As virus cases and hospitalizations drop and increasing attention turns to the state’s vaccine rollout, California officials are attempting a fine balancing act between speeding up the process and ensuring that vulnerable populations aren’t shut out.

On Tuesday, Dr. Mark Ghaly, the state’s secretary of health and human services, said in a news conference that the two goals were not mutually exclusive.

“This notion that we have to make a choice between speed and equity — it’s a false choice,” he said. “We can do both.”

This notion that we have to make a choice between speed and equity — it’s a false choice. We can do both.”
— Dr. Mark Ghaly, California’s secretary of health and human services

But in a state where officials have repeatedly said that equity was a top priority, and that transparency would be built into the effort, information about who’s getting vaccinated and in what order has been difficult to come by.

So far, more than 3.5 million doses of vaccine have been administered in California, Ghaly said. The rate of vaccinations statewide, he said, has been building day by day, since a surge in hospitalizations over the holidays. According to a New York Times tracker, about 7.4% of the state’s population has gotten at least one shot. That number is 8% for the nation overall.


However, the state has not released demographic statistics about who received the vaccines, so it’s unclear whether Latinos or other Californians of color who have been at disproportionate risk have been vaccinated at commensurate rates.

Ghaly suggested that state officials were weighing several methods of incentivizing vaccine providers to specifically target vulnerable communities, including with payments for performance.

Gov. Gavin Newsom last week announced that the state would revamp its vaccine distribution approach after widespread criticism that the rollout had been confusing and piecemeal.

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Part of that restructuring involved enlisting two of the state’s biggest health insurers, Blue Shield of California and Kaiser Permanente, to help with a statewide distribution system that would prioritize equity and streamline a patchwork system.

And the state created a website and data portal that officials have said will not only notify Californians when they are eligible for a vaccine and help them make appointments, but also would help collect and share data with federal agencies or others who may be working to allocate vaccines.


On Tuesday, Ghaly declined to share details of the partnerships but said any transitions to new systems would not disrupt existing appointments.

Experts have said that enlisting bigger, more experienced health care providers could help accelerate a vaccine rollout that has been hampered by its being implemented by already overwhelmed local public health departments.

In at least one place, though, simply having a smaller, more nimble agency in charge has made a significant difference, officials there have said.

A look at Long Beach

Mayor Robert Garcia of Long Beach told me that the fact that the city has its own health department, separate from Los Angeles County’s, had helped make its vaccine rollout a model within the state, hailed by Newsom.

“We can move fast and make decisions quickly,” Garcia said. “It’s been very beneficial.”

The city of about 467,000 people — Los Angeles County’s second largest — was the first jurisdiction to move from vaccinating health care workers and nursing home staff and residents to inoculating grocery store workers and critical public schoolteachers and staff. Anyone 65 and older has also been eligible, as directed by the state.


And it is also set to begin vaccinating crucial workers at California State University, Long Beach.

As of Tuesday, some 48,000 doses had been administered, according to data provided by Jennifer Rice Epstein, a city spokeswoman. The city has also been inoculating nonresidents who work in Long Beach, but if the doses had all gone to residents, that would represent more than 10% of the population.

That includes shots for 16,000 health care workers, almost 7,000 long-term care facility residents and staff, and 2,500 grocery store workers.

Garcia said the city’s health department was able to build on significant work bringing testing to harder-hit neighborhoods, where many lower-wage, often undocumented workers live.

“We had one of the best testing operations of anywhere in the state. A lot of our testing sites just became vaccine sites.”
— Robert Garcia, Long Beach’s mayor

“We had one of the best testing operations of anywhere in the state,” he said. “A lot of our testing sites just became vaccine sites.”


Those efforts have been coupled with a robust notification system that frequently updates users, even if they are not yet eligible for a vaccine, he said.

The city data showed that about 49% of the people who have been vaccinated in Long Beach are white — a reflection of most of the vaccines having gone to residents 65 and older, a population that is mostly white, Epstein wrote in an email. Roughly 21% were Hispanic or Latino, about 20% Asian and 7.6% Black or African American.

The city’s population is nearly 45% Hispanic or Latino, and roughly 28% white, 12% Asian and 11% Black, according to data from the U.S. Census Bureau.

Still, it’s tough to get a sense of how this compares with other jurisdictions or the state more broadly in the absence of more detailed data. But the numbers suggest that it will be challenging to fast-track vaccinations to specific at-risk groups.

In any case, Garcia said he believed that the statewide partnerships with insurers could help streamline vaccine distribution even more, in particular the allocation of doses to providers — whether they are public health departments or clinics.

“There needs to be a change,” he said. “I’m very hopeful this new system will fix some of the issues.”