State Considers Flip-Flopping (Again) on Vaccine Priority After Objections From Disability Advocates

After months of advocacy, disability rights groups have succeeded in convincing state officials to reconsider moving people with serious medical conditions further up in line to receive the COVID-19 vaccine.

The state has flip-flopped several times on whether to prioritize vaccinations based on age or on occupation and underlying medical conditions, weighing the virus risk for the different groups.

Last week, the state shifted its plan to a simpler age-based system, deprioritizing those in certain front-line jobs or with underlying medical conditions, who had previously been closer to the front of the line. Under that system, set to begin in mid-February, the state would first prioritize people 65 and older, as well as certain essential workers, including grocery workers, teachers and emergency responders. It would then move to vaccinate the rest of the adult population in age order, from oldest to youngest.

That change, however, sparked an uproar, particularly among younger people with disabilities — many of whom have chronic underlying medical conditions and often have to be in close contact with multiple caregivers — and are particularly vulnerable to contracting and dying from the virus.

The state's latest proposal, discussed Wednesday, would place people with disabilities higher on the list — after seniors 65 and over and those in the riskiest jobs, but before moving to an age-based system for people 64 and younger.


Dr. Oliver Brooks, co-chair of the state's Drafting Guidelines Workgroup, said people with disabilities would have to get their shots at hospitals or clinics, rather than mass vaccination sites like Dodger Stadium.

"It applies where the underlying conditions or disabilities can be verified through access to medical records," Brooks said on Wednesday during a meeting of California's Community Vaccine Advisory Committee.

Brooks said there’s still much to be decided, like defining which specific medical conditions will be prioritized, or perhaps adopting a system that favors people with multiple health problems first.

His working group will meet on Friday to discuss final recommendations before submitting a final proposal to the governor.

April Dembosky

As Vaccines Open Up, California Is Still Struggling With Equity

California expanded vaccine eligibility late Wednesday, allowing everyone ages 16 and older to sign up for an appointment. But the state is still struggling to vaccinate communities that have been hit hardest during the pandemic.

According to the latest data from the California Department of Public Health, out of the total number of vaccine doses administered, only 3.2% have gone to Black people and 22.4% to people who identify as Latino. Nearly 31% of the shots have gone to white people.

Of the total number of COVID-19 cases in the state, 44% of the positive results have occurred in the Latino community and more than 7% in the Black community.

Kiran Savage-Sangwan, executive director of the California Pan-Ethnic Health Network, a statewide multicultural health advocacy organization, told KQED the state needs to continue to push forward in getting the vaccine to communities of color.

“We need to double down on the equity strategies that we’re using in California,” she said. “We need to make sure that we continue that 40% allocation to the most vulnerable neighborhoods.”


Savage-Sangwan said the biggest challenge for these communities has been access — access to accurate information and nearby distribution sites located in easy-to-get-to places, as well as ensuring that vaccine sites remain open beyond the typical 9 a.m. to 5 p.m. workday.

Without expanded hours, she said, it can be difficult for some folks who work long days and can't take time off to get a shot.

Keith Mizuguchi

Kaiser Says Vaccine Appointments Will Be Harder to Book for the Next Few Weeks

California’s pause in the use of Johnson & Johnson coronavirus shots will decrease Kaiser Permanente’s vaccine supply and the number of appointments the health giant can offer, the company told patients late Tuesday.

The Oakland-based health system says they’ll be able to administer shots at 69% of their capacity in California. That means roughly 500,000 doses each week, compared to the 720,000 doses the company could administer if supplies allowed.

The reduction comes as Kaiser is set to expand vaccine eligibility to people 16 and older Thursday.

In an email to patients, Kaiser leaders wrote that not everyone will be able to make vaccine appointments immediately and that appointments will be limited through April. Kaiser leadership said they will only cancel existing appointments if no other COVID-19 vaccine is available.

The constraints come not only from the Johnson & Johnson pause following reports of the extremely rare but serious blood clots experienced by six women who received the shot, but also, the company says, due to other vaccine supply limitations that have reduced the number of doses coming to the state from the federal government.


Kaiser has played a significant role in vaccinating Californians, including people outside of their network. The company reports having administered more than 3.2 million vaccine doses in California as of April 13.

Laura Klivans

'A Tough Week': Alameda County Shifts Course to Make Do Without J&J Vaccine

California officials directed counties and other providers on Tuesday to pause use of the single-dose Johnson & Johnson vaccine following recommendations by federal agencies, which are examining potential side effects after six recipients, among millions, developed blood clots.

