high profile example of the under-addressed inequities about which many of the officials complained. Chaffee said that technical issues have been fixed and that Othena now includes language options for Spanish, Vietnamese, and Korean.

Fullerton Councilmember Jesus Silva was one of the officials speaking on Feb. 12. “We do have to shift how we are doing things,” he said, citing his own octogenarian parents as an example of individuals who would not have been signed up for a vaccine appointment unless he had done it for them. He suggested going door to door, if necessary, to reach those who most need the vaccine but aren’t getting it. “I know we can do it safely.”

Frances Marquez, a member of the Cypress City Council, recounted her disappointment and frustration at making an appointment for her 80+ year-old mother, only to be told there were no vaccines when they arrived for it. She wrote a letter to the County of Orange urging them to set up a POD (Point of Distribution) site in her city rather than expecting older individuals to have to travel to the County’s SuperPOD sites at Disneyland or SOKA University in Aliso Viejo.

Buena Park Councilmember Susan Sayre, also speaking at the Richman press conference, said “We owe the communities everything. We have to be sure they have access to the vaccines,” referring to the workers in grocery stores and other crucial sectors of the economy. Dr. Jessie Jones, who directs the Center for Healthy Neighborhoods in Fullerton, described the vulnerable people her organization serves as “scared, hurting, and desperate,” and said they needed to be prioritized for vaccines.

Dr. Jessie Jones of the Center for Healthy Neighborhoods joined State Assemblymember Sharon Quirk-Silva and other local leaders at Richman Park in Fullerton on Feb. 12 to discuss the need for vaccinations in underserved areas.

It was not immediately clear to whom the urgent concerns of the gathered officials, who included school and community college board members, city councilors, and non-profit directors, were supposed to be directed, unless they were to Sup. Chaffee himself. As one of two Supervisors who form the Board’s ad-hoc vaccinations committee, Chaffee plays a critical role in helping to determine where the scarce vaccinations are available and to whom they should be given within the State of California’s vaccination allocation framework.

The County has, so far, concentrated efforts to reach underserved communities in the ZIP codes with the highest rates of infections, sickness, and death from COVID-19, in the western part of Anaheim, Santa Ana, and, to a lesser extent, San Juan Capistrano. Al Jabbar, a Deputy Chief of Staff for Sup. Chaffee and an elected member of the Anaheim Union High School District, said that although no distribution sites have yet been set up in Fullerton, there is work being done to reach individuals here who need assistance in scheduling vaccine appointments. Seniors in Fullerton have reportedly been called to make appointments for two March vaccination events at the Fullerton Senior Center.

To address the inequities in vaccination rates between ethnic groups, OC’s Health Care Agency is partnering with the non-profit Latino Health Access, who are, in turn, working with local organizations who are most familiar with individuals least likely to make their own vaccination arrangements and are most at risk from the virus. Once collected, their information is used to sign them up on the Othena platform so they will eventually be scheduled to receive a vaccination. The County recognizes that transportation is a serious issue for some individuals, and has brought in idle mini-buses from the Orange County Transportation Agency to drive individuals to and from vaccination PODS, often to so-called mobile sites, which are, in fact, static sites set up in different locations for single day use.  No such site has yet been planned for Fullerton, but two have been held at Magnolia High School in Anaheim, and a medium sized POD site is set to open soon at Santa Ana College that will be able to administer up to 1,000 shots per day.

At Richman park, Sharon Quirk-Silva spoke of her sadness at learning she had just lost another friend—a mother who leaves behind a son in high school— to COVID-19, but said she was “feeling more hopeful by seeing the resources we know are coming.” Two days prior, President Joe Biden announced efforts to purchase 2 million additional vaccine doses to be available by July, as well as steps to make more of the existing supply available to state and local governments within the next three weeks. If a new vaccine from drug maker Johnson & Johnson is approved soon, as is predicted, the supply would increase further.

State Assemblymember Sharon Quirk-Silva addressed COVID-19 inequities at a press in Fullerton conference on Feb. 12.

