After inviting all affiliated medical workers to get vaccinated, Stanford Health Care has opened up COVID-19 vaccines to patients over the age of 65.
Stanford’s decision comes after the state revised its guidance, allowing health care centers to determine when to expand vaccine eligibility. The University is also developing protocols for future vaccinations of community members on campus, according to an email sent by Russell Furr, associate vice provost for Environmental Health and Safety, to the Stanford community.
Stanford Medicine faced criticism during its initial vaccine rollout after inadvertently vaccinating affiliates in non-patient facing roles on two occasions, forcing leadership to apologize and revise the distribution plan.
Despite these early blunders, Stanford Medicine has moved to vaccinate all eligible medical affiliates — approximately 29,000 individuals — though its leadership has opted against requiring its health care workers to receive the vaccination. Around 21,000 first doses and 11,000 second doses have been administered as of Wednesday, according to Stanford Medicine’s vaccine distribution dashboard. The data below shows the rate of vaccinations being administered is slowing down over time. This is consistent with the reduction in remaining available first and second doses.
Stanford Health Care primary and specialty patients who are over 75 and reside in Santa Clara and San Mateo counties have been able to schedule vaccination appointments since Friday, a change that came two days after Santa Clara County health officials opened vaccines to individuals 75 and older.
Despite California Governor Gavin Newsom’s decision last week authorizing individuals over 65 to receive the vaccine, the county said it would only open eligibility for those 75 and older because of dose shortages. Stanford Health Care receives vaccine doses from Santa Clara County on a weekly basis: The hospital currently has under 9,000 doses available, according to the dashboard.
Revised guidance from the California Department of Public Health on Friday shifted responsibility for determining who can receive vaccines away from the county to individual health care systems. Following this announcement, Stanford expanded vaccinations to patients over the age of 65 and began scheduling appointments for these patients on Wednesday, according to an email sent to Stanford Medicine affiliates and obtained by The Daily.
Stanford professor of medicine Dean Winslow said that he supports Stanford’s eligibility expansion, citing the CDC’s recent recommendation to prioritize patients over 65 with underlying conditions like diabetes, heart disease and pulmonary disease. He added that the “mortality rate of even otherwise healthy individuals over 75 is very high.”
Stanford Medicine is offering vaccines for its patients over 65 at locations across the Bay Area. Residents of Santa Clara and San Mateo counties can schedule their vaccination at El Camino Health in San Jose or starting Friday on campus at the Arrillaga Center. Residents of Alameda and Contra Costa counties will be vaccinated at a location in Emeryville starting on Thursday.
Stanford Health Care has received 4,000 doses “to date” from Santa Clara County for eligible patients, and has scheduled 4,180 vaccine appointments within the next week at its San Jose site, according to the vaccine dashboard. More than 900 doses have already been administered to eligible patients since last week.
Bradley Segal, a child neurology resident at Stanford Hospital, also said that he agrees with the move to vaccinate patients over 65. “Age-based prioritization makes sense to me,” Segal wrote. “Risk generally tracks with age. But unlike an algorithm, age cutoffs are simple enough to implement.”
Niraj Sehgal, chief medical officer of Stanford Health Care, and Dennis Lund, chief medical officer of Stanford Children’s Health, wrote to medical affiliates in an email last week that Stanford Medicine is “working diligently to secure additional supplies of vaccine and activate sites” in Palo Alto, Dublin and Emeryville to ensure equitable access for eligible patients in Alameda and Contra Costa counties.
Expanded vaccine eligibility in the coming weeks to essential workers in the education sector could include Stanford faculty members, according to Sehgal and Lund, though the vaccine would likely be administered by their health care provider because the University is not yet permitted to provide vaccines directly to the Stanford community.
Stanford’s COVID-19 Vaccine Governance Committee is establishing distribution plans that will outline when the University can provide vaccines to the campus community, according to Furr. The committee, chaired by Faculty Senate Chair Judith Goldstein, global health and infectious diseases professor Yvonne Maldonado and Sehgal, will develop plans “in accordance with public health protocols and guided by principles of equity and ethics.”
“We are advocating for the needs of our university community” in the vaccine distribution process, Furr wrote in an email to the Stanford community on Friday. A spokesperson for Furr did not immediately return a request for comment on specifics of the University’s advocacy.
Stanford appears to be on a faster vaccine distribution timeline in contrast to some peer institution health centers. Last week, the University of California, San Francisco, began offering vaccines to patients over 75, vaccinating a few hundred patients per day. UCSF is “scaling up as quickly as possible” and though limited by vaccine supply, aims to expand eligibility to patients over 65 in the coming days and weeks, UCSF assistant clinical professor of infectious diseases Bryn Boslett told The Daily.
While UCSF received 8,000 doses yesterday and expects to receive additional shipments in the coming days, UCSF professor of medicine Peter Chin-Hong said that “we have tens of thousands of patients aged 75 and over, so supplies are lower than we would like.”
“This is a massive effort, the largest health campaign that this nation has ever seen, and health systems are already quite strained by the ongoing and worsening pandemic,” wrote Boslett, who is aiding in UCSF’s vaccine response. “We are currently doing the best we can with limited vaccine supply, limited staffing and limited space.”
This article has been corrected to reflect that the University does not oversee Stanford Medicine employees or its vaccine program. The Daily regrets this error.