The sudden shortage of millions of vaccine doses has left some health providers scrambling to meet growing demand, as vaccine eligibility expands Thursday to everyone in the state ages 16 and older.

Alameda County says it may have to cancel some appointments due to supply shortfall.

"This week was kind of a blow. We had a reduction of about 35% overall [vaccine supplies]. And now this news about our inability to use the J&J [Johnson & Johnson] is making this a tough week," said Dr. Kathleen Clanon, medical director of the Alameda County Health Care Services Agency, who oversees vaccination efforts.

The county has not had to cancel many appointments yet, she said, because it had already made fewer than usual, expecting a drop in supply.

"But we have thousands of people who are expecting to get vaccinated this week who will not be," she said.

Clanon said the county is scrambling to redistribute as much of the two-dose Moderna and Pfizer vaccines as it can to clinics that have been using the J&J vaccine.

"We've been able to patch a lot of our appointments that way," she said. "Where we have to just outright cancel, we are letting people know by email and other mechanisms that this is not a 'No,' it's a 'Not yet,' and that we will be back to them with more information."

Because it only requires a single shot, the J&J vaccine has been particularly useful for inoculating certain vulnerable populations that are often hard to reach, like those who are homeless, incarcerated or homebound.

One clinic that had planned this week to give the J&J vaccine to transgender women of color will now be using the two-shot Moderna vaccine instead, Clanon said. Another effort to administer the vaccine to homebound seniors is now being put on hold.

"It's really breaking my heart that we have to change [those clinics]," Clanon said. "It's really hard. When you see people get vaccinated, they have really deep emotional responses of joy and relaxation. It's a huge deal, and then to have it delayed is really tough on them."

Clanon said it's important for people to "keep an open mind" and try to be patient, as the risks of the vaccine are assessed.

"Trying to get people to hold in their uncertainty and wait until we get more information is the toughest part of all," she said.

Raquel Maria Dillon and Matthew Green

San Francisco Reopens for Indoor Live Events, Other Activities Thursday

Starting Thursday at 8 a.m., San Francisco will allow the return of indoor live-audience events and performances, as well as private events like conferences and receptions.

Under the new health order, the city will open indoor ticketed and seated events with up to 35% capacity for venues with an approved health and safety plan. Participants will be required to keep their masks on except when eating or drinking in designated concession areas, maintain distancing requirements and show proof of vaccination or a negative COVID-19 test before entering the venue. Venues can create vaccinated-only sections with relaxed distancing requirements.

For indoor venues operating at 15% capacity or less, with no more than 200 people, proof of vaccination or a negative test may not be required. Outdoor ticketed venues may expand capacity up to 50%.

“San Francisco is continuing to reopen and this latest round of activities and events that can start to resume is an exciting step for our city,” said Mayor London Breed in a statement Wednesday. “Throughout our response to COVID-19 and our reopening efforts, we’ve focused on moving forward in a way that protects public health, and we’re going to need everyone to keep doing their part to keep our community safe."

San Francisco's expanded reopenings largely following the state's updated guidance for activities permitted under the orange tier of the color-coded plan for navigating the COVID-19 pandemic.


The city will also allow meetings, conventions and other private events with up to 150 participants indoors and up to 300 people outdoors, as long as safety requirements have been met.

The updated health order also loosens some restrictions on indoor and outdoor social gatherings, indoor and outdoor dining, recreation and hotels.

Community centers serving seniors and adult day care will also be able to reopen to 25% capacity beginning Thursday.

In a statement, the city said it will post the full updated directive on its website later on Wednesday.

Peter Arcuni

All Bay Area Counties Confirm They Have Paused Using Johnson & Johnson Vaccine

All nine Bay Area counties announced Tuesday that they are momentarily halting the use of the Johnson and Johnson coronavirus vaccine after reports of six women in the U.S. experiencing a rare and severe type of blood clot.

Early Tuesday, the Centers for Disease Control and Prevention and the Food and Drug Administration recommended health providers pause using the vaccine pending a review of the cases expected on Wednesday. The California Department of Public Health followed suit.

The six cases were reported out of the approximate 6.8 million doses of the J&J vaccine that have been administered in the U.S.

KQED reached out to all nine counties in the Bay Area to ask how they are responding to this recommendation. Alameda, Contra Costa, Marin, Napa, San Francisco, San Mateo, Santa Clara, Solano and Sonoma counties all have confirmed that they have paused using the Johnson & Johnson vaccine.

