Whether or not California can reopen its economy after a year of COVID-19 restrictions depends heavily on how many of the state’s residents can become fully vaccinated against the illness. It’s an increasingly challenging situation with fluctuating vaccine supply and new, more infectious strains of the virus becoming dominant.
To streamline what some experts have called a clunky vaccine roll-out, the state has signed a $15 million contract with insurance provider Blue Shield of California. While the arrangement was announced in February, Blue Shield representatives only recently revealed more information about how that changes vaccine distribution going forward.
Under Blue Shield’s system, the company pays providers, such as community clinics or hospitals, for their performance based on how quickly and equitably they administer the vaccines. To meet the criteria, providers must reach monthly goals for vaccinating underserved populations, use vaccine doses within one week of receiving them and ensure people don’t travel more than 30 minutes to access a vaccine (60 minutes in rural areas).
Blue Shield’s contract states that they must build a network of providers meeting these standards, and help the state determine how to distribute vaccine doses through the network.
On Friday, Blue Shield announced that it has the capacity to vaccinate six million people per week, at 2,400 sites. The company released a list of 363 hospitals, community health clinics, pharmacies and home care agencies that are now part of the vaccine distribution network. These facilities make up the network of vaccination sites that Californians may access through the MyTurn scheduling system. All of those plans are contingent on how many doses of vaccine are available.
Lawmakers and health policy commentators have questioned whether Blue Shield’s involvement will actually lead to faster vaccine distribution, or whether the move is a publicity stunt for the company, which has previously donated large sums of money to Governor Gavin Newsom.
There has also been pushback from county health departments. Some initially refused to join the Blue Shield network, expressing concerns about the new system not helping Californians from underserved communities access the vaccine.
CapRadio talked with Blue Shield CEO Paul Markovich about how the takeover is going, and what’s in store. This interview has been edited for length and clarity.
There’s been a recent decrease in vaccine availability nationally. How does that impact what Blue Shield is able to do with the rollout?
It's just a short term dip in the supply, related to the Johnson and Johnson vaccine. We received, as a state, 572,000 doses in last week’s allocation, and that fell to 62,000 doses this week. The expectation is that they will get back on track. The [vaccines] do need FDA approval, but assuming that they get it, they will get right back into being able to manufacture and distribute at the levels that they had promised the federal government. So I think what we're looking at here is a two week, maybe three week, dip in J and J vaccine from what was expected. Then we would expect it to grow and get back to levels that were originally forecast by the federal government. What has to happen in the meantime, is we need to communicate to all of the players, the local health jurisdictions and the providers, let them know what we expect and so that they can all be ready for an increase in supply.
What role do county health departments play in this equation?
They play a crucial role in the success of this effort. Much of the network that is established right now, in fact, most of it, they had established already. They had identified providers they thought were crucial, not just for geographic reach but importantly to reach vulnerable communities … They also work with us each week to indicate where the vaccine ought to go, to which providers that will have the biggest impact, particularly on reaching vulnerable communities. [And they help connect to] vaccination efforts by large employers to bring general agricultural workers and migrant agricultural workers in to get vaccinated.
What is the plan for getting vaccines to people who can’t leave their homes?
It's really a community by community solution. When we first started, we were hoping we would get big providers that could handle large geographic areas for homebound populations. But as we worked our way through it, that's really not a viable solution. So what we've been doing is just going through this with each local health jurisdiction. There are some home health agencies that are able to do it, there's some local health jurisdictions themselves that have set up capabilities, but they tend to all be very local in nature.
The other place that we're spending a lot of energy right now to fill in the gaps with emergency services … an ambulance or people that are first responders that go out to people's houses. They obviously go pick people up and bring them to the emergency room when they need to. And so, [we are] equipping them with the ability to vaccinate, and go to people's homes and vaccinate.
What do you see as the major barriers that could slow down our vaccine roll-out?
The biggest barrier coming is vaccine hesitancy, because we are going to, in the not-too-distant future, probably by the month of May, have enough supply that everybody who wants to get vaccinated can get vaccinated. And then the question is, can we convince people who aren't sure they want to get vaccinated to actually get vaccinated? And that to me, is going to be the bigger challenge in the longer term. In the short term, it's really just trying to make sure the vaccine supply gets back on track, and that we receive the volumes that the federal government has been expecting from the manufacturers. If we get that and it goes through, we're all set up to vaccinate people in every single community in every single category.
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