Coronavirus Today: The second-dose chokepoint

Good evening. I’m Amina Khan, and it’s Wednesday, Feb. 3. Here’s what’s happening with the coronavirus in California and beyond.

It’s no secret that California’s vaccine rollout has been, if I may be so blunt, a hot mess. There are twentysomethings with social media jobs getting COVID-19 vaccines while senior citizens can’t make appointments. More than a third of the Pfizer and Moderna doses in California appear to be unused, but health officials say they can’t dole out the shots any more quickly. And the state’s imperfect data systems have left officials in the dark about how many doses have actually been administered, leaving the picture of the state’s progress unclear.

While the state has administered 3.45 million shots — by far the most of any state in the country — it ranks near the bottom when it comes to shots per capita and in using up doses allocated by federal officials. About 7.2% of California residents had received a first dose by Monday, and 60.9% of the state’s vaccine supply had been administered. That’s a major improvement from a week ago, but it still lags behind other big states like Texas, Illinois and New York, and comes in only slightly ahead of Florida.

California’s a big, complicated state, and so its sluggish rollout defies any simple explanation, my colleagues Maya Lau and Laura J. Nelson report. However, they were able to identify a few likely suspects.

Among the big issues: Gov. Gavin Newsom and public health officials initially limited vaccine access to the state’s 2.4 million healthcare workers and residents of long-term care facilities. To be fair, this mirrored the federal recommendations. But the state seemed to lose ground as others such as South Dakota, West Virginia, Texas and Florida moved on to new groups of patients.

Part of the problem came from the unexpectedly high levels of vaccine hesitancy among the priority groups, including healthcare and front-line workers. Take Los Angeles city firefighters: Only 55% of them have stepped forward to get a shot.

The state process was akin to waiting for every first-class passenger to board an airplane before opening up the boarding process to people flying in coach, said Dr. David Lubarsky, chief executive of UC Davis Health. “What you’d end up with is a plane that never left the airport,” Lubarsky said.

Experts add that the structural barriers of a large, decentralized state leaning heavily on 61 local health departments to administer the vaccines also complicated the response.

The biggest and most persistent problem, though, has been beyond the state’s control. Officials have been hamstrung by vaccine supply shortages and a lack of predictability from the federal government and vaccine manufacturers.

“The supply crunch creates this huge unmet demand, which creates chaos,” said Andrew Noymer, associate professor of public health at UC Irvine. “There are just layers and layers of logistical issues that we have today that we didn’t have in previous vaccination campaigns.”

That’s been of particular concern in many areas of the state where health officials say they’re still struggling to secure a sufficient and reliable stream of doses. Many of them, including Los Angeles, have seen shipments shrink over the last few weeks.

This is especially problematic because we’ve reached a point where folks who have already gotten their first dose of vaccine are now scheduled to get their second at the same time that others are trying for their first. In some cases, that has led to abrupt appointment cancelations for people who thought they were finally about to get their first dose.

“The supply of vaccine, we acknowledge that’s going to be our rate-limiting step,” said Dr. Mark Ghaly, California’s Health and Human Services secretary.

By comparison, Texas and Florida — early leaders in distributing a high share of their available doses — both opened up vaccinations to more residents, including seniors, in December. New York, meanwhile, relied on large public hospital systems to administer doses to their workers and to the general public, and Gov. Andrew Cuomo threatened to fine them or cut off their supplies if they didn’t get shots into arms fast enough.

California has now adopted an age-based priority list, and the share of vaccine doses that get into people’s arms has surged 13 percentage points in a week, bringing the Golden State almost level with the national average. State officials also contracted with Blue Shield of California in the hopes that it may be able to distribute doses more efficiently.

The age-based plan, however, has drawn criticism from groups representing essential workers and disabled people, who argue that speed is being favored over fairness. But Ghaly said that wasn’t the case.

“This notion that there’s a choice that we have to make between speed in vaccinations and equity, this is not a choice,” he said. “This is a false choice. We can do both.”

By the numbers

California cases, deaths and vaccinations as of 5:40 p.m. PST Wednesday:

Track California’s coronavirus spread and vaccination efforts — including the latest numbers and how they break down — with our graphics.

