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As Blue Shield Takes Control Of California Vaccine Rollout, Some Counties Worry About Distribution

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Marcio Jose Sanchez
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AP Photo

As health care giant Blue Shield of California gets set to take over the state’s distribution network for COVID-19 vaccines, public health officials say the state is on track to begin administering 3 million weekly doses.

Meeting that goal will depend on two things: vaccine supply and Blue Shield’s handling of distribution logistics. But the latter is already facing some scrutiny from county health officials who are speaking out about delays in the system. 

Yolanda Richardson, secretary of the California Government Operations Agency and the state’s lead on vaccine operations, is optimistic.

“We are building on the strong foundation of clinics operating in our local health jurisdictions, and dramatically increasing the capacity to deliver vaccines by adding new vaccination providers and sites where the vaccine will be available,” Richardson told reporters Friday afternoon on a call with Blue Shield President and CEO Paul Markovich.

Richardson said the state has the capacity to scale up as more doses become available. 

“We are well on our way to hitting our 3 million doses per week capacity goal, and by the end of April, our goal is to create the capacity to administer 4 million shots per week,” she said.

That goal includes doses administered at the state’s mass vaccination centers, smaller clinics and private facilities that receive vaccines directly from the federal government.

But with vaccination supply still limited, the state has yet to reach half of that weekly goal. According to data from the California Department of Public Health, the state is averaging roughly 1 million doses administered weekly. 

Blue Shield, which received a no-bid contract with the state worth up to $15 million, is expected to take full responsibility of the state’s distribution network by the end of the month. Until then, the company will gradually work with counties to get them acclimated to the new network, including using California’s MyTurn website, which will soon be the main source for the state’s residents to sign up for appointments.

The state says more than 500,000 vaccinations have been administered through MyTurn and more than 1.6 million people are signed up. About 40 million people live in California.

“The use of My Turn will also help the state have greater visibility into who is getting vaccinated and how to better fine tune equity-focused allocation and outreach efforts,” the state wrote in a press release. “This will be a key component of the state’s continued focus on vaccine equity.”

But there have already been issues with the state’s website.

A report from the Los Angeles Times found people who were not yet eligible to receive the vaccine were getting shots reserved for Black and Latinx communities that have been hit hard by COVID-19. The program sent out access codes to community organizations to give to residents in underserved neighborhoods, but those codes made it into the hands of some of LA County’s wealthy residents.

Several other counties in recent days have complained of poor communication with Blue Shield and a delayed transition to the new statewide system.

In Sacramento County, health officials said they received far fewer doses of the COVID-19 vaccine than it was allotted in prior weeks. County acting health director Jim Hunt said he spoke with California health officials about the discrepancy, but was told it wasn’t the state’s problem anymore.

“This is just unacceptable, and that’s just what we have said to them,” Hunt told the Sacramento County Board of Supervisors on Wednesday. “And we have pointed out the flaws in their methodology, we have pointed out the inequities, and we’ve been told ‘We can’t do nothing about that now, it’s Blue Shield’s problem.”

Hunt said his department was working to set up a meeting with Blue Shield.

County data show that Sacramento received about 3,300 fewer doses this week compared to last. It’s the lowest amount they’ve received this month.

As part of California’s partnership with Blue Shield, starting in March the health care provider will make allocation recommendations to state health officials for doses delivered weekly. The state will make the final decision and even set the criteria Blue Shield will use to determine allocation. The state’s current criteria allocates 70% of doses for senior residents and 30% for frontline workers in education, childcare, emergency services and food and agriculture.

But San Joaquin County supervisors said they may attempt to challenge Blue Shield’s partnership. The county was using the BAYESIANT risk assessment data system to determine who was most at risk of dying or being hospitalized by COVID-19.

County Public Health Officer Dr. Maggie Park said they were making good progress.

“We all feel we were doing a great job trying to hit our health equity, trying to get the vaccine into communities where we know the need is because we know our own community,” Park said.

Supervisor Chuck Winn agreed, saying that their approach was much more surgical than what the state model will be. 

“We can pick those individuals or neighborhoods that are most affected by the virus,” Winn said. “We had the Cadillac, now we’re down to Chevy.”

San Joaquin County has administered roughly 120,000 doses of COVID-19 vaccine. Of those who have received the vaccine, 26.7% are white residents, 9.6% are Latinx, another 9.6% are Asian American, and 3.4% are Black. About 47% marked “other” or “unknown,” which means they don’t identify with any listed race or ethnicity, or they declined to or did not state their race and ethnicity.

At 41%, Latinx residents make up the largest portion of the county’s demographics, and have also been among the hardest hit by COVID-19. About 15% of the county are Asian Americans, 6.6% are Black and 32.7% are white.

Blue Shield says it’s working out kinks along the way and will take full management responsibility of the state’s vaccine network by the end of March. 

The state’s vaccine appointment website MyTurn is available in eight languages, and is available by phone at (833) 422-4255. The hotline is available in English and Spanish, with third-party translators available in more than 250 additional languages.