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Health Department outlines plan to vaccinate Kern County

The Kern County Board of Supervisors heard the outline of a plan to vaccinate county residents against COVID-19 on Tuesday morning. It includes opening up the Kern County Fairgrounds for mass vaccination clinics, sending out mobile clinics and allowing state-approved local providers to administer vaccinations.

“Theoretically, we have 920,000 to vaccinate countywide,” Kern County Public Health Services Director Matt Constantine told the board. “This is going to be one of our biggest endeavors.”

Each successive tier and phase, defined by federal and state guidelines, will gradually scale up to encompass more employees and residents until eventually the general public is able to get the vaccine.

But the surge of active COVID-19 cases in the county now poses some barriers to the county’s plans for a vaccine rollout.

Originally, the plan was for hospitals to vaccinate their own staff, then pivot to the rest of the community. But the local surge has made it impossible for hospitals to handle vaccinations on a mass scale right now, Constantine said.

Constantine also warned that his department is stretched to its limits right now with the active cases in the county.

“We have plans, we have capacity, we have knowledge to do this. But all of that is tied up in our case investigations and contact tracers,” Constantine told the board.

Constantine said in an interview that the department will face a balancing act in the weeks ahead, especially if the county sees another surge from Christmas and New Year’s cases. On a hypothetical day when 1,000 new COVID-19 cases are reported in the county, contact tracers would be tasked with attempting to reach and provide information to, on average, about 4,000 people.

“It’s becoming taxing,” he said.

Right now traveling nurses who have contracts with the county are handling those cases. But as vaccinations become a priority for the county, the department may want to shift some of those contracts to handle vaccinations.

No action was taken during Tuesday’s board meeting.

THE PLAN

This week Kern County is set to wrap up vaccinations for Tier 1. This includes hospital employees, skilled nursing facility employees and residents, emergency medical technicians and paramedics and dialysis center employees.

Next week the county will begin to scale up as it rolls out to the next tier. Originally, hospitals were going to help administer vaccines in Phase 1a – Tier 2, Constantine said. This includes employees in primary care and urgent care clinics, home health and supportive services. It also includes community health workers and public health field workers.

Instead the county is turning to a list of 80 local providers who have registered through a state system to administer vaccines. This list includes pharmacies, community clinics, urgent care clinics and private doctors. To be on the state-approved list, these providers need the right equipment to store the temperature-sensitive vaccines. By signing up, they are also agreeing to vaccinate their own employees as well as the broader community.

“This not a public health department vaccination plan,” Constantine said. “It’s a community vaccination plan, and we’re going to rely on our providers to assist us.”

Constantine said in an interview that his department would study the list this week to figure out which of these providers might have the infrastructure and capacity to help with the vaccine rollout in the coming weeks for the next tier of workers, as well as the later phases.

The county is also working on its own plan to distribute vaccines in what it calls POD clinics, which stands for Point of Dispensary. These will likely be set up at the Kern County Fairgrounds and also mobile sites.

“It has lots of space, it’s centrally-located,” he said. “It is Bakersfield-based, so we’re now exploring ways to get to more outlying areas but right now that is the plan.”

The plan for Tier 2 is to reach out to employers. The plan is similar for Tier 3, which Constantine said the department hopes to achieve within January. This group includes employees who work in laboratories, pharmacies, dental offices, physical therapy, optometry and outpatient clinics.

Constantine said the smaller tiers will be a good opportunity for the health department to figure out what works before the teams have to distribute the vaccine to larger numbers in the community. Constantine said his department has experience with mass vaccination clinics, such as pertussis or previously H1N1.

But the COVID-19 vaccine has some additional logistical challenges. For instance, once a vial is open, it has to be used within a certain time frame. Patients need to be monitored for 15 minutes after they receive a vaccine. There is more paperwork.

“We’re going to start with small health care organizations,” Constantine said. “It’s a good way for us to practice and then we’re going to ramp way up.”

The next two phases will be much larger and require the department to scale its plans up. At this point, the plan is to expand the vaccination clinics being offered at the fairgrounds. The county also plans to create a website where the public can look up providers who are offering vaccinations.

Phase 1b will include those over 75 years old and those considered by the state to be essential frontline workers: employees who work in food and agriculture, education, transit, grocery store workers and first responders.

The final phase, 1c, is the last one before vaccinations are opened to the general public. It includes those ages 65 to 74, those with a high-risk medical condition and other essential workers. The state has yet to define who exactly this may include.