Appointments pushed back, confusion reigns over 2nd COVID-19 vaccine dose

Staff and volunteers distribute the COVID-19 vaccine at the Forum in Inglewood.

Jan. 29, 2021 5 AM PT

The instructions upon getting a first dose of COVID-19 vaccine are clear: People should get the second shot three or four weeks later.

But things get a lot murkier when it comes to actually getting an appointment to meet that deadline.

As more Los Angeles County residents than ever receive their first doses, tightening vaccine supplies and online scheduling problems are hampering their ability to finish the two-dose vaccination process.

On Thursday, potentially thousands of people had their vaccine appointments postponed after the Ralphs supermarket chain — a large vaccine distributor — said the county’s Department of Public Health, at the request of state officials, had “recovered” 10,000 doses previously intended for scheduled appointments, according to emails obtained by The Times. A Ralphs spokesperson said only first-dose customers were affected, but it only added to the confusion.

Many other residents are facing problems navigating the county’s online scheduling system, a confusing and frustrating process that can result in hours of wasted time. So many people have concerns about second doses that the county’s call center is jammed with 1,000 calls an hour at times, according to public officials.

The uncertainty highlights continuing problems with how the county is managing diminishing vaccine supplies and sharing critical information with a community desperate for answers. Anxiety levels are rising among residents because getting a second dose comes with the added pressure of a time constraint.

The Centers for Disease Control and Prevention last week updated its second-dose guidance and said that while individuals should receive their next dose as close to the instructed time as possible — three weeks after the Pfizer-BioNTech vaccine and roughly four weeks after the Moderna dose — they will still see efficacy if they wait up to six weeks to do so.

“There hasn’t been a lot of transparency,” said Andrew Noymer, UC Irvine associate professor of public health. “Why can’t seniors get a straight answer when they ask?”

After people get their first dose at one of the county’s five large vaccination sites — Pomona Fairplex, the Forum in Inglewood, Cal State Northridge, the L.A. County Office of Education in Downey and Six Flags Magic Mountain in Valencia — they should receive a card with their next appointment date and time on it.

Workers then register that appointment in the system, and residents should receive a confirmation notice from the county.

But as the county has rushed to open and staff these large sites, this practice has varied. L.A. County Public Health Director Barbara Ferrer said Tuesday during a Board of Supervisors meeting that there is a standard set of instructions for all staff and volunteers working those sites about giving people their second appointments, and her agency would work to ensure that the practice is uniform across county locations.

Officials are less clear about the process for people who receive their first shots at private pharmacies and clinics.

Supervisor Janice Hahn, whose 4th District includes several beach cities, said at the Tuesday meeting that when she was vaccinated at the county’s Downey site last weekend, she was handed a card with information about her second dose.

But she was concerned that people vaccinated at private providers aren’t being signed up for their second doses. Retailers have said they are scheduling the second shot, but it’s clear some people remain confused over how to know when to get it.

The news about the postponed appointments at Ralphs further clouded the picture for private distributors. Ralphs, in an email sent this week to customers, said people whose appointments have been postponed might have to wait four weeks or longer for new appointments. John Votava, a Ralphs spokesman, said that only appointments for first-dose customers were affected and that those who have received a first shot are guaranteed a second-dose appointment.

“At this time, we regret to inform you that your COVID-19 vaccination appointment is delayed for potentially four weeks or more, depending on future delivery of additional doses,” said the email sent to customers.

“We thank you for your patience and look forward to seeing you at one of our local pharmacies very soon.”

But some people who received their first doses at Ralphs said they are now concerned their second doses will be delayed and questioned why pharmacies were losing their supplies. “They shouldn’t be confiscating doses from pharmacies,” said Joy, a West L.A. resident who asked that her last name not be used.

The 10,000 doses diverted to the county will be distributed through the county’s mass vaccination sites, according to the email. Ralphs recommended that customers pursue appointment opportunities through one of the vaccination sites.

The lack of answers, Ferrer said earlier this week, is causing substantial anxiety. At Tuesday’s board meeting, she said residents who received their first vaccine shot at one of the county-run sites would receive an email this week to schedule their second. But Ferrer also warned that if dose allocation remains limited, the strained supply could affect future plans.

“Hardly anybody feels like they can get into the site and get their appointment at this point,” Ferrer said, “so that also is causing so much volume at the call centers because people can’t make an appointment on the website, so then they’re on the call center to explain their problem, ‘Hey, I need a second dose.’”

Marjorie Klein, 76, received her first Moderna vaccine dose at Dodger Stadium last week. When she was done, she obtained a card telling her to schedule an appointment for her second dose, roughly 28 days later.

But since that time, she has spent hours trying to sign up for that designated time slot to no avail and has received no notification about when a time may open up. She’s compared her search for a shot to a scavenger hunt — with little clue as to when the situation may change.

“The first shot means nothing unless you can get the second one,” she said.

Officials throughout the state have said that vaccine allocation projections have shrunk in recent weeks. While that could change, the lack of advanced notice into how much vaccine the state and counties will receive in the future has thrown a wrench in long-term planning.

As of this week, 662,963 doses of vaccine have been administered in L.A. County — more than 544,000 as first doses and more than 118,000 as second doses, the public health department said. The most recent vaccine allocation to the county included more than 137,000 doses — over 89,000 were to be set aside for second doses. The total was about 25,000 fewer than the week prior.

To date, the state has administered more than 2.8 million vaccine doses and has shipped more than 4.7 million doses to local health providers.

Noymer of UCI said that it’s understandable that seniors are confused about obtaining their second dose as officials continue to warn of limited vaccine supply, all while information around second-dose logistics remains sparse. And while it’s likely that no one will miss that second-dose shot, nothing is set in stone right now.

“The first dose ought to be a promissory note on the second dose. When you get your vaccine card telling you that you received your first dose, you should receive a Post-it note stuck to that vaccine card that says where and when, down to the hour, the second dose should be administered,” Noymer said.

The fact that that’s not regularly the case “boils down to the fact that they don’t know if they’ll have enough vaccine,” he said.

If the time period between first and second doses has been factored into county and state scheduling plans, it has not yet been communicated to some residents.

“I’m a little bit uncertain what’s going on with the vaccine rollout. Are they setting aside enough for the second dose so they’ll be adhering to the CDC recommendations? I’m not really certain,” Joel Miller, 73, said.

Miller said that he and his wife received their first Pfizer dose at the county-run Forum site in Inglewood last week. Following their vaccination, they received a card to schedule a vaccine 21 days later.

Days later, the couple have not had any luck getting an appointment anywhere in the county, he said.

Times staff writer Jessica Roy contributed to this report.