The state is recommending that hospitals and health departments administer vaccines to people in Phase 1A and Phase 1B concurrently during January and February. As of Jan. 12, some health systems in California started making vaccines available to some patients aged 75 and older.
As demand from health workers and other people in the first phase wanes, vaccinators can begin inviting individuals age 65 and older to get their shots.
*Emergency services includes law enforcement, corrections, search and rescue, 911 call center employees, workers in disaster prevention, workers maintaining equipment supporting these groups, and workers responding to child, elder, and dependent adult abuse.
Phase 1C includes the following groups, and is expected to start between February and spring 2021.
- Individuals 50-64 years of age
- People age 16-64 with an underlying condition that puts them at greater risk of severe COVID-19
- Workers in water and wastewater, defense, energy, chemical and hazardous materials, communications and IT, financial services, government operations and community-based essential functions.
The proposed phase 2 would include people age 16 to 64 without underlying medical conditions, but that phase has not been broken into tiers.
Do you need to be a resident of a county to get the vaccine there?
Each county is making their own decisions on who to vaccinate and whether to factor in what county someone lives in — there is no statewide guidance on this. In Sacramento County, people are being offered the vaccine based on where they work, or where they are a patient. So for example, if you live in Yolo County but you work or are a resident at a Sacramento County long-term care facility, you can still get vaccinated in Sacramento.
What underlying conditions make you eligible to get the vaccine sooner?
At this point, the state does not have a list of underlying conditions that make someone eligible for a vaccine. As of Jan. 13, people older than 65 are eligible regardless of whether or not they have an underlying condition, though some health systems are prioritizing people based on their medical history.
When it comes to the general adult population — people between the ages of 16 and 64 — those with underlying conditions will have higher priority than healthy people. But the state has not specified which conditions are included in that criteria.
In a Dec. 23 presentation, the state’s Community Vaccine Advisory Committee estimated the following distribution dates to different groups:
➔ Phase 1A: December
➔ Phase 1B: January
➔ Phase 1B/1C: February
➔ Phase 1C/2: Spring/Summer
That timeline will vary by county, as each region of the state has a different population of workers in certain eligible sectors. The timeline is also contingent on how often the state gets allocations of vaccine doses from the federal government.
If a health department is getting through a tier quickly and has more supplies available, they can vaccinate multiple tiers at once but should coordinate with the state about available supplies before taking on a new tier or moving onto the next phase.
As of Jan. 4, Sacramento County is vaccinating only health workers and others in Phase 1A, and expects to stay on that group through January. They have not yet provided a ballpark date for moving to Phase 1B.
As of Jan. 13, Yolo County is vaccinating people in all three tiers of Phase 1A, and expects it will be at least another week until they move to Phase 1B. Their website is regularly updated with what tier and phase they’re on, and how many doses they’ve administered.
El Dorado County says it will move on to the first tier of Phase 1B by the end of the day Wednesday, Jan. 13. The county provides an updated timeline showing where they are in their roll-out plan.
Placer County says they plan to move to the first tier of Phase 1B in the second half of January, and that other phases are likely to roll-out during spring and summer. Their timeline, like with other counties, is contingent on how many doses they’re allocated and how many people sign up. To find out what phase Placer County is on, visit this vaccination website.
What is the state’s best estimate on when people outside of these groups will have access to a vaccine?
The state’s vaccine website says that Spring 2021 is the “best estimate” for the general public getting vaccinated, but that may change depending on vaccine production and how quickly other vaccines become available.
State health officials have said they expect the general public will have access to vaccines in early summer.
How is California deciding who gets the vaccine first?
California has a Drafting Guidelines Workgroup that’s developing guidance for how to prioritize allocation of vaccines. This group is housed within the California Department of Public Health and chaired by the chief of the department’s immunization branch and a past president of the National Medical Association. Its membership is made up of leaders from hospitals, academic institutions and health departments throughout the state.
There is also a Community Vaccine Advisory Committee made of representatives from dozens of organizations, including the American Civil Liberties Union, California Teachers Association and Disability Rights California, that looks over the state’s recommendations. The group holds virtual, public meetings to discuss priority groups and the reports back to the state.
The state is also trying to monitor equity in vaccine coverage by comparing what percentage of people have been vaccinated in vulnerable communities versus the percent vaccinated in less vulnerable communities. The committee has proposed using a tool called the Healthy Places Index to track these trends.
How are counties identifying people who are eligible for vaccination during each stage?
