When can you get your COVID vaccine? How much will it cost? Answers to your top questions
As more doses of COVID-19 vaccines are distributed to counties and other health agencies, demand – and competition – is growing in Fresno County and across the central San Joaquin Valley for the protection promised by the new drugs.
Since mid-December, when the first doses of vaccines from Pfizer-BioNTech and Moderna were approved and shipped, the first priority was to vaccinate front-line hospital workers, including doctors, nurses and technicians most directly exposed to coronavirus patients, said Dr. Rais Vohra, Fresno County’s interim health officer.
In recent weeks, the vaccine program has been expanded to other types of health care workers, as well as to senior citizens confined to long-term care facilities, which have been prone to outbreaks.
As California, Fresno County and neighboring Valley counties unveiled proposed schedules this week based on priorities for different parts of the population, the federal government moved to accelerate its distribution of vaccines and open vaccinations to seniors ages 75 and older. That effectively forced local health agencies to juggle their schedules to advance older residents – people who are considered among the most vulnerable – closer to the front of the line, Vohra said.
“It’s certainly a dynamic situation, and it’s changing day by day and sometimes even hour by hour,” Vohra told The Bee on Thursday. “What we had planned for this week was to vaccine our health care workers” at a pair of high-volume sites. The elderly, he added, were set to start getting shots next week “and we would work through those people as fast as we could.”
But the state and federal pronouncements about immediately vaccinating the elderly “kind of threw those plans out the window,” Vohra said. “This week, we’re facing a confluence of competing elements. We basically had to accommodate our elderly populations a little bit earlier, and at the same time figure out where the line of seniors who are 75 versus 65 was going to fall on us.”
“Now it’s out there that people over 65 are eligible now. We’re not built out for that yet, but they’re showing up,” Vohra added.
Since Fresno County’s first case of coronavirus was confirmed in early March 2020, almost 80,000 people have been infected, with thousands becoming sick enough to require hospitalization. Almost 850 deaths in Fresno County are blamed on COVID-19, including 135 in just the past two weeks.
As people begin to clamor for the vaccine, it’s creating a bit of a tightrope on which the county must balance the competing demands for what remains a scarce resource. “Every day it feels like we’re about to break the mousetrap that we’ve built,” Vohra said. “How can we appease the crowd, control the throughput, and pay attention to equity and fairness?”
In a telephone interview with The Bee, Vohra addressed some of the questions that are cropping up now that the vaccines are becoming more widely available to more than just health care professionals.
How many people have gotten shots so far?
Vohra said that as of Thursday, Fresno County had received about 47,000 doses of the two different vaccines that are available; of that number, more than 30,000 doses have been distributed to hospitals and other facilities that are offering the shots, including a vaccination site set up this week at the Fresno Fairgrounds that is capable of injecting about 1,500 people a day.
Both the Pfizer and Moderna vaccines require a second shot for full effectiveness: 21 days later for the Pfizer product, 28 days for Moderna. Vohra, who also serves as an emergency room physician at Community Regional Medical Center in downtown Fresno, said some of the first hospital workers who received shots in mid-December are now getting their second doses, adding that he received his second shot on Jan. 8.
When will it be my turn to get the vaccine?
Unless you’re part of a prioritized group, it’s likely to be at least May before you can get your first dose of vaccine in Fresno County. Neighboring counties have their own vaccination information and plans online:
Kings County: bit.ly/35IRgqQ
Madera County: bit.ly/2N8nCEZ
Tulare County: covid19.tularecounty.ca.gov/covid-19-vaccine
What are the prioritized groups?
The current plan in Fresno County is to complete the vaccination program for health care workers from front-line hospital doctors, nurses and technicians to paramedics, EMTs, long-term care facility staff and residents, dialysis centers, and people who work in health clinics and medical practices throughout the county. Those are the people in what’s been dubbed Phase 1A of the vaccine rollout.
Senior citizens are part of Phase 1B, which got a premature start after the state and federal pronouncements. While Fresno County’s website provides registration slots through at least Jan. 23 for people ages 75 and older to get vaccinated at the Fresno Fairgrounds, “we’re not turning anyone away if they’re over 65,” Vohra said.
Why are seniors getting vaccinated earlier?
Senior citizens are among the most vulnerable populations for serious illness from COVID-19, with higher rates of hospitalizations and deaths than younger people. All of the appointment slots that initially became available for seniors 75 and older this week were completely spoken for by Thursday morning. On Thursday afternoon, the county opened registration for more seniors to make appointments next week.
“Right now we’re being very strict, health care workers and the elderly only,” Vohra said.
The relief of people who are getting their shots at the fairgrounds is palpable, he added, even after they’ve waited in line for two to three hours or more. “We have elderly people who have been shut in for the last 10 months, and for many this is the first significant trip out of their house that they’ve been able to make,” Vohra said. “It’s really heartwarming to see their excitement about getting this vaccine.”
I don’t use the internet. How can I sign up?
“We’re strongly encouraging people to register online and not just show up at the fairgrounds,” Vohra said. “We know some seniors don’t use the internet, so they can make a phone call to us, but our phone lines are swamped right now.”
Until the county can set up a call center to field phone calls to register for appointments – probably sometime next week – Vohra urged people to help their older relatives go online for a vaccination date and time.
The registration links for slots at the Fresno Fairgrounds can be found online at bit.ly/35MgBjs.
