January 14, 2021

California expanded access to the Moderna and Pfizer COVID-19 vaccines to those 65 years old and older today, adding six million more people to the vaccine line on top of the 1.5 million healthcare workers and long-term care residents prioritized for vaccination.  

The expansion to those 65 and up comes as the rollout of vaccinations continues to be bumpy in California, with little state coordination and multiple entities tasked with identifying eligible recipients and administering the vaccine.

In an urgent meeting the California Department of Finance Wednesday morning, CSAC, along with the Urban Counties of California (UCC), Rural County Representatives of California (RCRC), the County Health Executives Association of California (CHEAC), and the Health Officers Association of California (HOAC) requested immediate state funding to fill in the gaps left by federal and other funding streams, many of which are on the way but have not yet been allocated.

CSAC President and Sonoma County Supervisor James Gore also participated in a meeting called by the Governor late last week to expedite the vaccine rollout. Leaders from health plans, clinics, doctors, and other public health and health care stakeholders in the meeting heard President Gore advocate on the importance of the county role in vaccine distribution and our readiness to partner with the state and everyone else to, as President Gore is fond of saying, “get it done.”

A rapid state response and immediate funding for vaccine site logistics, security, workforce, and communication with the public is necessary, and we hope to hear from the Governor on emergency funding within the next 24 hours.

The above county coalition raised additional needs, outlined in this January 11 joint letter, including: 

• Increased vaccination coordination via a nimble strike team of key decision-makers as well as a broader state-led weekly stakeholder forum for communication on all priorities and issues around vaccine distribution, administration, and tracking.
   
• Allow counties to lead efforts to implement state priorities on vaccines by providing county workforce flexibility, relief from some liabilities, and close coordination with other local vaccine players, as well as providing timely data on vaccine allocation and distribution by all other entities in each county.
   
• Utilize the existing county LEMSA mutual-aid structure to manage capacity and identify and respond to county needs, and commit to working with affected counties when a broader solution is required.

Overarching all of these needs is the question of vaccine availability, as county public health departments and health plans have no control or timeline associated with receiving vaccines. As of last night, 2,466,125 vaccine doses have been shipped to California, and 816,673 have been administered statewide.

For counties, the new 65+ expansion adds additional pressure on county public health departments and public communication efforts even as counties strongly support efforts to vaccinate as many Californians as quickly as possible. Meeting the vaccine challenge requires immediate state coordination, communication, funding, workforce flexibility, and a massive increase in the number of doses available to counties.

We’re not there yet on any of these fronts, but will keep counties updated.