Vaccines surge in West Marin

03/03/2021

The effort to vaccinate people is picking up steam in West Marin. Food service workers and emergency service workers are now up for their turn, and many just received their first doses. School employees are set to be fully vaccinated by spring break at the beginning of April, and providers are inoculating the few residents over 65 they can find who haven’t been vaccinated. An estimated 35 percent of West Marin residents— 3,712 out of 10,729 people—have received their first dose.

“Every day more and more people are getting vaccinated, and fewer and fewer people are getting infected,” said Dr. Matt Willis, Marin’s public health officer. “That’s the recipe for the eventual resolution of the pandemic. We are on that path.” 

Only one case was reported in West Marin last week, bringing the February case count to 13.

Marin has vaccinated nearly one in four residents, second among California’s more populated counties, and is on pace to vaccinate every willing adult by the end of June.  

Residents with certain medical conditions will become eligible on March 15. The state has taken full responsibility from counties for determining eligibility.

Marin’s public health department and three hospitals have set up mass vaccination sites that can offer thousands of doses each day, limited only by the supply they receive. In West Marin, primary care providers are targeting the most vulnerable populations first, though the logistics are a challenge. Curative, the West Marin Medical Center and the Coastal Health Alliance have been allotted 100 doses a week. 

The vaccine comes as a huge relief for Palace Market employees, who have been on the frontlines for a year now. By the end of the week, 44 of 47 employees will have received their first dose; the three who opted not to are vaccine hesitant. 

“It gives our team a light at the end of a very long and dark tunnel,” store director Brittany Hartwell said.

The first group of employees was vaccinated in Mendocino in early February because that county had no restrictions on residency. Older employees were vaccinated through their health care providers, while the rest of the staff couldn’t find an appointment until last Thursday, when a customer told them the Coastal Health Alliance had vaccines. Fifteen worjers walked over and returned with a shot in their arms.

Susan Joseph, the store’s front-end manager, is 65 and diabetic, and she takes care of her mother, who is on oxygen. She has worked at the Palace for 19 years and hasn’t missed a day during the pandemic, but she is constantly scared of catching Covid-19 and bringing it home. Now that she’s been vaccinated, a rough year is looking up.

“I’m not so scared anymore,” she said. “I’ll always be worried about it, but I won’t be terrified like I have been in the past.”

Alma Sanchez, the food pantry manager for West Marin Community Services, speaks daily with Spanish-speaking residents. She said it seems like the whole town is getting vaccinated this week and last week, and people are generally excited. Young adults are more enthusiastic than older adults, who are worried about an allergic reaction or unknown long-term consequences, she said.

Latinos make up 16 percent of Marin’s population but have been handed 55 percent of all Covid-19 cases. The county has been focused on equity in its pandemic response, and the vaccine rollout is no exception. It’s hard to gather the exact demographics of those who have received the vaccine because 10 percent of recipients have missing ethnicity information, but state data shows that Latinos are receiving more doses per capita than white residents in Marin. Latino residents have received 17 percent of the vaccine, while white residents, 71 percent of Marin’s population, have received 32 percent, according to the state’s vaccination progress dashboard. Dr. Willis said this is because frontline workers are largely Latino.

“Our strategy for vaccinating to protect that community that has been particularly hard-hit matches really well with the sectors that we are now able to, under the state, vaccinate currently,” he said.

The county is now using the state’s system for people to sign up to be alerted when it is their turn; visit myturn.ca.gov to complete the form.

The state decides who is eligible, but providers have room for different approaches because multiple groups are up for their turn. Largely, residents over the age of 65 have been taken care of in West Marin. Dr. Colin Hamblin at the West Marin Medical Center said anyone who knows a senior who wants a vaccine but hasn’t received one should call his office.

The Coastal Health Alliance is targeting its doses with an equity framework that prioritizes individuals first based on age, then exposure, ethnicity and medical complexity. Medical staff who know patients will bring them in based on their comorbidities, and patients will receive a link to a survey this week about their profession so the clinic can identify essential workers. Next Friday, the clinic will offer 100 doses in Bolinas.

“We can be an access point where the more vulnerable, people with transportation issues or those who might not have access to information can get the vaccine,” said Dr. Christina Gomez-Mira, the Coastal Health Alliance’s lead physician. 

Pharmacies, hospitals and the county public health department have been tasked with administering the bulk of the vaccine; by contrast, primary care providers are taking on the project in West Marin. 

Dr. Hamblin sees this as both an opportunity and a hindrance for his small clinic. On one hand, he knows his community. He can easily call up places like the Stinson Beach Market or the Spaletta Ranch and ask them to bring employees in or go there himself. He visits homebound seniors, and he knows who is the sickest. But because eligibility is restricted and the medical center must deliver 100 shots in one day, finding the exact population has been a challenge, and the data entry is a burden on staff. 

Once everyone is eligible, he envisions the medical center offering patients routine doses, allowing him to keep the clinic open for regular visits. “You come in for a hangnail, and I give you the vaccine,” he said.

As the virus transmits between humans, it can mutate into a deadlier, more infective strain that has greater resistance to vaccines. The rollout of the vaccine is a race against the spread of these variants. 

California is gene sequencing about 3 percent of tests to detect variants. A California strain is already widespread and has shown increased infectivity in laboratory tests. But at the same time it has proliferated, the state has seen dramatic drops in cases, hospitalizations and deaths. Dr. Willis said the variant doesn’t seem to be changing how the virus spreads in the real world, and the strategies used for the past year are the same ones to employ now.

Another tool is on the way: a vaccine from Johnson & Johnson, the third to be approved. The vaccine is 85 percent effective at preventing severe illness and only requires one dose. Marin is expecting 2,000 doses this week. “We see it as a huge asset to us, given the major barrier for us is the lack of product,” Dr. Willis said.