As SLO County hits its COVID-19 vaccine stride by replacing a first-come, first-serve system with a lottery designed to make things more equitable for those eligible to receive vaccines and a multilingual pilot program to vaccinate and educate underserved essential farmworkers, California introduces a more centralized vaccine distribution system. MyTurn, a state web portal for registering first- and second-dose vaccine appointments, is glitchy with major problems. The county is uncertain how the transition to both MyTurn and Blue Shield's impending takeover of state vaccine distribution will affect its progress.

—Camillia Lanham, editor

SLO County Public Health prepares for transition to MyTurn and Blue Shield COVID-19 vaccination systems

After a frenzied few months of setting up new clinics, creating appointment systems, and working with an inadequate vaccine supply, San Luis Obispo County Public Health finally appears to be hitting its stride with COVID-19 vaccinations.

On March 3, SLO County Public Health Officer Penny Borenstein shared that the county had the supply to administer 13,000 vaccine shots for the week of March 8—a record that inches it closer to its ultimate target of 15,000 weekly shots.

That same day, Borenstein reminded locals about the county's new vaccine lottery system. Striving for more ease and equity, each week, the lottery randomly selects which residents will receive the following week's vaccinations from a broader pool of eligible registrants. It retires the county's first-come, first-serve system that brought a flood of traffic to its website each week as people vied for appointments.

But as Borenstein highlighted these positive developments on March 3, she also delivered a clear warning about future uncertainty.

"There is a caveat," she said. "We should not yet believe that this is our new normal. ... We do not have it in our sights to necessarily maintain that level of vaccination."

As Borenstein and SLO County settle into a vaccine groove, a major shakeup in the California vaccination system lies ahead. Over the next month or two, SLO County will join other counties in a sweeping, mandatory transition to Blue Shield of California as the state's new contracted vaccine distributer and to a centralized vaccine appointment web portal, MyTurn.

Both changes are promised by state leaders to enhance and accelerate California's vaccination campaign by streamlining processes, platforms, and data. But so far, the overhaul has faced criticism from stakeholders across the state—as counties that have worked hard to develop their own systems to vaccinate their residents begin to make the transition.

Flaws and glitches in the MyTurn website portal and confusion and distrust around Blue Shield's management of vaccine allocations have triggered a "bipartisan chorus of concern" among county health officials, according to recent reporting in the Los Angeles Times and CapRadio. Some counties, including Ventura and Santa Clara, are asking the state for an opt-out option.

"All we really need from the state is more vaccine," Santa Clara County Executive Jeffrey Smith told the LA Times. "We don't need a new and inferior delivery system."

In SLO County, the changes are coming but are not here just yet as the state rolls them out in phases. SLO County Public Health Department spokesperson Michelle Shoresman told New Times that the county expects the required transition to MyTurn to occur sometime in April, adding that officials are "still learning more about what features will be required."

Complaints about MyTurn range from the site crashing, to it providing inaccurate information about vaccine appointments, to it allowing wealthy Los Angeles residents to steal vaccine access codes meant for disadvantaged communities.

Shoresman said that as "with the implementation of any new system, there are bound to be benefits and challenges" with MyTurn.

"We don't yet fully understand what those will be," she said. "We will continue to learn more as we get closer to 'go live' with MyTurn and will do everything we can to make this transition, when it happens, as smooth as possible for our residents."

SLO County expects that the MyTurn transition will disrupt elements of its current vaccination process, like the newly introduced lottery system.

"When we transition to MyTurn, it will likely replace the new registry system we created and implemented this week," Shoresman said.

Predicting the potential consequences of the Blue Shield transition is also difficult, Shoresman said.

In January, the California Department of Public Health decided to outsource COVID-19 vaccine allocation responsibilities to the insurance giant, which will contract with health providers and use data-driven algorithms to determine where the state's supply should go. That handoff is expected to happen statewide by the end of March.

SLO County hopes that the change will not impact the flow of vaccines coming to its three vaccine clinics at the Paso Robles fairgrounds, Cuesta College, and Arroyo Grande Community Center.

"We are not yet clear on how the Blue Shield agreement will impact our own vaccine clinic efforts, or others, but we hope that it will improve availability of vaccine for all," Shoresman said.

One question about the Blue Shield arrangement is whether it might lead to more local health care providers offering the COVID-19 vaccine. Currently, other than the Public Health clinics, only a handful of local pharmacies are administering vaccines in SLO County.

French Hospital Medical center in SLO had a short-lived vaccination drive in January and February but paused it indefinitely to "focus on patient care," according to a Dignity Health Central Coast spokesperson.

The lack of options is expected to change soon. Borenstein announced on March 3 that Community Health Centers of the Central Coast is starting vaccinations. Tenet Health Central Coast officials told New Times on March 8 that it plans to launch vaccine clinics at Sierra Vista Regional Medical Center and Twin Cities Community Hospital in the near future, working with the state and Blue Shield to secure supply.

"Our hope is that the vaccine will ultimately be widely available from regular health care providers and pharmacies across SLO County," Shoresman said. "Until this wider infrastructure exists, we are providing the vaccine through our three clinics." Δ

Reach Assistant Editor Peter Johnson at pjohnson@newtimesslo.com.

SLO and Santa Barbara Counties work through barriers to provide COVID-19 vaccine to farmworkers

Erica Ruvalcaba-Heredia, director of the Promotores Collaborative of San Luis Obispo, got emotional over the phone when she talked to New Times about the work the SLO County Vaccine Task Force and Public Health Department are doing to vaccinate the farmworker community.

As a daughter of immigrants herself, Ruvalcaba-Heredia said many farmworkers and Latinos feel that the greater community is finally valuing them and their work.

