As the first front-line workers begin receiving their COVID-19 vaccines, many others are left wondering when they may be next in line. Details about the next stages of vaccine rollout are emerging on pace with supply, but much is still unknown about where, how and when more San Mateo County residents will get their shots.

With 22,200 doses received so far and more on the way, the county is on track to get enough vaccines to its 38,000 front-line health care workers and 12,000 residents of long-term care facilities soon. But the next phase of distribution, set to start mid-January, will be entirely new territory. 

Next up for the vaccine, according to San Mateo County Health Chief Louise Rogers, are high-priority essential workers and residents age 75 or older. That edict follows the state’s soon-to-be-released guidelines. The third phase is set to be complete by late spring and is likely to include adults 65 to 74 and anyone with underlying medical conditions, plus the remaining essential workers. Prioritization of workers will take into account “societal impact of the job, equity, impact on the economy and occupational exposure/risk,” Rogers wrote in an internal update to county health staff and partners. In California, 68 percent of all workers fall into the essential worker category.

It’s not yet clear how, logistically, any of those groups will get access to the vaccine and if they’ll have to prove their status or qualification in any way. 

The first phase of vaccination of the so-called “1a group,” including health care personnel, emergency first responders and long-term care facility residents, has been largely successful, Rogers wrote. Health care providers have taken the lead on vaccinating their own staff. CVS, Walgreens and now Safeway, will go into long-term care facilities this week, with four of the county’s 17 skilled nursing facilities already scheduled for vaccination.

“The rollout of the first vaccines has gone smoothly,” Rogers wrote on Dec. 24.

But the Phase 1 rollout may not prove a good model for subsequent phases, which could require much more complex logistics.

The county’s vaccination distribution plan, sent to the state on Dec. 4, indicates that drive-through or walk-up clinics might be utilized, similar to successful socially distanced flu clinics this year. Details, however, have been scant. 

There is one indication of how future vaccination events might roll out. Last week, in partnership with the county, local fire departments and American Medical Response, which runs local ambulances, ran vaccination clinics to get shots to around 1,200 local first responders. 

Cal Fire Public Information Officer Cecile Juliette said Cal Fire’s designated infection control officer worked with the county health department to create a vaccination schedule of eligible firefighters based on their shift schedules. She said firefighters were required to bring identification to the clinic.

“We had an overwhelming majority of our firefighters choose to get the vaccine,” Juliette wrote in an email to the Review. “That includes all first responders who might have patient contact in the course of their duties.”

For local doctor Dan McMillan, the lack of clarity about upcoming vaccine distribution isn’t a surprise.

“Basically, we have almost no guidance,” said McMillan, who sees patients at Purisima Family Medicine in Half Moon Bay. “It’s not that surprising given our chaotic federal response. Why would we expect this to be different, or smooth?”

McMillan has gotten an influx of phone calls lately from patients asking when they might be eligible for the COVID-19 vaccine. While he doesn’t have answers, he can give a word of advice.

Because people will still be advised to take precautions like mask wearing and social distancing even after having been vaccinated, McMillan said he is telling his patients not to be too concerned about their place on the list. While he hopes to get the vaccine himself when it’s his turn, he says there is an upside to waiting just a bit. 

“My message is this: If they’re not the first people to get the vaccine, don’t panic,” McMillan said. “People who are last to get it, consider yourself lucky. You will have a few more months to see what happens.”

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