Since the first tier of Phase 1A covers hospital workers and both residents and staff at long-term care facilities, counties are largely relying on the institutions receiving the doses to create a list of employees or clients that need the vaccine, and to track who’s gotten it and who hasn’t.
City and county health departments should be doing outreach to other providers who qualify for Phase 1A, such as behavioral health workers and dentists, through social media and professional societies.
The next few tiers will involve working with schools to locate educators, sending teams out to fields to find farmworkers and “combing the internet” for home health providers, urgent care providers and others who need to be added to lists for vaccination, according to acting state health officer Dr. Erica Pan.
Counties are vaccinating people based on where they work, not where they live. So for example, a nurse who lives in Yolo County but works in Sacramento County would be vaccinated in Sacramento.
I’m a health worker or a member of another priority group and I haven’t gotten a vaccine. What should I do?
Reach out to your local health department, they should be tracking calls that come in from eligible residents. If you’re a health provider that is part of a professional society, they may have additional information.
Find contact information for every California county health department here.
How many vaccine doses have been distributed in California so far?
As of Jan. 9, the state health department has shipped 2,180,725 doses of the Moderna and Pfizer vaccines to county and city health departments, as well as hospital systems with facilities spanning multiple counties. You can find an updated list of how many doses each region and hospital system received here. Only 734,405 of those doses, or about a quarter of the total, have been administered according to the list. Each version of the vaccine requires two doses for the person to be fully protected, with the second coming around three weeks after the first.
Gov. Gavin Newsom said at a press event Monday, Jan. 4, that distribution has gone too slowly, and that he’s making efforts to speed the process such as allowing dentists to administer the vaccine after they take a special training. On Friday Jan. 8, the state issued a new rule giving counties the flexibility to offer vaccines to lower-priority groups if demand subsides in the current groups, or doses are about to expire. On Jan. 11, Newsom announced plans for mass vaccination sites in Sacramento, Los Angeles and San Diego.
Are there any safety issues with the vaccine?
Scientists at both the federal and state level have determined that the vaccine is safe and should be administered — except not to children under 16, people who are pregnant or people who are allergic to any of the ingredients in the drug. Though there have been documented side effects, vaccine experts say the benefits of taking the shot outweigh any potential negative consequences.
California created a Scientific Safety Review Workgroup, which began meeting in October to determine the safety of vaccines being approved by the U.S. Food and Drug Administration. The group notes side effects associated with both vaccines during clinical trials, but stated these were “not at a level of concern to change the recommendation that COVID-19 vaccines are safe and effective.”
The group recommended that the federal government continue to monitor for side effects related to the vaccine. Neither therapeutic has been tested on pregnant women or children under age 16. People who are allergic to any component of either vaccine should not be vaccinated. There are special considerations for people who are immunocompromised.
What are the known side effects so far, both short and long term?
In clinical trials, adverse reactions to the Moderna vaccine included pain and swelling at the injection site, fatigue, headache, soreness, chills, nausea and fever.
Data from the Pfizer clinical trials found the following most common short-term side effects:
- Pain at injection site (84.1%)
- Fatigue (62.9%)
- Headache (55.1%)
- Muscle pain (38.3%)
- Chills (31.9%)
- Joint pain (23.6%)
- Fever (14.2%)
- Injection site swelling (10.5%)
- Injection site redness (9.5%)
- Nausea (1.1%)
- Malaise (0.5%)
- Lymphadenopathy (0.3%)
In clinical trials, 64 of 38,000 people who received the Pfizer vaccine experienced lymphadenopathy (a disease of the lymph nodes), lasting for 10 days on average, which the CDC says is “plausibly related” to the vaccine. Four participants developed a type of facial paralysis called Bell’s palsy, which the CDC stated was not likely caused by the shot.
There were no documented severe allergic reactions among the 38,000 participants in the Pfizer trial or the 30,000 participants in the Moderna phase three trial. Still, the CDC says health workers should not immunize individuals with a known history of severe allergic reaction to any component of either vaccine.
Since vaccine roll-out began, 29 people in the U.S. have experienced a severe allergic reaction, and none have died. These reactions were from both the Pfizer and Moderna vaccine, and were not clustered geographically. A recent CDC report estimated the rate of anaphylaxis at 11 cases per 1 million doses given, which is higher than the flu shot. The majority of anaphylactic reactions happen within the first 15 minutes of the shot, so health workers are urged to have epinephrine on hand and monitor the patient after immunizing.