In late February, the vaccine task force approved a plan drafted by the SLO County Farm Bureau to begin vaccinating farmworkers in mid-March—the date is dependent on vaccine availability—at the South County Regional Center in Arroyo Grande. Fieldworkers who are set to have their first dose of the COVID-19 vaccine this month, she said, are happy, thankful, and excited.

"It's important to mention that they feel like, 'OK my work as an essential worker matters and the people at [the Department of Public Health] care about me," Ruvalcaba-Heredia said.

At the beginning of the COVID-19 pandemic, Latino residents accounted for a majority of SLO County's confirmed COVID-19 cases. Although initially Latinos were disproportionately impacted by the virus, over time the percentage of cases has evened out to match SLO County's demographic makeup. As of March 8, Latino residents—who are 22 percent of the population—made up 33 percent of SLO County's total positive cases since March 2020.

Ruvalcaba-Heredia represents these communities on the SLO County Vaccine Task Force and recently shared that some community members have doubts about the inoculations.

"They say they heard from a neighbor or a friend that if they get the vaccine and they don't have any symptoms like a head cold then the vaccine didn't work and they'll get the coronavirus or some other illness," she said.

Other rumors include that if you get the vaccine you'll die or if you get it you'll become sterile. Ruvalcaba-Heredia compares it to the telephone game: One person says something to another, and that person passes it on to someone else, and all the while the message becomes more and more distorted.

Promotores tries to eliminate misinformation by getting its information directly from the Public Health Department, translating it, and dispersing it to the community. She said that having someone who's not only bilingual but is a member of the community, has a family or friend working in the fields, and understands the challenges the Latino community faces makes it easier for individuals to reach out to them for assistance or information.

"It makes a difference because they understand and have empathy for their community," Ruvalcaba-Heredia said.

Brent Burchett, executive director for the SLO County Farm Bureau, said that compassionate multilingual outreach was a goal of the SLO County Farmworker Task Force that formed in November 2020.

As a member of the task force, Burchett's first course of action was educating and helping farmers with regulations and coronavirus testing to ensure the safety of their workers. When the vaccine first became available, Burchett also joined the vaccine task force, where he learned that SLO County decided to follow an age-based tier to vaccinate county residents.

"The doctors on the [task force] had a good point. While occupation may be a great indicator of COVID exposure, whether you're a teacher, police officer, or farmworker, the greatest predictor of mortality in a serious health implication from COVID is age," he said.

When the task force debated how to determine which industries to vaccinate, Burchett said the team realized there are and would be many barriers to vaccinating farmworkers.

The California Department of Public Health placed agricultural workers in phase 1B, so the task force began trying to figure out how to reach the farmworker community. Burchett said the plan for the pilot vaccination program, a date is yet to be set, will get modified after the first clinic is done. But for now, the task force has the names and contact information of farm labor contractors and large-scale farmers. Each employer will submit a list of interested employees' names, date of birth, and another identifier (the task force and county are still working together to decide on a third category). The Farm Bureau doesn't want a driver's license or a Social Security number as identifiers because it might dissuade individuals from getting the vaccine on account of their legal status.

"That's a barrier. We want to make this as easy as possible and for the farmworkers to feel comfortable coming in," Burchett said.

SLO County Public Health spokesperson Michelle Shoresman said that the county is still working out the details of how to verify employment and residency with the Farm Bureau and employers "for this high-risk group, but we are committed to making the process as non-intimidating as possible."

When a worker arrives for the appointment, he or she will need to fill out a health screening document, and multilingual staff will be available to help. In an effort to get their workers vaccinated, Burchett said he hopes employers will offer paid sick leave or half the day off to allow employees to participate in the program.

Currently, the county can't provide mobile vaccination clinics on-site because of the vaccine's storage needs.

According to a recent survey conducted by the Farm Bureau, 180 agriculture farmers and farm labor contractors in the county employ a collective 6,000 agriculture workers who need the vaccine.

The survey also takes into account seasonal farmworkers. For instance, about 1,800 workers included in the survey are coming to the Central Coast from Arizona. Burchett said the numbers are estimated and the workers included could overlap with those who live in Santa Barbara County and work in SLO County.

"The rule is you can either work or live in SLO County. Either one of those is acceptable [for vaccine eligibility in SLO County]," he said.

Shoresman said the county doesn't know how Blue Shield's efforts will impact its pilot program yet.

SLO County is slightly behind other California counties that have already carried out pilot programs to vaccinate their farmworker populations. Santa Clara, Fresno, Santa Cruz, Imperial, Tulare, Riverside, San Joaquin, and Santa Barbara counties vaccinated their field workers in mid-February.

The first Farm Worker Friday in SLO County is slated to vaccinate approximately 500 to 600 workers, similar to Santa Barbara County's pilot program that took place on Feb. 28 at the Santa Maria Health Care Center. Santa Barbara County's first trilingual, tri-cultural vaccine clinic successfully vaccinated nearly 500 workers with the help of 30 on-site bilingual staff members.

Although the program was a success, Mixteco Indigena Community Organizing Project (MICOP) policy and communications associate Vanessa Terán said MICOP and partnering organizations identified several ways in which the program could improve, such as on-site registration. Many participants don't have access to a computer, a cellphone number, or an email account to register for a vaccine with. Terán said digital literacy can be another barrier to registration.

"It's a big learning experience for us as a community, as a society, to see who we prioritize in these moments so that others don't feel left out. It's important to say your turn will come," Terán said. Δ

Staff Writer Karen Garcia can be reached at kgarcia@newtimesslo.com.