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Editorial: Turning around the COVID vaccine debacle

by BAR Editorial Board

People sit at a COVID vaccine site in San Francisco. Photo: Sari Staver
People sit at a COVID vaccine site in San Francisco. Photo: Sari Staver  

So far, Governor Gavin Newsom's administration has largely failed to manage a comprehensive COVID vaccination effort for California. It's critical to inoculate as many people as possible before new strains proliferate and mutate further, possibly rendering the available vaccines useless. As time passes, the probability of effectively containing the pandemic diminishes.

There are a number of reasons why the vaccination effort has faltered. As the Los Angeles Times reported, "For weeks, vaccine access was limited to only health workers and nursing homes. Data snafus complicated the picture, as did the structural barriers of such a large, decentralized state that leaned heavily on 61 local health departments. But the biggest and most persistent problem has been beyond the state's control: Officials have been hamstrung by vaccine supply shortages and lack of predictability from the federal government and the manufacturers."

For it's part, the federal government is making changes to address the supply problem. The Biden-Harris administration will increase overall, weekly vaccine supply to states, Tribes, and territories to 10.5 million doses nationwide beginning this week, the White House stated February 2. "This is a 22% increase since taking office on January 20," the White House said. "The administration is committing to maintaining this as the minimum supply level for the next three weeks, and we will continue to work with manufacturers in their efforts to ramp up supply."

Newsom announced Wednesday that with help from the Biden administration, large-scale vaccine sites would open by mid-February in Oakland and Los Angeles. It's a pilot program that is part of a larger effort to set up 100 vaccination sites nationwide in 100 days.

But there's been a problem quantifying health consequences for the LGBTQ community that's been looming over the state from the beginning. As we've written before, the lack of sexual orientation and gender identity data means that the LGBTQ community doesn't have a clue as to the severity of the virus' impact on us, although some early surveys have pointed to unique health risks that put LGBTQ individuals at greater risk of contracting COVID. Without accurate data, health policy cannot be written to identify and prioritize LGBTQ people most in need of early vaccination.

And it turns out that no matter how many inquiries gay state Senator Scott Wiener (D-San Francisco) makes to state health officials, they are hampered by an obscure federal panel that he didn't even know about until the former acting director of the California Department of Public Health told him of it late last year — months after he started sounding the alarm about the lack of SOGI data and nearly a year after the pandemic started. As we reported last week, the Public Health Work Group oversees what are known as Health Level Seven International (HL7) standards that provide guidance on the collection of certain patient characteristics, such as racial and ethnic data. But they do not include sexual orientation and gender identity data, which has hampered efforts in California and other states to collect health information about LGBTQ people in order to better address unique health risks related to COVID infection. Wiener and Dr. Mark Ghaly, the state's health secretary, had written to the Public Health Work Group, asking that it immediately include the SOGI questions in such a way that labs in the state can incorporate the information and the state's electronic disease reporting and surveillance system can read it.

The Public Health Work Group responded that it's working on the issue. Unfortunately, that's likely to take a lot more time. And, as Wiener pointed out, the group's response lacked specificity.

Again, time is of the essence: mutant strains threaten to undo the progress made against this virus and may leave us without options. Newsom needs to quickly loosen up the vaccine logjam — more supply from the feds is crucial, of course, but so is opening more sites and leaving room for some flexibility. One Bay Area site was shut down recently because it was reportedly giving shots to people deemed ineligible. Questions of equitable access to vaccines must be balanced with a common sense approach to uncommon situations. The doses should not go unused — there was a great story that made the news about health workers stranded on a snowed-in road in Oregon who, instead of allowing their batch of vaccines to expire, just started vaccinating other stuck motorists. In so many ways, the clock is ticking down, and we've no time to lose.

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