San Mateo County Health Officer Dr. Scott Morrow said that he does not yet have a full understanding of how the COVID-19 vaccine is flowing through the county.
Via a statement released Tuesday, Morrow said that a lack of data and the various routes of vaccine distribution make it difficult to grasp how many people and exactly who has received the vaccine in the county. He urged people to be patient as uncertainty and ambiguity are expected in the early phases of such a large endeavor.
“If you are confused, don’t be alarmed. We are all confused,” he said. “I share your frustration of not having good, clear, understandable data on the efficiency of the vaccine roll out. There is no single entity that has a good understanding of the whole process.”
In San Mateo County, the COVID-19 vaccine is being distributed through three major routes or “pipelines.”
One is through the federal government’s partnership with CVS and Walgreens to distribute the vaccine to congregate care facilities like nursing homes.
Next, health care providers like Kaiser Permanente and Sutter Health are responsible for the bulk of vaccinations. Those large health systems span counties and are known as “multi-county entities” or MCEs.
Third, the county’s health department receives a small amount of vaccine doses, between 100 to a few thousand a week. Of the 25,800 first vaccine doses received, the county has administered 22,354 doses, a spokesperson for San Mateo County Health said via email on Tuesday.
County health officials recommend that people check first with their health care provider for information about the vaccine. Morrow estimates that about 98 percent of county residents are insured, with 70 to 80 percent covered by MCEs.
For individuals who are not covered by a health plan or have no other route of getting the vaccine, the county will provide vaccination opportunities such as a clinic last week that vaccinated 9,550 Phase 1A individuals over seven days.
“This means that while the County should be a good partner, it will not be the main provider of the vaccines to the general population,” Morrow said.

As it waits for additional vaccine doses, the county will prioritize vaccination for Phase 1A individuals, which includes health care workers and residents of long-term care facilities. However, some health care providers have begun to vaccinate people in Phase 1B, which includes adults over 65 years old.
“Despite what you may have heard, we do not yet have any real understanding of how vaccine is flowing into our county through these three pipelines, except for the small portion flowing to the health department,” Morrow said.
While information about vaccinations should be reported to the California Immunization Registry, known as CAIR2, Morrow said the system was not designed for this situation and some doses don’t seem to be reaching the system.
As a result of the various county entities vaccinating different groups at different times, Morrow said it is not likely that vaccine distribution has been equitable.
In addition, there is high demand but a limited supply of the vaccine, and Morrow said the federal government is behind schedule with its vaccine allocations.
“We all want to go faster, but until this supply issue is ameliorated, we won’t be able to. The solution is to ramp up production. I don’t know how feasible this is,” Morrow said.
A spokesperson for Kaiser Permanente Northern California said via email that as of Saturday, Kaiser had administered more than 170,000 vaccines in California but “at the current rate, we are looking at vaccine distribution that is much slower than any of us find acceptable.”
Morrow estimates that in order to vaccinate most of the population by July, entities in the county need to vaccinate 40,000 people a week, or about 6,000 daily. However, the supply coming to the county’s entities is about one-tenth of that rate.
As the vaccine would not be available to the general public for a while, Morrow encouraged people to be patient and practice gratitude that there is a vaccine so early in the pandemic.
Even after receiving the vaccine, people should continue to practice COVID-19 restrictions.
“It [the vaccine] is not a free pass for you to get out of our situation,” Morrow said. “Masking, social distancing and not gathering will be a way of life for us for some time to come, probably at least through most of 2021.”
San Mateo County’s COVID-19 vaccination information is available at smchealth.org/covidvaccine.