14 January 2021: On Vaccine Distribution

So today I have had a lot of questions about vaccine distribution as well as excited calls from patients who have been able to make appointments at Ralphs. This came as a surprise to me as Los Angeles County has not yet moved into a phase where those over 65 years of age are even eligible to receive vaccine – the Health Department is still working to vaccine healthcare workers and expects that this process will take until “the beginning of February” to complete.

Links: https://www.dailynews.com/…/la-county-will-not-speed…/


Here is my general advice in a nutshell on the COVID-19 vaccine, appointments and the roll-out in Los Angeles County:

  • 1. Remember that the COVID-19 vaccine is a series of two shots. Whatever scheduling and logistical gymnastics that you performed to get the first shot will need to be repeated in 21 (Pfizer) or 28 (Moderna) days.
  • 2. Remember that pharmacies and grocery stores vaccinate people by convenience when they are there to pick up medications or when they are shopping. Vaccination is not their primary expertise. They will need to simultaneously manage all their usual pharmacy and grocery store tasks and take on a mass vaccination campaign with not just one but two shots. They have no track record of doing this which is not to say that they are not capable, but just that they have no experience.
  • 3. If you have had severe allergic reactions to previous vaccines, Penicillin or environmental triggers (bee stings) or if you carry an EpiPen – be aware that if you have a vaccination in a pharmacy or a grocery store, the medical professional attending to you may have no experience in managing severe allergic reactions or anaphylaxis. Again, not to say that they will not be capable, but just that this is not their expertise.
  • 4. If you have scheduled Shot #1, there must be some mechanism by which you can schedule Shot #2. The second vaccine dose must be administered within a fairly tight window of about 4 days on either side of when due. If this is lacking, think about some contingency plan. Our office, for instance, should it receive vaccine would certainly prioritize somebody who had one shot and cannot get a second. All vaccines administered are reported to a statewide registry so there is no reason why you would have to get the two shots at the same location (although this would be preferable).
  • 5. Health care professionals who have received their vaccines from Los Angeles County vaccination sites have, without exception, reported professional staff, punctual appointments and an ease in scheduling their second vaccination.
  • 6. While I am sympathetic to those who are looking to rush out of this inexorable period of confinement – particular those 65+ who are at highest risk – there may be some benefit in waiting to see how the process unfolds. I have used the analogy of buying a car in the first model year insofar as it may be useful to let some of the kinks in the system work themselves out.
  • 7. Be aware that long lines and lack of physical distancing at a vaccination site could expose you to the virus. If you see or experience this, it may be reasonable to wait rather than risking exposure.

I am sure there are other concerns and tips that I am missing so please feel to add comments or ask questions in the comments below. I am hopeful that we can pull off this unprecedented mass vaccination effort. I am, on the other hand, acutely aware that the CDC, State Health Department and County Health Department have stumbled badly at nearly every critical juncture in this pandemic – from testing, to masking, to contact tracing, to premature lifting of shelter-in-place and now to way too slow vaccination distribution. As every financial commercial says “past performance is not indicative of future results” – but suffice it to say I have accumulated more than enough pessimism over the past 10 months to be skeptical.

This Post Has 2 Comments

  1. Renee Montagne

    Will the new Executive Order by Chair of LA County Board of Supervisors Hilda Solis, ordering LA County to make
    Covid -19 vaccinations available to residents over 65, starting January 21st, speed up vaccines arriving at medical groups, like Dr. Bretsky’s office? I am trying to avoid pharmacies and the Stadiums!

    1. The Executive Order widening criteria of who is eligible for vaccination did not come with a request or mandate to increase vaccine supply. So, in essence, it is an empty gesture. At the writing, the County of Los Angeles has unilaterally decided to provide vaccines through 5 sites – each of which at maximum capacity will vaccine 4,000 patients a day. Because the vaccine is a two dose series, it will take the County 2.7 years to vaccinate the 10 million residences of the County. There has been no additional allocation to individual physician’s offices (ours has been State and CDC certified since December 17th, 2020) or health systems (can refer to recent statements by Providence and UCLA Health).

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