"Immediately on the first day, there probably won't be availability for everybody, just because ... when you make millions of people eligible overnight, there's not millions of appointments immediately available at that moment," Markovich said. "But I would say by the time we get to the end of April, or potentially early May, I don't think that's going to be an issue."
Blue Shield says California now has the capacity to administer 4 million vaccines a week. But to meet that capacity, manufacturers have to deliver the vaccine supply they have promised, Markovich said.
The scope of California's vaccination push is massive. To date,16.4 million vaccine doses have been administered, more than the amounts that some entire countries — Russia and Germany — have administered. About 18% of Californians are fully vaccinated, but far more are needed to achieve the herd immunity that will ease pandemic restrictions.
In San Mateo County, nearly 284,000 people have received a dose of COVID-19 vaccine, or 44.2% of residents age 16 and older, and nearly half of them — 135,000 — are fully vaccinated, San Mateo County Health announced on March 31.
California is expected to receive 2.5 million vaccines per week in early April and close to 3 million by the second half of the month. That's a substantial increase from the approximate 1.8 million vaccines a week the state is currently receiving. The boost allows California to expand eligibility to residents who are 50 and older starting April 1, and then to everyone 16 and older beginning on April 15.
At the same time, two mass vaccination sites in Oakland and Los Angeles run by federal and state agencies are expected to close April 11, California officials announced on March 26. The federal-state pilot project ends then, although the local health agencies may take over the sites.
California's no-bid, abruptly announced contract with Blue Shield to oversee vaccine distribution has been controversial. Some counties refused to sign a contract with the insurer, fearing giving authority to a private company. Counties now are allowed to sign modified agreements with the state to join Blue Shield's network.
In a troubleshooting meeting on March 26 for vaccinators, some doctors complained that they had tried to sign up with Blue Shield yet couldn't get doses for their patients.
But that's by design, Markovich said. Blue Shield first will bring on board the clinics and doctors who can reach the most people, he said.
"We're certainly going to get back to everybody who's interested," Markovich said. "But some of that delay has been intentional. We didn't see a lot of point in making them go through the work if they were going to then have to potentially wait three or four or more weeks" for doses.
As of March 25, only 20 of the 61 county and city health departments had signed onto the new network. Only Kern and Orange counties signed up directly with Blue Shield. Blue Shield's network so far includes 270 providers with 2,100 sites, including hospitals, pharmacies and community clinics.
Markovich said he expects all counties and more providers to make the switch.
Doctors and other providers must sign onto the Blue Shield network to continue getting doses.
For months, the state has been dogged by concerns over equity as Latino and Black Californians hardest hit by the pandemic are being vaccinated at lower rates than white people.
A study published on March 26 found that the age-based approach in California helped white people more than people of color. That's because California's older population is more white.
Vaccinating all Californians 75 and older would have prevented the deaths of two-thirds of white people compared to 42% of Black people's deaths and 35% of Latinos' deaths, according to the study.
"An age-based approach in California benefits the state's older white populations at the expense of younger BIPOC (Black, Indigenous and people of color) populations with a higher risk of death from COVID-19," wrote the researchers from the University of California at San Francisco, University of Minnesota and other institutions.
The study suggests that California's more recent move to put more focus on disadvantaged neighborhoods will improve this inequity.
California last month began earmarking 40% of its vaccine doses for the state's lowest income and most diverse communities.
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