Marin shifts its vaccine focus back to residents 75 and older

Marin County is again shifting its COVID-19 vaccination plan, giving top priority to the county’s roughly 30,000 residents older than age 75 — with a goal of administering 2,000 shots of the two-dose inoculation per day over the next 30 days.

California’s framework for vaccine prioritization had initially called for the next phase, 1B, to start with those 75 and older, but on Jan. 13 it gave counties the option to lower the eligible age to 65 following the same revised recommendation from the U.S. Centers for Disease Control and Prevention. Those announcements came as Marin was wrapping up its offering to those in Phase 1A — health-care workers, first responders and seniors in congregate-living facilities — with the county on Jan. 15 saying it would adopt the new recommendation. Local health-care providers such as Kaiser Permanente immediately began allowing Marin residents 65 and older to book vaccine appointments, with Tiburon Peninsula residents reporting they were able to get their first doses as early as Jan. 17.

But with still-limited vaccine supplies, Marin officials announced Jan. 21 that the county, and all its health-care facilities, would refocus their efforts on the 75-and-older set.

“While we want to vaccinate every Marin resident, we have to start somewhere and this prioritization is the right move for Marin,” Dr. Matt Willis, the county’s public health officer, said in the announcement. “Three out of four COVID-19 deaths in Marin are among our residents 75 years or older. A vaccine offered a resident above age 75 is more than 300 times more likely to save a life than a vaccine offered to someone under age 50.”

Marin County spokeswoman Laine Hendricks said appointments made before the shift — such as for previously age-qualifying residents 65-74 or occupation-qualifying workers like educators and child-care workers — would still be honored, but almost all new appointments will be reserved for those 75 and up.

In a Jan. 20 question-and-answer session with Marin Villages, a nonprofit group of volunteers that help seniors age in place and stay active, Willis said he was anticipating a similar move would be made by the state but would be implementing it locally regardless of any new guidance from Sacramento.

State health officer Dr. Erica Pan said Jan. 20 during a meeting of the Community Vaccine Advisory Committee that the panel is “thinking very seriously about focusing primarily on age and not as much on the (workplace) sectors.”

Marin has the oldest population in the state, with roughly 25 percent of residents older than 65 and 11 percent older than 75. At the same time, nearly 93 percent of Marin’s COVID-19 deaths are among those older than 65, 77 percent among those older than 75.

Willis said that between high-risk essential workers and residents older than 65, Phase 1B would have made nearly a third of the county’s residents eligible for the vaccine, a demand that would far outstrip supply.

“We have nothing that we store,” Willis said. “We use all the doses we receive.”

While the phase’s first tier is now open only to those 75 and older, it will eventually include those 65-74 and high-risk workers in education, child-care, emergency services and food and agriculture — assuming that framework doesn’t change further. Its second tier would include moderate-risk essential workers as well as the homeless and incarcerated in congregate living facilities. Phase 1C would include those 50-64, those 16-49 with underlying health conditions and lower-risk essential workers.

The county’s citizen advisory group, which will help decide how to prioritize allocations and communicate with minority populations, particularly in Phases 2 and 3, met for the first time Jan. 15, though it was closed to the public. The group includes Southern Marin Supervisor Stephanie Moulton-Peters and representatives from Asian Advocacy, Canal Alliance, the Marin Child Care Council, the Marin Community Foundation, Marin Interfaith Council, Multicultural Center of Marin, North Marin Community Services, Performing Stars of Marin and the Spahr Center for LGBTQ residents.

Willis said although major health providers receive their vaccine supply directly from the state, rather than an allocation from the county, and are not mandated to follow the federal, state or county framework, Kaiser Permanente, MarinHealth Medical Center and Sutter Health have all agreed to follow his new prioritization.

Kaiser’s San Rafael Medical Center is requesting only Phase 1A-eligible patients book appointments online or by phone, saying it will individually contact those 75 and older when a vaccine and appointment is available for them. MarinHealth, formerly Marin General Hospital, also said it will contact its patients 75 and older for vaccine and appointment availability. Both have reported long call-center wait times and warn their lines are being overwhelmed, blocking other patients seeking care.

Sutter’s Novato Community Hospital is, however, accepting online and phone appointments for Phase 1A residents and those 75 and older at sutterhealth.org/covid-vaccine and 844-987-6115.

For those without insurance, Marin Public Health is offering vaccinations for Phase 1A residents, as well as those 75 and older who also receive home health-care services, Medicaid or are residents of low-income senior-housing facilities.

The county has also created a vaccine-interest form online, via arkn.ws/cov19vaxinterest, which intends to notify residents when it’s their turn to be vaccinated and how to book appointments. The form asks for age, race or ethnicity and medical condition, though it does not ask for specific occupations that could qualify a resident for a higher phase of eligibility.

According to data now being released on the county’s COVID-19 website, more than 20,250 Marin residents, about 7.8 percent of the population, have received at least their first dose of the vaccine, with about 3,700 of those receiving their second dose. The figures do not include residents of long-term care facilities vaccinated by CVS or Walgreens through a state initiative, or inmates at San Quentin State Prison.

Marin is doing better than California as a whole, which has administered at least one dose to just 4.7 percent of residents as of Jan. 24. The state has administered the highest number of total doses in the U.S. at roughly 2.2 million, but it ranks near last as a percentage of the 4.9 million doses it has received, about 45 percent.

The state’s lagging vaccination rate has been variously blamed on the state’s size and terrain for transporting the vaccine; that hospitals weren’t equipped with the required ultra-cold storage systems; that distribution software was buggy; that health-care workers feared they might be punished for giving leftover doses to those not eligible under the initial phase; and that there initially weren’t enough mass-vaccination sites.

Kevin Hessel is The Ark’s executive editor. Reach him at 415-435-2652, on Twitter at @thearknewspaper and on Facebook at fb.me/thearknewspaper.