California prioritizes those over age 50 in vaccine line

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WALNUT CREEK, CA - JANUARY 6: Resident Jean Sullivan, 96, left, receives the Pfizer COVID-19 vaccine from resident physician Lauren Azuma during a clinic held at Byron Park, a Kisco Senior Living Community, in partnership with John Muir Health and local public health officials, in Walnut Creek, Calif., on Wednesday, Jan. 6, 2021. (Anda Chu/Bay Area News Group)

The move reflects growing recognition of elders’ risk.

California is changing its COVID-19 defense strategy to offer the vaccine earlier to a broader segment of the elder population, protecting the most medically vulnerable populations.

Elaborating on guidelines outlined by Gov. Gavin Newsom earlier this week, on Tuesday during California’s community vaccine advisory committee meeting Dr. Robert Schechter unveiled criteria that elevate people in two groups: ages 50 and 64, and 65 to 74 years.

The timing of this next step has not yet been announced, and the state’s coronavirus vaccination program for first priority workers and residents is lagging so far.

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“Very soon, as the supply increases over the next weeks, you can expect a formal announcement of when (the next phase) comes into effect,” said Schechter, chief of the Immunizations Branch of the California Department of Public Health and co-chair of the state’s drafting guidelines workgroup.

Of the 2 million doses of COVID-19 vaccine that have been allocated to health departments in California, about 490,000 doses have been administered. The state is enlisting dentists, pharmacy technicians and other health care providers to expand its delivery of shots. Another 1 million doses should be arriving in the state soon.

“There has been a slower ramp up than hoped,” the state’s acting Public Health Officer, Dr. Erica Pan told the vaccine advisory committee. “We continue to get better with every step.”

Although three different strategies have been proposed to stretch supplies — using a half dose, delaying a second dose and mix-and-matching doses — there’s too little scientific evidence to change the current approach without study, according to the new director of California Department of Public Health, Dr. Tomás Aragón.

California counties are still vaccinating healthcare workers at highest risk – those in direct contact with COVID-19 patients or the virus’s infectious particles. And the vaccination program to inoculate residents and staff of nursing homes and assisted living facilities — also in the highest priority group — is just getting started.

Alameda County estimates that it can complete this group, identified as phase 1a, by the end of January 2021, but the timing is dependent on vaccine supply and participation rates. San Mateo County expects phase 1a to continue through the end of February. Other counties did not offer their timelines by deadline.

As the state struggles with a nightmarish surge of new cases and deaths, the group assigned with setting guidelines has updated and refined the list of who is next in line.

People at least 75 years old are still grouped at the top of phase 1b —just below phase 1a — so they’ll get a vaccine before it’s available to the general public. This 1b group, categorized as tier 1, also includes workers in education and childcare, emergency services, and food and agriculture.

What’s changed is access for people ages 50 to 74. Seniors of ages 65 to 74 years have been elevated to the next in line, phase 1b, tier 2, along with workers in transportation / logistics; industrial, residential and commercial sheltering facilities; critical manufacturing; and incarcerated and homeless people.

Next come people ages 50 to 64. This group, classified as 1c, also includes people ages 16 to 49 with an underlying medical condition or disability. Workers in defense, energy, IT, water and wastewater, chemical and hazardous materials, communications, financial services, government operations are also in this priority group.

The move reflects many emotional appeals made by residents who wrote to the state committee. Since Oct. 1st , 65% of those hospitalized and 80% of those who died of COVID-19 were 61 or older.

“Hospitalization and ICU use are driven by the older population, as is the death rate. Prioritizing the elderly would decrease the burden on statewide hospital systems, particularly in critical care areas, and sharply decrease the death rate. This in turn
would improve normalization of business, large and small,” wrote San Carlos vascular surgeon Dr. Walter Kwass.

“I worry every day about my husband, who is 65 with heart disease”, said Deborah Biederwolf of Emeryville, a nurse at Alta Bates Summit Medical Center. “I’m writing you with concerns about the priority on who receives the vaccine.”

On Tuesday, the state also outlined what high-risk conditions will give Californians a boost in line. They are: cancer, chronic kidney disease, chronic obstructive pulmonary disease, heart conditions, organ transplant, obesity, pregnancy, sickle cell disease, smoking and type 2 diabetes mellitus.

(Mercury News)

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