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SF Expands Vaccine Eligibility to Include People with Medical Conditions

  • Effective March 15, San Franciscans with certain medical conditions, including HIV, cancer, pulmonary conditions, and physical, mental or behavioral disabilities, are eligible to receive the COVID vaccine

  • People who live or work in congregate settings, such as jails or homeless shelters, are also eligible

  • Eligible residents do not have to provide documentation of their condition, but are required to sign a form attesting that they are eligible

  • Roughly one-third of San Francisco residents have received at least one dose, with wide variations by neighborhood

A larger group of San Franciscans are now eligible to receive the COVID vaccine under expanded state guidelines.

As of March 15, people with certain medical conditions, including cancer, chronic pulmonary disease, sickle cell disease, Down syndrome and pregnancy, can receive the vaccine under the state's expanded guidelines. In San Francisco, people with a broader range of disabilities or conditions, including HIV, physical, sensory, and behavioral health disabilities, severe mental health conditions, and substance use disorders are also eligible.

"Although supply is still not at the level we need it to be, we’re continuing to make good progress and we’ll keep doing our best to get vaccines to people as quickly and conveniently as we can,” said Mayor London Breed in a statement. People who reside or work in congregate settings, such as homeless shelters, jails or other behavioral health facilities, are also eligible to receive the vaccine.

Roughly 10% of San Franciscans identify as disabled or deaf, and health providers will not require verification of one's medical condition. Instead, vaccine recipients must sign a form attesting that they are eligible.

About 31% of San Francisco residents over 16 had received at least one dose as of March 15, although the real number may be higher. Due to issues with the state's immunization registry, vaccination data have been underreported since March 2. Among San Francisco residents age 65 and up, 73% had received at least one dose.

At the neighborhood level, Japantown and Portola are the most-vaccinated neighborhoods, with 43% and 32% of residents having received at least one dose, respectively. Lakeshore (15%), Presidio (15%) and Treasure Island (10%) are the least-vaccinated. The neighborhood data doesn't include roughly 20,000 vaccinated people who don't have a valid address.

Differences by neighborhood may partly reflect demographics: Japantown is among the City's older-skewing neighborhoods, with 42% of residents older than 60 according to a U.S. Census survey from 2016. Treasure Island is among the youngest neighborhoods, with a median age of 25 and only 5% of residents older than 60. Likewise, Lakeshore and Presidio skew younger and have relatively few residents who are eligible by virtue of age, according to Census data.

Both California and San Francisco have sought to ensure vaccine availability in the hardest-hit neighborhoods. Cumulatively, Bayview-Hunters Point, the Tenderloin and parts of the Mission have seen a disproportionate number of COVID cases and deaths since the pandemic began.

In response, San Francisco established pop-up vaccination clinics serving hard-hit neighborhoods, in addition to larger sites at Moscone Center, City College and Zuckerberg San Francisco General Hospital.

In partnership with Blue Shield, the state's primary vaccine administrator, California is also allocating 40% of vaccine doses to zip codes that are likely to have higher case counts and residents with chronic health conditions, based on a metric called the Healthy Places Index.

Two San Francisco zip codes are ranked in the lowest HPI quartile: 94130, which covers Treasure Island, and 94102, which covers parts of the Tenderloin, Civic Center and Hayes Valley. Once California has vaccinated 2 million people total in the lowest-quartile zip codes, it plans to begin loosening the reopening thresholds under the state's Blueprint for a Safer Economy.

With the recent approval of a one-dose Johnson & Johnson vaccine, California is expecting a ramp-up in vaccine supply by the beginning of April.

"We believe the largest number we'd get from the federal government is about 4 million," doses per week, said Paul Markovich, CEO of Blue Shield of California, which is acting as the third-party administrator of the state's vaccine rollout.

President Biden said last week that he will direct states to make all adults eligible to receive the vaccine by May 1.

"If President Biden and his team can deliver the supply, we're ready for it," Markovich said on a call with reporters last week.


Image by Jake Buonemani
Image by Rasmus Gundorff Sæderup

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