Across California

A little help with vaccinations is coming in from Washington. The federal government is setting up two community vaccination centers at Cal State Los Angeles and the Oakland Coliseum.

The initiative will help “two of the communities most hard hit by this pandemic,” said Jeff Zients, coordinator of President Biden’s COVID-19 task force. Both sites will be run in partnership with the state but staffed mostly by federal workers, including officials from Federal Emergency Management Agency and the Department of Health and Human Services. “These sites in California are just the beginning,” Zients said Wednesday.

The vaccination centers are part of the Biden administration’s effort to get more shots into arms as new and worrisome coronavirus variants emerge. With the Golden State’s initial efforts marred by confusion and supply chain problems. Gov. Gavin Newsom said the two sites would help “safely, swiftly and equitably vaccinate all Californians.”

While announcing the new centers, Newsom also said he believes schools can start reopening even if not all teachers have yet been vaccinated against COVID-19 — as long as proper safety measures and supports are in place.

“I’d love to have everybody in the state vaccinated that chooses to be vaccinated,” he said. “Not only would I like to prioritize teachers, we are prioritizing teachers.”

Newsom’s comments came the same day that Dr. Rochelle Walensky, director of the U.S. Centers for Disease Control and Prevention, said schools can safely reopen even if teachers are not vaccinated. Zients added that Biden wants schools to reopen and stay open. “And that means that every school has the equipment and the resources to open safely, not just private schools or schools in wealthy areas, but all schools,” he said.

Those pronouncements run counter to the position of some teachers unions, including United Teachers Los Angeles, which have said vaccinations need to happen before in-person instruction can resume. L.A. Unified Supt. Austin Beutner has also said it is critical that health officials inoculate school employees while campuses are closed. “Vaccinating school staff will help get school classrooms opened sooner,” Beutner said.

In San Francisco, meanwhile, the city has taken the “drastic step” of suing its own school district to try to force the reopening of public schools for in-person learning.

“It’s a shame it has come to this,” said City Atty. Dennis Herrera, whose office is seeking an emergency order to compel the district to act. “The Board of Education and the school district have had more than 10 months to roll out a concrete plan to get these kids back in school,” Herrera added. “So far they have earned an F.”

Mayor London Breed said data show that Black, Latino, and Asian students — especially those who are low-income — have fared worse than white and wealthier students during distanced learning. “While I don’t control the schools,” she said, “I am the elected leader of the city and I am not going to stand by” while kids suffer.

Supt. Vincent Matthews said the city and the school district should be working together, not embroiled in a lawsuit. He suggested it would take a combination of vaccines and a reduction in the virus for school unions to be willing to return staff classrooms. Board of Education President Gabriela Lopez suggested the city was applying a double standard to schools, noting that “City Hall is shuttered.”

Finally, as some public health experts question the wisdom of California’s decision to ease coronavirus restrictions, they are warning residents to step up their precautions, my colleague Maura Dolan reports. That’s especially crucial now that highly contagious variants and a still-high positive test rate have combined to create a world even more fraught with danger than before.

Dr. John Swartzberg, a UC Berkeley infectious-disease expert, said he believes California ended the regional order too soon. “Projections suggest that we will suffer far fewer deaths between now and June if we persist in the lockdown,” he said. “I’m not talking about a prolonged lockdown. Even an additional few weeks will make a big difference in terms of lives saved.”

For now, he and other experts say residents, when near others indoors, should wear more protective face coverings — not just single-layer masks or gaiters — and consider protecting their eyes with face shields or goggles. Trips to the grocery store should be limited and quick, Swartzberg said. “This advice doesn’t cut very well for people who have to go out every day and work in the grocery store,” he added. “For those folks, this has just become a more dangerous world.”

See the latest on California’s coronavirus closures and reopenings, and the metrics that inform them, with our tracker.

Around the nation and the world

Dr. Anthony Fauci is weighing in on the Super Bowl: He’s not predicting who will win, but he is telling Americans not to proceed with any unsafe football festivities this Sunday. Holding a traditional, or even a slimmed-down, Super Bowl party could risk a further and catastrophic spread of COVID-19. “Every time we do have something like this, there always is a spike — be it a holiday, Christmas, New Year’s, Thanksgiving,” the nation’s top infectious disease expert told Savannah Guthrie on the “Today” show.