Asked by The Observer what she could do statewide to assist counties with the distribution of vaccines, Quirk-Silva acknowledged the supply issue, but said it was important that the limited number of doses sent to OC be allocated to not only the larger POD sites, but also to small trusted sites like neighborhood clinics and schools, when possible, and to CalOptima, the County’s Medi-Cal provider for low income and disabled residents. CalOptima is the healthcare provider for a full third of the 4th Supervisorial District, which overlaps much of the 65th Assembly District. Sup. Chaffee said that some vaccines had been allocated to CalOptima for distribution at clinics familiar to and trusted by constituents.

Quirk-Silva noted that CVS will now be working with senior care facilities and vaccinating in their stores, but that it didn’t seem equitable to her that three of the chosen stores were in south County. The CVS website’s list of stores in Orange County offering vaccinations includes Yorba Linda, Seal Beach (home of a Leisure World campus), San Clemente, Mission Viejo, Irvine, Huntington Beach, Costa Mesa, and Buena Park, but none in the hardest hit OC cities of Santa Ana and Anaheim, and none in Fullerton. “It’s still slow, and it’s too slow,” she said of the vaccine’s distribution, “and in the meantime people are dying.”

Asked how a site like the Richman Community Center itself might become a site for vaccines, Quirk-Silva referred to it as a County decision, but Sup. Chaffee explained that the sites must first be licensed by the state of California and clarified that CVS and other drug stores were sent vaccines directly from the State, not from the County which receives only 20% of the supply sent to OC by the State. He also noted that the County does not have access to data detailing who has received vaccinations from drug stores and hospitals, which receive the bulk of the other 80% of the supply and will not have that data until California releases its own app in the near future. Once that data is there, he said, “we can focus better on where the inequities are.”

“The whole thing can be resolved if we have plenty of vaccines. That’s the whole issue,” Chaffee said. “People are frustrated because they can’t get an appointment. We don’t have a vaccine to give them.” Chaffee predicted that by April there would be plenty of vaccines. In the meantime, when possible, the County would try to reach those most at risk, door to door if necessary, but until an adequate supply was available, it didn’t make sense to spend resources getting people excited about a vaccine when they couldn’t yet be served.

Sharon Quirk-Silva has introduced AB 420 that would allow amusement parks to reopen when the counties in which they are located reach the Orange, or “Moderate” Tier of the state of California’s Blueprint for a Safer Economy (Nearly all California counties remain in the Purple, or “Widespread” Tier for the foreseeable future). At present, only smaller theme parks are allowed to open in the Orange Tier, while larger ones, like Disneyland and Knott’s Berry Farm, both of which are located in Quirk-Silva’s Assembly District, must wait until their counties reaches the Yellow, or “Minimal” Tier to reopen. The bill is co-sponsored by Assemblywoman Suzette Martinez-Valladares of Santa Clarita, whose district includes Magic Mountain. Quirk-Silva and Martinez-Valladares are Chair and Vice Chair respectively of the Assembly Committee of Arts, Entertainment, Sports, Tourism, and Internet Media. The two legislators cite not only the substantial job loss caused by the inability of theme park workers to telecommute to work, but also the ripple effect on the local tourist economies dependent on the parks as reasons for the passage of the bill.

Commenting via Facebook during the Feb. 11 online Breakfast Club event hosted by Quirk-Silva, Anaheim City Councilmember Dr. José F. Morena wrote, “The Disney Open bill should include an equity threshold. If indeed essential workers who are disproportionately  Latino are not getting vaccinated, and surrounding communities of Resorts are hot spots, any reopening should in local data context of equity,” and “It’s clear from the session that before bringing thousands of tourists into our city we must assure the surrounding communities and workers are vaccinated. Disney has set up a great bubble but I worry about those outside the park.” Moreno represents Anaheim’s 3rd District, which borders Disneyland and includes one of the ZIP codes where residents have experienced the worst rates of COVID-19 infections and deaths in OC.

The County Healthcare Agency urges residents to visit covidvaccinefacts.com for more information or call the COVID-19 Hotline at (714) 834-2000.

1 reply »

  1. Poorly written article, statistics on ethnic groups receiving the vaccine are misleading, because it doesn’t reveal the % of each ethnic group in the total population of the City of Fullerton.