San Francisco announced plans on Thursday to close its two remaining “mass vaccination sites” in the coming weeks, a decision supported in separate conversations with five experts in infectious diseases or epidemiology.
The experts also separately agreed on the next steps for getting shots in arms, and their recommendations are in line with San Francisco’s: It’s time to hit the ground and take the vaccines to communities, the doctors said.
“For those who are on the fence, I don’t think whether or not there’s a mass vaccination site somewhere in the city is going to necessarily make it easier for them to decide to get vaccinated or to entice them,” said Dr. Jake Scott, an infectious disease specialist and clinical professor at Stanford University. “So, I think that targeting those communities that have been more reluctant to get vaccinated is going to be key with community outreach and all other sorts of creative approaches.”
“For those who are on the fence, I don’t think whether or not there’s a mass vaccination site somewhere in the city is going to necessarily make it easier for them to decide to get vaccinated or to entice them.”
Dr. Jake Scott, infectious disease specialist and clinical professor at Stanford University
The sites at City College of San Francisco and Moscone Center South will close on June 26 and July 14, respectively, as Covid-19 cases and hospitalizations fall, according to a press release from the San Francisco Joint Information Center. The city will continue offering vaccinations at low-barrier neighborhood sites, mobile access points, pharmacies and clinics — along with two “high-volume sites” at the Zuckerberg San Francisco General Hospital and Southeast Health Center, according to the Department of Public Health.
Mass-vaccination sites were efficient for vaccinating people at the start of the pandemic, the doctors said. About 111,000 doses were administered at City College and 332,730 at the Moscone Center South, according to the Department of Public Health.
However, with 81 percent of eligible San Francisco residents having received at least one dose, the doctors vouched for redirecting resources from those sites toward strategies for meeting people where they are — and through a means people trust.
That would translate into a focus on vaccinating residents through mobile operations, neighborhood sites, primary care offices, churches, community organizations, workplaces, schools and pediatricians’ offices.
“It’s the boots on the ground, as they say — meeting people where they are, where they work, where they live, the neighborhoods that they’re in and really going,” said Dr. Kirsten Bibbins-Domingo, the epidemiology and biostatistics chair at University of California San Francisco.
Dr. George Rutherford, a professor of epidemiology and biostatistics at UCSF, added, “I think moving this down to where it’s more localized, and getting these smaller-scale sites and smaller-scale operations that can be tailored to what the local needs are is one thing.”
For example, he said, if the city wishes to vaccinate Latino men between the ages of 20 and 29 who work every day, perhaps offering the single-dose Johnson & Johnson vaccine on Sunday at local clinics makes the most sense.
“Obviously, you have to sound people out and figure all this stuff out, but it’s that kind of level of detail that we need,” he said.
Bibbins-Domingo stressed the importance of redirecting resources from the two closed sites.
“If mass vaccination closures just means we are saying we don’t need to direct resources because there’s no longer demand, then that’s a failure, and it’s a failure that will quite clearly worsen the inequities that we’re already seeing,” she said.
“If mass vaccination closures just means we are saying we don’t need to direct resources because there’s no longer demand, then that’s a failure, and it’s a failure that will quite clearly worsen the inequities that we’re already seeing.”
Dr. Kirsten Bibbins-Domingo, epidemiology and biostatistics chair at University of California San Francisco
The Department of Public Health told Mission Local that while many city workers are returning to their usual jobs as California reopens, some disaster service workers from the two sites will be relocated to neighborhood sites and mobile teams.
Marin County Public Health Officer Dr. Matt Willis vouched for the same strategies noted above. His county is currently focusing on improving access to vaccines through mobile operations and working with healthcare partners, Willis said.
“We’ll go to the apartment complexes and park our van and vaccinate people who are willing and seeking vaccines,” Willis said. “So, instead of asking people to come to the vaccine, you bring the vaccine to them.”
The offices of primary care providers and doctors are also going to be an especially important part of the city’s vaccination effort.
Scott, the clinical professor at Stanford University, said one of his Black patients diagnosed with HIV would generally refuse being vaccinated at mass vaccination sites “because they didn’t know him, or his medical history or HIV status, and he didn’t feel comfortable.”
But Scott said the patient told him he would get the vaccine if Scott administered it.
However, Scott’s office doesn’t provide many vaccines because of the costs associated with storing and administering them, he said.
“When you look at trusted members of the community, typically right at the top is your doctor,” said Dr. John Swartzberg, an emeritus professor at UC Berkeley who specializes in infectious diseases.
“When you look at trusted members of the community, typically right at the top is your doctor.”
Dr. John Swartzberg, emeritus professor at UC Berkeley specializing in infectious diseases
He expressed the hope that future vaccines will no longer require the extreme cold storage temperatures nor have the limited shelf-lives the current crop of vaccines are known for.
Doctors expressed similar thoughts about vaccinating adolescents 12 and up, adding that pediatricians’ offices and schools will be important.
The Department of Public Health is also helping open and expand vaccine delivery in primary care at the San Francisco Health Network and other clinics and health systems, the department said.
“I definitely commend San Francisco for its incredible vaccination efforts, especially compared to other cities,” Scott said. “California in general has really stepped up and put a lot of money into vaccination efforts, but I think there’s always room for improvement, and it’s just so critical that we get as many people vaccinated as possible.”