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.
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.”