Fauci, a baseball fan, isn’t trying to be a party pooper. He acknowledged that the “Super Bowl is a big deal.” But he urged Americans to exercise restraint when the Tampa Bay Buccaneers face off against the Kansas City Chiefs. (He could have reminded football fans that sports celebrations in the wake of Lakers’ and Dodgers’ championship wins last year probably spurred a deadly and devastating surge in Los Angeles.)

“Enjoy the game, watch it on television, but do it with the immediate members of your family, the people in your household,” he said. “As much fun as it is to get together in a big Super Bowl party, now is not the time to do that.”

In Denmark, the government said Wednesday that it is working with businesses to develop a digital passport that would show whether the holder has been vaccinated against COVID-19. The move comes as authorities work to facilitate and revive travel, which suffered a major hit during the pandemic. Even now, big European airlines are flying about one-10th of their normal traffic.

Danish Finance Minister Morten Boedskov said that “in three, four months, a digital corona passport will be ready for use in, for example, business travel.” As a first step, before the end of the month, citizens will be able to check a Danish health website for official confirmation of whether they have been vaccinated, he said.

The European Commission has also been considering proposals to issue vaccination certificates that could help get travelers to vacation destinations and avoid another disastrous summer for Europe’s tourism sector. But the European Union’s executive arm said that for the time being, such certificates would be used only for medical purposes, such as monitoring possible adverse effects of COVID-19 vaccines.

A new study suggests that a single dose of the Oxford-AstraZeneca COVID-19 vaccine provides a high level of protection for 12 weeks. Mene Pangalos, an AstraZeneca executive, said no patients experienced severe COVID-19 or required hospitalization three weeks after receiving a first dose, and that efficacy appeared to increase up to 12 weeks after the initial shot. “Our data suggest you want to be as close to the 12 weeks as you can” for the second dose, Pangalos said.

The research, which hasn’t yet been peer-reviewed, was greeted with excitement by British officials who’ve been under pressure to justify their decision to have vaccine recipients delay the second dose in order to protect more people quickly with a first dose. The study “backs the strategy that we’ve taken,” said Health Secretary Matt Hancock.

The preliminary findings from Oxford University, a co-developer of the vaccine, also suggest the vaccine reduces transmission of the coronavirus by two-thirds. Until now, scientists only knew that the authorized vaccines reduced the risk of illness but didn’t know if it halted viral spread.

Volunteers in the study underwent regular nasal swabs, and the level of virus-positive swabs was 67% lower in the vaccinated group. “That’s got to have a really beneficial effect on transmission,” Oxford lead researcher Sarah Gilbert said at a meeting of the New York Academy of Sciences.

Your questions answered

Today’s question comes from readers who want to know: How will I know when it’s time for my second dose of COVID-19 vaccine?

Los Angeles County residents awaiting their second dose should keep an eye on their email, officials say. Where that email comes from depends on where you got your first shot.

Those who got their first dose at a county-run vaccination site will have a second-dose appointment scheduled for them. Then they’ll get a direct message that should allow them to confirm their follow-up appointment.

People who rolled up their arms at a site run by the city of Los Angeles — such as Dodger Stadium — will automatically be scheduled for a second appointment as well, officials said. They should receive a text message and email with details, including a link to reschedule their appointment if they’d like.

Those who were vaccinated at a pharmacy, community clinic or hospital should contact those facilities with questions about their second dose appointment.

County officials said most Angelenos will receive their second shots wherever they got their first dose, but it’s possible some residents will be instructed to go elsewhere.

A key point: Make sure that second dose, wherever you got it, is the same type of vaccine as the first. The recommended wait time for the Pfizer-BioNTech vaccine is 21 days, and for the Moderna vaccine, it’s 28 days.

More information is available at vaccinatelacounty.com and corona-virus.la/covid-19-vaccine.

If you’re not in L.A. County, you can find more information on vaccination where you live in our county guides here.

We want to hear from you. Email us your coronavirus questions, and we’ll do our best to answer them.