The main phone line for the Fresno County Department of Public Health is 559-600-5956.
Who’s next in line after seniors?
More segments of Phase 1B are expected to start getting vaccinations in February. The first tier includes workers in food and agriculture, including farm workers; people who work in education and child care; and emergency services personnel including police and firefighters.
Tier 2 of Phase 1B will come in March, and include the homeless; jail and prison inmates; people who work in transportation and logistics including truck drivers, bus drivers and others; critical manufacturing; and the industrial, commercial and sheltering facilities sectors.
Phase 1C is expected to commence in April. That will include people between the ages of 50 and 64; people ages 16 to 49 who have underlying medical conditions that put them at greater risk for serious illness or death from COVID-19; workers in the water, waste management, defense, energy, chemical and hazardous waste industries; the communication and information technology sectors; financial services; and government operations and community services.
All of those expectations, however, are based on having a steady supply of vaccine coming from the two manufacturers.
Where will I get my shots when my turn comes?
Prior to this past week, most of the shots being given were by hospitals to their staff. The fairgrounds site was initially intended to help speed the distribution of vaccines to other health care workers from Phase 1A, as is an orthopedic center in northeast Fresno.
Vohra said many more vaccination sites, including health clinics and medical practices, will be ready to start offering vaccinations as soon as next week. In the meantime, he urged people to contact their own doctor’s offices to see if and when they will be providing shots for their established patients.
“We have almost 100 providers that are going through the process” of getting approved to provide the vaccines in Fresno County, Vohra said. That includes ensuring that they have freezers capable of storing the vaccines at temperatures cold enough to keep them viable until the shots go into arms.
Even those sites, however, will be expected to follow the schedule of prioritized groups.
How much will it cost to get the vaccine?
The vaccine itself is free of charge, provided by the federal government. Some clinics may charge a fee or co-payment to cover the cost of providing the shots, Vohra said, but the county health department is using some of the money it received from a massive federal coronavirus relief bill to help support clinics.
Why does it take two shots?
The clinical trials for both of the vaccines indicated that two shots provide the most thorough protection. Vohra said that the United Kingdom is going with only one shot and seeing what happens, but the U.S. is taking a more cautious approach.
Ideally, a person who gets the Pfizer vaccine will get their second shot three weeks later; the interval is four weeks for the Moderna vaccine.
But a delay in getting the second dose, or even missing it altogether, “is not a huge concern right now,” Vohra said. “Even if someone waits five or six weeks to get that second shot, that doesn’t disqualify you.”
That presumes that there is a reliable supply of the vaccine coming from the two companies. In an effort to speed the initial distribution of the vaccine, the federal government is pushing out millions of doses to providers nationwide rather than holding some back to provide the follow-up shots later.
“As a medical community, we want those second doses available,” Vohra said. “I’m sure hoping we get more doses from the manufacturers, because we’re going to need them.”
How many people in Fresno County need to get shots for us to be safe?
“Our plan, once we get our roster of sites built up, is to give 20,000 to 30,000 vaccines a day across the county,” Vohra said. “We have 750,000 people who need to be vaccinated by the end of the summer” to ensure that enough are protected from the virus.
The Phase 1B groups that began to receive shots this week represent “a really big pool of people, about 260,000 in Fresno County,” Vohra said. “That’s going to take many weeks and months.”
Are there people with conditions who need to avoid getting the shots?
Vohra said that so far, guidance does not indicate any health conditions that would disqualify anyone from getting the shot. People with a history of allergies may be held for up to a half hour after getting the shot to monitor them for any bad reactions, but those reactions are rare – about one person out of one million, Vohra said, citing data from the U.S. Centers for Disease Control. “But they should still go ahead and get a shot.”
The chances of catching COVID-19 without a vaccination are “much higher” than the prospects of an adverse reaction to the vaccine.
Women who are pregnant or breastfeeding can also get the shot, even though some are waiting for more information before they do so.
More information on the vaccines is available from the U.S. Centers for Disease Control. The Self-Advocacy Resource and Technical Assistance Center, or SARTAC, has also published information explaining the vaccine rollout schedule and other aspects of the vaccination program.
How safe is the vaccine?
After more than 10 months of public health orders that have closed or curtailed thousands of businesses and required people to wear masks and maintain physical distance in public, and avoiding gatherings both large and small, Vohra said he hopes people don’t shy away from the vaccine because of fear.
“We don’t know a lot about this vaccine specifically” because it is so new, Vohra said. “But we know a lot about the science of vaccines in general, and we know they work.”
Polio, smallpox, measles and other once-dreaded diseases are examples of vaccine successes in history. “We don’t hear about those diseases anymore because we’ve all been vaccinated against them,” Vohra said.
The clinical trials for both the Pfizer and Moderna products indicate that each is about 95% effective. “What that means is that it drives down your chances of getting hospitalized to only about 5%, if you catch it,” he added. “That’s what makes us draw the bold conclusion that this is our best shot at reopening.”
This story was originally published January 15, 2021 at 9:57 AM.
CORRECTION: In the original story, Dr. Vohra said new vaccines against COVID-19 are about 95% effective. In that story, he said, “what that means is that it drives down your chances of getting hospitalized to only about 5%, if you catch it.”
After questions from readers, Vohra clarified Tuesday that the 95% reduction is for the number of cases of COVID-19. He added that “the reduction of serious illness presumably resulting in hospitalization is about 90%.”
