Ira Kurtz, executive director of Rhoda Goldman Plaza in San Francisco, gets his vaccination. (Photo/Gabriel Greschler)
Ira Kurtz, executive director of Rhoda Goldman Plaza in San Francisco, gets his vaccination. (Photo/Gabriel Greschler)

Nursing homes get vaccine, others navigate byzantine system

UPDATED: Feb. 1, 11 a.m.

In mid-January, 85-year-old Doris Bloch of San Francisco heard the coronavirus vaccine was becoming available. She called the city’s health department and was put on hold for close to an hour. Feeling impatient, she hung up and called her doctor’s office, whose staff at first said they couldn’t help, but then eventually were able to schedule her an appointment for her first dose of the vaccine.

The soonest availability? Feb. 27.

“I thought, gee, that is a long time to wait,” Bloch said. “I’m 85. It’s a shame. It’s a damn shame.”

Across the Bay in Oakland, 74-year-old Loretta Eskenazi was also trying to get an appointment. Her son Joe waited on the phone for close to five hours to get his mother eligibility with the health insurance company. When she called, an automated voice message said there were no more slots, but Eskenazi did not hang up. Eventually, a person answered and she was able to get her shot scheduled on Jan. 18. Her second dose is on Feb. 8.

“You have to be able to just wait it out,” Eskenazi said.

Those two experiences offer a glimpse of the vaccine rollout in California, where people are navigating an often byzantine system to obtain their doses. Their stories contrast with the relatively smooth process of vaccinations at Jewish nursing homes, which have been inching forward with efforts to inoculate residents and staff who are in environments that are particularly vulnerable to coronavirus outbreaks.

But when it comes to individuals, most are confused and frustrated by the process. A Kaiser Family Foundation study released on Jan. 22 found that among those 65 and older, a high-priority group for the vaccine, six out of 10 said they lacked enough information on where and when to get a dose.

The state is currently in the first tier of Phase 1B Tier 1, which prioritizes 65-plus individuals and certain workers, such as those in the education and food sectors. California has used 60.6 percent of its supply and has administered the first dose to 6.9 percent of the population, compared with 7.9 percent in New York and 7.8 percent in Florida, according to a vaccine tracker from Bloomberg.

As of Feb. 1, the state had administered 3.4 million of its 5.7 million-dose stockpile.

Dr. John Swartzberg, an infectious diseases specialist with the UC Berkeley–UCSF Joint Medical Program, explained that the problems facing the vaccine rollout are multifaceted.

Mary Ann Salinas holds up two doses of the Pfizer-BioNTech Covid-19 vaccine at San Francisco Campus for Jewish Living, Dec. 21, 2020. (Photo/Gabriel Greschler)
Mary Ann Salinas holds up two doses of the Pfizer-BioNTech Covid-19 vaccine at San Francisco Campus for Jewish Living, Dec. 21, 2020. (Photo/Gabriel Greschler)

For starters, the state’s health care system is already under immense strain from the pandemic, and bringing on another onerous task, vaccinating millions of people, is proving to be a monumental challenge.

“Everyone is stretched so thin,” he said. “To superimpose upon those institutions the distribution of the vaccine is difficult when you’re in a crisis mode.”

Swartzberg also said he places blame on the federal government not providing enough funds for states to successfully roll out the vaccine. Although the federal stimulus package passed in late December included $8 million for vaccine distribution, U.S. health officials had asked for $8.4 billion in federal funds for nationwide efforts in October, but received only $400 million.

“You can put together a plan on paper,” he said. “But making that plan operational and ready to go is an enormous challenge without the money to do it.”

Another problem Swartzberg identified is that the vaccines themselves are not easy to manage. The required two doses “doubles” the level of effort in the rollout, he said. In addition, the cold-storage requirements of both the Pfizer and Moderna vaccines add an extra layer of complexity to the puzzle.

Swartzberg said this contrasts sharply with the polio vaccine, which was  administered in the 1950s and ’60s, first by injection and then later orally.  It was straightforward and simple, Swartzberg said. He remembers standing in line and being handed a drop of the polio vaccine on a sugar cube.

Mikhail Karton, a physician assistant at an oil refinery in Martinez and a 20-year member of the National Guard, said every county in the Bay Area is handling the vaccine rollout with varying levels of success.

Karton is volunteering with Contra Costa County by administering the vaccine at skilled nursing facilities. So far, he said, he has not experienced any issues with the rollout and was even able to schedule a dose for himself in early February. However, he tried scheduling a vaccine appointment for his 75-year-old mother through an Alameda County website, and so far no one has reached out to set up an appointment.

Sinai Memorial Chapel executive director Sam Salkin said counties have different rules around prioritizing mortuary and cemetery workers. Sinai, the only Jewish funeral home between Los Angeles and Seattle, has locations in San Francisco, San Mateo and Contra Costa County.

