Weeks into the California’s mass vaccination plan, we’re far behind schedule. Of the roughly 2 million doses that have been distributed, only about 650,000 have been injected into the arms of state residents, according to Friday’s data from the California Department of Public Health.
Facing criticism, officials are now moving to expand access. This week they began to offer vaccines to the next two tiers of eligible recipients — moving beyond hospital staffers to a broader range of health care workers, such as people who work in specialty clinics, dental clinics and pharmacies.
As early as next week, dentists will be offered a four-hour online training course on how to administer the shot.
Meanwhile, President-elect Joe Biden announced Friday that his administration would release nearly all available vaccine doses when he takes office later this month, rather than holding back supplies for a second dose. Currently, the Pfizer and Moderna vaccines are approved for use.
Here’s a look at the process, and when you can expect to be vaccinated.
Who is getting the vaccine now?
We’re currently in Phase 1A, providing the vaccine to health care workers and residents of long-term care facilities. Phase 1A has three tiers; counties are moving through these tiers at different speeds, depending on local supply and demand.
Tier 1: Acute care, psychiatric & correctional facility hospitals; staff and residents of skilled nursing & assisted living facilities; paramedics, emergency medical technicians and dialysis centers.
Tier 2: Intermediate care facilities; home health care; community health workers; public health workers; primary care clinics; correctional facility clinics, rural clinics, and urgent care facilities.
Tier 3: Other settings and health care workers, including specialty clinics, lab workers, dental and oral health clinics and pharmacy staff who weren’t covered in higher tiers.
This phase of the vaccine rollout is relatively easy because employers are simply notifying their staff. Staff are easily identifiable through professional licenses, employee badges or pay stubs.
The majority of doses for residents of skilled nursing and assisted living facilities are distributed by the federal government’s pharmacy program, not the state, although some counties have opted out of that program. CVS or Walgreens is communicating directly with each facility.
Who gets the vaccine next?
The next step is Phase 1B, which will likely start in early February. The hope is for everyone in this phase to be offered at least one dose by late March. Phase 1B has two tiers:
Tier 1: Anyone age 75 and older; workers in education and child care; emergency services workers (fire, police and corrections officials); workers in food and agriculture, including grocery store workers.
Tier 2: Anyone 65 and older; workers in transportation/logistics; industrial, residential, & commercial sheltering facilities /services; critical manufacturing; incarcerated individuals; homeless.
When the vaccine is available to these groups, it will likely be given by doctors and health plans, primary care clinics, pharmacies, some workplaces and special vaccination sites run by county departments of public health and other community partners.
If you’re eligible based on your age, your doctor or health plan may reach out. Kaiser, for instance, will identify eligible members and offer an appointment. Local health departments say they’ll seek out older adults by working with community groups and retirement communities.
If you’re eligible based on your occupation — education, agriculture and food services — your employer may notify you. Doctors can’t make that decision, because they don’t keep occupation information. County health departments will communicate with employers regarding access to mass vaccination sites. Some employers may conduct their own vaccination campaigns.
People who are incarcerated will be reached through correction officials. People at homeless shelters will be vaccinated by “strike teams” or at mass vaccination sites, run by county health departments.
Who’s after that?
Phase 1C comes next. There’s no estimated start date yet to vaccinate this group but officials aim to offer everyone in this phase at least one dose of vaccine by late April or early May.
This group includes anyone age 50 or older and anyone age 16 to 49 at high risk due to disability or underlying medical conditions and/or disability (cancer, chronic kidney disease, chronic obstructive pulmonary disease, heart conditions, organ transplant, obesity, pregnancy, sickle cell disease, smoking and type 2 diabetes mellitus).
This group also includes workers in water and waste management; defense; energy; communication and information technology; financial services; chemicals/hazardous materials; government operations or community service.
These groups will get vaccines from doctors and health plans, primary care clinics, pharmacies, some workplaces and special vaccination sites run by county departments of public health and other community partners.
What about the rest of us?
Phase 2 is just proposed and will likely change before the estimated start date of spring 2021.
It will probably include the staff and residents of congregate settings and group homes for people with disabilities or serious mental illness, as well as people at moderate risk due to underlying health conditions.
As supplies expand, it will also include the general population, children and workers not covered in Phase 1.
How do I know if I’m eligible?
Call the state’s COVID-19 hotline: 1-833-422-4255 (8:00 a.m. to 8:00 p.m. Monday – Friday; 8:00 a.m. to 5 p.m. Saturday and Sunday). The hotline will provide general information about eligibility in Phase 1A, 1B and 1C. Provide your age and a description of the kind of work you do.
I’m a veteran. Where do I go?
Like the state, the Veterans Administration also has a phased plan. It is currently offering vaccines to these three groups: Veterans living in long-term care facilities, veterans with spinal cord injuries and VA health care personnel.
After completion of these groups, the VA will begin to offer vaccines to veterans who are at high risk of severe illness due to age or health, based on federal criteria.
If you’re a veteran who is eligible to get a vaccine, your VA health care team will contact you.
Are vulnerable communities getting any special help?
Using the “California Healthy Places Index,” an online tool that measures life expectancy and living conditions across the state, health officials aim to track vaccination rates among communities and target underserved neighborhoods and rural areas.
How quickly does the vaccine protect me?
It typically takes a few weeks for the body to build immunity after vaccination. That means it’s possible a person could be infected with the virus that causes COVID-19 just after vaccination and still get sick. It’s not known how long vaccine-induced immunity lasts, but after COVID-19 infections, most people have a robust immune response lasting at least 8 months.
What else is in the pipeline?
Both Johnson & Johnson and AstraZeneca will likely get results of their U.S. COVID-19 vaccine trial by late January. If all goes well, they would seek emergency use authorization in February.
The overall efficacy of these two vaccines in preventing infection is lower than the Pfizer and Moderna vaccines. But they have other advantages. Both vaccines are easier to store because they don’t require freezing. The Johnson & Johnson vaccine is a single dose, making administration simpler.
Currently, you do not have a choice of vaccine. But when several are available, that may change, as some people may prefer the shots with higher efficacy – or one shot, for more simplicity.