Contra Costa Health Services Updates COVID-19 Vaccine Priority List

The COVID-19 vaccine is now available to all populations in Phase 1A and Phase 1B-Tier 1 in Contra Costa County, according to the health department.

The following is from the Contra Costa Health Department:

Eligible groups are outlined in the sections below.

At this time, Contra Costa is no longer including veterinarians and veterinarian staff in Phase 1A.

Vaccine Allocation within Phase 1A:

Tier 1

• Acute care, psychiatric and correctional facility hospital staff
• Staff and residents of skilled nursing facilities, residential care facilities for the elderly, and similar settings for older or medically vulnerable individuals
• Paramedics, EMTs and others providing emergency medical services
• Dialysis center staff

Tier 2

• Intermediate care facilities for persons who need non-continuous nursing supervision and supportive care
• Home health care and in-home supportive services staff
• Community health workers, i.e. Promotoras, African American Health Conductors, CORE Team, SPIRIT workers, homeless outreach workers, etc.
• Public health field staff
• Primary Care clinic staff, including Federally Qualified Health Centers, Rural Health Centers, correctional facility clinics, and urgent care clinics

Tier 3

Other settings and health care workers, including:

• Specialty clinics
• Laboratory workers
• Dental and other oral health clinics
• Pharmacy staff not working in settings at higher tiers

Vaccine Allocation within Phase 1B:

Tier 1

• Individuals age 65 and older, prioritizing those 75 years or older due to increased risk of death
  and serious illness
• When further prioritization is needed within age groups, vaccine should preferentially be
  offered to individuals based on:
  1. Place of residence in relation to the California Health Places Index (HPI), prioritizing communities that have been disproportionally impacted by the pandemic
  2. Occupational risk of exposure
  3. Underlying medical condition or disability
• Jail inmates and staff working inside county detention facilities who are unable mitigate their risk of exposure
• Individuals working within the Contra Costa County Emergency Operations Center and Contra Costa Health Services Department Operations Centers

Doses may be promptly offered to people in lower priority groups when:

• Demand subsides in the current groups
• Doses are about to expire according to labeling instructions
• Doses that have been thawed and would otherwise go to waste

As Contra Costa County prepared to receive initial supplies of COVID-19 vaccine, Contra Costa Health Services convened an Ethical and Equitable Allocations Committee to ensure a fair, transparent, and evidence-based approach to access during the early stages of availability. Committee participants were chosen to include stakeholders from across the county system with various backgrounds and interest, and to represent those groups that have been most impacted by the pandemic.

The Committee understands the need for flexibility as evidence emerges and medical realities change throughout the
phased distribution of COVID-19 vaccine. The recommendations from this Committee are based on the best available and most up to date scientific information along with data trends specific for our unique community. As our county moves through the phases of vaccine allocation, the Committee make-up will change to match the interests and voices of those within each group.

Ethical Framework

Contra Costa County maintains that all persons are worthy of receiving the COVID-19 vaccine, regardless
of a persons’ payer status, socioeconomic status, age, race, gender, ethnicity, national origin, sexual orientation, religious affiliation, or disability.

The Committee endorses the guidelines outlined by the Center for Disease Control and Prevention (CDC), Advisory Committee on Immunization practices (ACIP) and California Department of Public Health (CDPH). The ethical framework which has guided these recommendations are grounded in the fundamental commitment that the response to the current pandemic will protect and promote the public’s health and its socioeconomic well-being in the short and long term. To honor this commitment, the vaccine allocation response must promote the common good by balancing three main ethical objectives.

1. To protect the population’s health by maximizing benefit in the form of reducing mortality and serious morbidity
2. Respect individuals and groups at highest risk of health disparities
3. Protect against systemic inequality by promoting equity in access

The Committee is committed to ensuring that the most impacted areas of our community receive vaccine, while working within the state and federal framework.