In San Francisco, the city sent a survey to funeral homes and cemeteries so they could gauge which employees needed the vaccine first. Salkin said that he filled out the survey for his 18 S.F.-based employees but hasn’t received any word back yet on when or if they can get an appointment.

San Mateo County is prioritizing mortuary workers for the vaccine but not cemetery workers; Salkin says he hopes the county will change the guidelines so five cemetery workers at the Sinai facility can get the vaccine.

Contra Costa County, on the other hand, has vaccinated all nine Sinai employees, four of them cemetery workers, in a rollout Salkin described as “very well organized.”

Other Jewish organizations are also navigating the vaccine distribution.

Rhoda Goldman Plaza, an assisted-living facility in San Francisco, had the first of three vaccination rounds for staff and residents on Jan. 27. Since the beginning of the pandemic, the senior facility has reported 22 staff and 36 residents testing positive for the virus. Eight have died.

“We were waiting, waiting, waiting,” said Elizabeth Wyma-Hughes, director of resident services. The facility worked with CVS Pharmacy to administer doses of the Pfizer-BioNTech vaccine.

Mikhail Karton, a physician assistant who administers the vaccine at skilled nursing facilities as a volunteer, gets a vaccine of his own.
Mikhail Karton, a physician assistant who administers the vaccine at skilled nursing facilities as a volunteer, gets a vaccine of his own.

CVS’ approach, Wyma-Hughes said, has been “a little bit scattered.” However, she described residents and staff at the facility as being “thrilled” for their chance to get vaccinated. “This is the light at the end of the tunnel for them,” she said.

According to data publicly available from the company, as of Jan. 29 CVS had administered the first dose of vaccines for 46 percent of the 14,557 assisted-living and long-term care facilities in California that chose to partner with the pharmacy.

Michael Wasserman, immediate past president of California’s Association of Long Term Care Medicine, described these efforts as “painfully slow.”

“It has been very concerning to me,” said Wasserman, who believes there was a premature decision by the state to open up the vaccine to California residents over 65 before everyone at senior facilities, including skilled nursing, long-term care and assisted living, was covered.

“We still haven’t [completely] vaccinated the most vulnerable people,” he said. More than a third of all coronavirus deaths in the country have been at senior homes.

CVS spokesperson Mike DeAngelis said the pharmacy is “on schedule” and by mid-February will have administered the first dose of the vaccine at 40,000 assisted-living facilities across the country.

“Our dedicated health care professionals are reaching long-term care residents and staff as soon as possible based on activation dates selected by the states, while navigating the challenges of a complex rollout,” said DeAngelis.

Skilled nursing facilities, which were prioritized before assisted-living facilities, have seen significant progress in their vaccination efforts.

The San Francisco Campus for Jewish Living has had 92 percent of residents and 87 percent of staff members vaccinated; the second dose will be administered in mid-February. At the other Bay Area Jewish skilled nursing facility, Reutlinger Community in Danville, about 80 percent of the staff and all 100 residents received their second dose on Jan. 26.

“We’re very lucky we have access to it here,” said Nonnie Fluss, a life enrichment coordinator at Reutlinger. “We’re thankful and grateful that we’re able to have access.”

For one clinical researcher at Stanford, Christin New, the vaccine is about “preserving life.” Whatever hoops necessary to jump through, she said, it is worth it for those around you. New gave birth last December and got a dose afterward; she believes that’s a testament to the safety of the vaccine.

“It’s not just for self-serving purposes, it is for a greater benefit for all of us,” New said. “That to me is so compelling. To me, it’s a mitzvah.”


Tips on getting the vaccine

Don’t be afraid to ask for help. The vaccine process has proven difficult for many. Recruit family members or friends to help assist you with finding an appointment. “Don’t try to handle it on your own,” said Dr. John Swartzberg. The doctor also suggests contacting your synagogue to see if it can help.

Schedule a virtual appointment with your primary care physician. Many are offering Zoom visits so you don’t have to go in-person. Your doctor will be able to determine whether a vaccine is right for you.

If you have a health insurance company, contact it. Check to see if it is offering any resources. If you don’t have health insurance, contact your county’s health department for more information.

Check to see if you are eligible. The state has set up a website called My Turn that helps individuals determine when they might qualify for a vaccine.

If you are looking for a vaccination location, check out VaccinateCA.com. The crowdsourced website allows you to type in your ZIP code and find a vaccination site with eligibility requirements, such as age and location.

Keep an eye on local news for more tips. Both KQED and the San Francisco Chronicle have county-specific guides to help people find the right information.

Gabriel Greschler

Gabriel Greschler is a staff writer at J. You can reach him at [email protected] and follow him on Twitter @ggreschler.