The state recommended that hospitals and health departments administer vaccines to people in Phase 1A and Phase 1B concurrently during January and February.
What has changed in the state’s tier system since January?
On Jan. 14, the California Department of Public Health announced that people 65 and older were eligible to receive the vaccine, moving them up from their original spot in a lower tier.
Then on Jan. 25, Gov. Gavin Newsom announced that vaccine priority will be determined only by age, not by occupation or underlying condition. This meant that after everyone in Phase 1A and the first tier of Phase 1B had been vaccinated — people over 65, food and agricultural workers, educators and public safety employees — the state would announce new eligibility by age brackets.
On Feb. 12, the state also announced that people with some severe health conditions would be eligible to start receiving vaccinations starting March 15.
This meant that people who were originally in the second tier of phase 1B and in phase 1C were no longer being prioritized. Those groups included:
- Workers in homeless shelters, jails and prisons
- Workers in transportation and manufacturing
- Workers in communications, defense, financial services and government functions
On March 1 the state shifted management of its vaccine distribution to Blue Shield, with counties beginning to move to the new system, though as of March 12 many counties were negotiating how or if they would take part in the plan.
On March 3 officials announced 40% of all COVID-19 vaccine doses would go to the communities hit hardest by the pandemic, based on neighborhoods in the bottom 25% of its Healthy Places Index.
On March 11, the state provided clarifications on some individuals eligible for vaccination, including people who reside in high-risk congregate settings, public transit workers, janitors, massage therapists, informal childcare workers, utility workers and more.
On March 24, health officials announced that starting April 1, all Californians ages 50 and older would be eligible for vaccines, and that all Californians ages 16 and older would be eligible April 15.
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.
How do underlying conditions impact when you get the vaccine, and what qualifies?
On Feb. 12 state health officials announced that people 16 to 64 years old with certain severe health conditions would be eligible to receive a COVID-19 vaccine starting March 15.
Here’s a list of those health conditions, according to the state’s health department:
- Cancer, current with debilitated or immunocompromised state
- Chronic kidney disease, stage 4 or above
- Chronic pulmonary disease, oxygen dependent
- Down syndrome
- Immunocompromised state (weakened immune system) from solid organ transplant
- Pregnancy
- Sickle cell disease
- Heart conditions, such as heart failure, coronary artery disease, or cardiomyopathies (excludes hypertension)
- Severe obesity (Body Mass Index greater than 40 kg/m2)
- Type 2 diabetes mellitus with hemoglobin A1c level greater than 7.5%
The state’s guidance also says that those in that age group could be eligible if, “as a result of developmental or other severe high-risk disability” the individual could die from COVID-19, stop receiving health care services that are “vital to their well-being and survival” or if getting COVID-19 care would be too challenging.
Medical providers will have the discretion to determine a patient’s eligibility. State health officials said the list of eligible conditions could change based on scientific data and analysis.
How did California decide who got 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.
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?
Here are the latest figures from the California Department of Public Health:
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 the Pfizer and Moderna 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 12. People who are allergic to any component of either vaccine should not be vaccinated. There are special considerations for people who are immunocompromised.
On March 2, the group authorized the Johnson & Johnson vaccine, finding it to be safe and effective. On April 13, federal health officials called for a pause on the Johnson & Johnson coronavirus vaccine. The stoppage came after six women reported getting blood clots weeks after receiving the single-dose shot. One of them died. The FDA and the CDC have since lifted the pause.
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.
The most common side effects of the Johnson & Johnson vaccine are pain, redness and swelling at the injection site and tiredness, headache, muscle pain, chills, fever and nausea.
As of Jan. 26, 2021, 29 people in the U.S. had experienced a severe allergic reaction to the vaccine, and none had died. These reactions were from both the Pfizer and Moderna vaccine, and were not clustered geographically. A January 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.
