The vaccination site at 24th and Capp Street. Photo taken by Annika Hom on Feb. 24, 2021.

The state’s latest plan to allocate 40 percent of vaccine doses to underserved communities leaves out some of San Francisco’s hardest-hit neighborhoods.

Two San Francisco zip codes — the Tenderloin and Treasure Island — were included in the state’s list of communities to be prioritized. But the Mission District and other parts of the city with high Covid rates did not make the state’s cut for priority vaccine allocation.

The Bayview has had nearly 1,000 Covid cases per 10,000 residents, topping the list of neighborhood cumulative Covid data, followed closely behind by Visitacion Valley, the Tenderloin and the Mission. Treasure Island comes in 10th, with about 500 cases per 10,000 residents. 

Communities prioritized were those that fell in the bottom quartile of the state’s Healthy Places Index, which measures socioeconomic opportunity, not case counts or other Covid metrics.

That method of prioritization leaves out communities like the Mission, as well as the Bay Area writ large. Many of the prioritized zip codes are in the Central Valley and Southern California — 10 Bay Area zip codes made the priority list, compared to 79 in Los Angeles.

Diane Jones, a former UCSF nurse and a leader in the Unidos en Salud vaccination campaign at 24th and Capp streets, said that the zip codes that have the least socioeconomic opportunity sometimes do overlap with the zip codes that have been hardest hit by Covid — but not always. And the decision to prioritize vaccines based on economics, and not Covid cases, means districts like the Mission, with a higher average income but a greater case count and Latinx population, are left out. 

“These are people who absolutely have to be served,” Jones said.

The idea to conduct place-based vaccination is not new, although the decision to prioritize vaccinations based on the Healthy Places Index is a recent development. UCSF and UC Berkeley researchers called for place-based vaccination in a February letter published in JAMA: The Journal of the American Medical Association. But the researchers Dr. Kirsten Bibbins-Domingo, Dr. Maya Peterson and Dr. Diane Havlir urged officials to vaccinate based on census tract or zip code in areas disproportionately affected by Covid infections, hospitalizations, and deaths.

“Vaccinating all eligible individuals in areas with high viral transmission has the potential to actively reduce important chains of transmission often associated with younger adults,” they wrote.  

It is unclear how the state’s policy change will impact vaccinations in the city.

According to California Health and Human Services Secretary Dr. Mark Ghaly, zip codes not in the priority list will likely get a smaller proportion of state’s vaccine supply, although the number of doses they receive might not be lower.

The city’s Covid Command Center wrote in a statement that it is awaiting additional information from the state regarding how the new policy will affect its vaccine allocation moving forward. The top three neighborhoods for vaccines administered by the city’s Department of Public Health are Bayview, Excelsior and the Mission.

“The state’s announcement that it would allocate 40 percent of vaccines to the state’s lowest-income residents aligns with DPH’s current vaccine strategy,” the statement read. The command center wrote that it is already prioritizing vaccines for disproportionately affected populations.

Jones said she and her team are also waiting for more information about how the state’s plan will affect their site.

District 6 Supervisor Matt Haney said that while the Tenderloin and Treasure Island need an immediate expansion of vaccine access, he hopes the city will continue to vaccinate other hard-hit and high-need neighborhoods.

“This approach is clearly going to leave out many of the hardest-hit areas of San Francisco,” he said. “Any equity-based approach that leaves out the Mission and the Bayview is one that has obvious flaws.”


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Kate Selig is an intern at Mission Local.

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  1. For anyone in tiers 1A/1B, or in high need, check the myturn CA website for vaccine appointments.

    As of right now, 6:45pm or so on Sunday 3/7, there are appointments for eligible folks available at the Moscone site for almost every day over the next week, including tomorrow (3/9 is the only current exception).

    No idea how long they’ll stay available, but they’ve been up for at least a couple hours – thought I’d post here given comment from Anon.

    Thanks for the great article Kate!

  2. I had my vaccine at the Mission site. Love the organization of the site
    Thank you latinos unidos and UCSF

  3. SF General and a location in the SE part of the city offer drop in vaccinations 7 days a week for people in zip codes in those neighborhoods, since both have had the highest number of infections. I received my 2nd vaccine at SFGH yesterday and the majority of people getting vaccinated seemed to be Asian and Latinx, with a smaller number of African Americans.

  4. It’s a strange world. People in bars brag to stranges they’re well off and have lots of money. But when public handouts are be doled out, the same people vie with others to be the neediest and poorest. Seems being needy has become a badge of honor.

  5. The TL has two ZIP Codes: 94102 and 94109. 94102 extends into Hayes Valley, which includes both the dwindling long-term residents and the new gentry-filled $1,000,000+ condos. 94109 includes part of the Tenderloin (including the multi-million dollar penthouse at 631 O’Farrell Street), but it also includes much of Nob Hill, the eastern part of Pacific Heights, and Russian Hill (including the $16.5 million “pied-a-terre” purchased by Steve Jobs’s widow a couple years back).

    It is rather unfortunate that the state can’t figure out a better way of mapping high-risk/disproportionately impacted communities than using a system developed by the US Postal Service for the purpose of delivering mail.

    While Ms. Jobs might not actually “reside” at her Russian Hill getaway, she just might say she does so she can get her shot(s) – if she hasn’t already found a faster way through the system. I highly doubt that all of her many houses and her non-essential worker status put her at high risk of COVID-19 infection, but I am certain that many of the households at the southern end of the 94109 ZIP Code have actual essential workers, elderly people, multigenerational families, and people with underlying health conditions, among other reasons that should give them priority. Though excluded from the state’s plan, the Mission’s 94110 ZIP Code has cavernous wealth/privilege inequalities.

    Any system will have its short-comings, but at least in densely populated cities, ZIP Codes are not the way to “discover” or “focus on” inequities. Some of the Mission should be included in the state’s plan, and some of 94102 and 94109 should be excluded.

  6. Omfg if you live within walking distance of Bart you have easy access to a vaccination site !
    TI , and the entire Western 1/2 of San Francisco are under served , and have the least access despite being heavily minority.

  7. So much of the city does not have their own pop-up covid sites, and that includes portions that have large minority and elderly populations

    The Mission has its own covid site.

    I am a 60 year old man with comorbidities due to congenital birth defects. My doctor tells me I am in the worst most vulnerable group to get COVID-19. I CANNOT EVEN SIGN UP FOR A VACCINE FOR ANOTHER TWO WEEKS

    What does the Mission and Mission Local actually want here? Would you like to join in support of the rest of the city?