Some have already specified that they will switch over to Moderna and Pfizer vaccines to make up for the gap left behind by J&J.


The San Francisco COVID Command Center released a statement saying that out of the 33,000 doses of the J&J vaccine that the city has administered so far, there are no reported cases of blood clotting.

"As this adverse event is reported to be extremely rare with just over six reported cases nationwide, we do not believe there is cause for immediate alarm," city officials said.

They added that anyone who has received the J&J vaccine should contact their care provider if they experience severe headache, abdominal pain, leg pain or shortness of breath within three weeks after vaccination.

However, some public health experts worry that this may impact counties' efforts to vaccinate communities that are the hardest to reach.

In Marin County, the J&J vaccine made up less than 3% of the doses allotted for this week. But many of those single-dose shots were intended for the county’s homeless population through mobile vaccination sites.

"We'll be using Pfizer instead, which just means that we'll have to be revisiting those sites in a few weeks. And we hope that the same people will be present when we revisit them," said Dr. Matt Willis, public health officer for Marin County.

Peter Arcuni

San Francisco, Santa Clara Counties Open Vaccine Appointments to Everyone 16 and Up

Less than two days before all Californians 16 and older become eligible to receive a COVID-19 vaccine, San Francisco and Santa Clara county officials announced that anyone 16 and older who lives or works in their counties is now eligible to make a vaccine appointment.

In a press release, San Francisco Mayor London Breed's office directed newly eligible people to the city's website to schedule an appointment at different vaccination sites. The state's My Turn tool is also showing eligibility for 16+ San Franciscans.

Santa Clara County has also fully opened vaccine eligibility to all county residents and workers 16 and older, although the county was not yet showing that eligibility through My Turn. Newly eligible Santa Clara County residents and workers may instead make appointments through the county website. An increase in vaccine supply allowed county officials to "release tens of thousands of additional vaccine appointments over the remainder of this week," according to a Tuesday press release.

The state on Tuesday directed all counties to pause using the Johnson & Johnson vaccine based on guidance from the Centers for Disease Control and Prevention and the Food and Drug Administration, which are examining a possible and rare side effect associated with only that vaccine.

State health officials said vaccine supply levels would not be affected by the pause because "less than 4% of our vaccine allocation this week is the Johnson & Johnson vaccine."


-David Marks

CDC and FDA Recommend Pausing Use of Johnson & Johnson Vaccine Over Blood Clot Concerns

The U.S. Centers for Disease Control and Prevention and the Food and Drug Administration said on Tuesday they are recommending a "pause" in the use of the single-dose Johnson & Johnson COVID-19 vaccine out of an "abundance of caution" while a review of reports of rare, potentially dangerous blood clots is conducted.

In a joint statement on Tuesday, the two agencies said they are "reviewing data involving six reported U.S. cases of a rare and severe type of blood clot in individuals after receiving the J&J vaccine."

"In these cases, a type of blood clot called cerebral venous sinus thrombosis (CVST) was seen in combination with low levels of blood platelets (thrombocytopenia)," said Dr. Anne Schuchat, principal deputy director of the CDC, and Dr. Peter Marks, director of the Food and Drug Administration's Center for Biologics Evaluation and Research.

"All six cases occurred among women between the ages of 18 and 48, and symptoms occurred 6 to 13 days after vaccination," the statement added. "Right now, these adverse events appear to be extremely rare."

Speaking at a virtual news briefing after the announcement, Marks said that symptoms averaged about a week to nine days after vaccination, but not longer than three weeks.


Schuchat and Marks recommended that individuals who had already received the Johnson & Johnson vaccine who experience severe headache, abdominal pain, leg pain or shortness of breath within three weeks of getting the shot contact their health care provider.

Following the recommended pause in vaccination with the Johnson & Johnson vaccine, Jeffrey Zients, the White House coronavirus coordinator, said, "we are working now with our state and federal partners to get anyone scheduled for a J&J vaccine quickly rescheduled for a Pfizer or Moderna vaccine."

In a statement sent to NPR, Johnson & Johnson said it was "aware of an extremely rare disorder involving people with blood clots in combination with low platelets in a small number of individuals who have received our COVID-19 vaccine."

"We have been working closely with medical experts and health authorities, and we strongly support the open communication of this information to healthcare professionals and the public," the company said.

Scott Neuman, NPR