City Plans Major Expansion in Vaccine Capacity

The announcement comes in the wake of criticism of the city’s vaccination program from the public and at least one Supervisor.

Dodgers Stadium, Cal Expo, Petco Park, Disneyland. All of these pleasure grounds are in California, have giant parking lots, and are being transformed into vaccination hubs. One more thing they have in common: none are in the Bay Area. 

Over the past week, the lack of a mass vaccination site in San Francisco or elsewhere in the Bay became a symbol of a frustratingly slow and opaque vaccination program, plagued by problems on many fronts. At a press conference on Friday, Mayor London Breed sought to shift the narrative, announcing three new high-volume vaccination sites and outlining the city’s overall vaccination plan. She emphasized that the real barrier to getting people vaccinated is not the city’s organization, but the number of vaccines the city and its various healthcare providers are receiving.

“I want to be clear with the people in San Francisco: we have a plan,” Breed said. “The locations are not the problem. It’s the supply.” 

The Basics

There are currently two coronavirus vaccines available in the U.S., one from Moderna and one from Pfizer. The vaccines are similarly effective (over 90 percent), and function much the same way, using a new mRNA technology. Both require two doses, spaced about a month apart. 

The vaccines are ordered from the federal government on behalf of the states, who then distribute them to local jurisdictions and healthcare providers. Since the beginning of the year, California has distinguished itself as one of the slowest states to allocate the doses that it has received. There are several reasons for this: California has a fairly strict vaccination schedule with severe penalties for those who try to violate the rules. It’s a geographically large, highly-diverse state that makes large-scale planning and coordination difficult. There have also been unexpected issues related to an unpredictable supply of vaccine doses, more healthcare workers than expected refusing the vaccine, and a technical glitch in the state’s vaccine tracking software program. 

In response to these hiccups, on Jan. 6 Governor Newsom announced a vaccination sprint that he promised would administer one million doses in 10 days. Shortly thereafter, Newsom announced that the aforementioned ballparks and theme parks were being transformed into mass vaccination sites. A federal government rule on Jan. 12 allowed states to vaccinate anybody 65 and up, dramatically expanding the pool of eligible recipients. 

But as all these developments were unfolding, no major vaccination plans were being announced in San Francisco. Frustrated residents took to social media to vent. Supervisor Matt Haney joined the chorus, calling on Mayor Breed and the Department of Public Health to establish mass vaccination sites at Kezar Stadium or Chase Center, and increase the transparency of their vaccination planning process. Private healthcare providers weren’t doing much better. Kaiser patients experienced hours-long waits on its vaccination hotline, and other providers’ websites crashed. 

The Latest Numbers 

As of Monday, Jan. 18, 1,454,626 doses of the coronavirus vaccine had been administered in California, out of about 3.2 million doses received. However, the California Department of Health emphasizes that reporting could be delayed, meaning these numbers may not be perfectly accurate. Governor Newsom and other state officials have insisted that the state met or exceeded its goal of distributing one million doses in 10 days. On Jan. 6, when the blitz began, California had administered about 480,000 doses. 

Despite increasing the pace of its vaccination efforts, California remains near the bottom of the list of states in terms of what percentage of its vaccines have been administered. According to the latest California DPH data, the state has administered about 45 percent of the doses it has received — that’s up from a vaccine distribution rate of 36 percent just a few days prior. Still, the Golden State remains below the U.S. average of 52 percent, according to this metric, as well as vaccines administered per capita. Nearly 4 percent of Californians have received at least one dose of the vaccine so far, according to the Bloomberg Vaccine Tracker. Several small, rural states have vaccinated upwards of 6 percent of their populations.  

At the press conference Friday, Mayor Breed emphasized that the vaccines the city has received have all either been administered or assigned. “We are not sitting on any vaccines, they are all moving out the door,” she said. 

As of Tuready, Jan. 19, the city’s Department of Public Health had received 31,655 doses, and administered 15,545. This effort has been complicated by an inconsistent number of vaccines coming in. The city had been receiving about 3,500 vaccines per week, but then, the week of Jan. 4, the city received 12,000 doses. 

This represents a fraction of total vaccines received and administered in San Francisco, as private healthcare providers undertake their own vaccination drives. The total number of San Francisco residents who had been vaccinated was unknown to the public until Tuesday, when the city released its vaccine dashboard. As of Jan. 18, 29,995 city residents had received at least one dose of the vaccine, and 35,308 total doses had been administered. The city is averaging about 1,800 doses administered per day.  (After publication, at a hearing on Jan. 20, SFDPH officials revealed that their goal is to vaccinate every city resident by the end of June.)

Ramping Up?

Those numbers are not where city officials want to be, and now, there are publicly released plans to speed up the vaccination process. As early as this week, the first of three planned mass vaccination sites, at City College, could be up and running. These sites, which also include the Moscone Center and the Wholesale Produce Market in Bayview, will be complimented by pop-up and mobile vaccination operations. The mass vaccination sites will be open to people from all of the city’s healthcare providers.

Altogether, the city’s planned and existing capacity will eventually be able to provide 10,000 vaccinations per day, Breed said. So, just as a back of the envelope thought experiment, if those sites run as designed and the city has enough vaccines coming in, San Francisco could vaccinate its entire population of approximately 900,000 people — with two doses — in 180 days.

“In terms of distribution, we are ready to ramp up to distribute 10,000 doses per day in the city as long as we receive the supply to do so,” Mayor Breed said at the press conference.

Of course, vaccine supply continues to be an issue, although the situation could be improved with the expected approval of the Johnson & Johnson and AstraZeneca vaccines in the coming months. President Joe Biden has pledged to disseminate 100 million doses in his first 100 days in office by invoking the Defense Production Act. Dr. Anthony Fauci has called that goal “an absolutely doable thing.” If Biden and Fauci are right, Mayor Breed promises that San Francisco will be prepared. “We’re ready for more doses,” Breed said. “We need more doses. We’re asking for more doses so we can ramp up and open these sites.”

Another issue critics have pointed to in the city’s vaccination program is a lack of information. Other counties, including Alameda and Contra Costa, have online portals that essentially allow people to get in line for the vaccine. Until Tuesday, Jan. 19, San Francisco lacked such a portal. Now, people who live or work in the city can go to sf.gov/vaccinenotify to sign up to be notified when a vaccine will be available to them.

For most people, that will still likely be a while. San Francisco’s vaccination program has been slowed by the fact that the city is such a major hospital town. The city has somewhere between 80 and 90 thousand frontline healthcare workers who need to get vaccinated first, a much larger proportion of the total population than many other counties.

Breed, whose tone of voice during the press conference was more strained and frustrated than usual, pushed back on critics, calling out Sup. Haney in all but name. “What we don’t need, especially from other public and elected officials, is misinformation about what is actually happening in San Francisco,” she said.

Haney, for his part, responded on Twitter, saying, “Here we go! Things are happening. Apparently I made some people mad by asking too many questions this past week, the same questions my constituents are asking. Don’t get mad, get active. Let’s get it done. Vaccines save lives, this is it.”

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