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Dear Patients of Sansum Clinic,
 
There is much news circulating about changing guidelines for who is eligible to receive a vaccine for COVID-19.   Yesterday California announced that those over 65 years old are eligible to receive a vaccine.   A change in eligibility criteria does not, sadly, change the realities of the amount of vaccine available to us at this moment or the reliability of future vaccine deliveries.  The good news is that there is a strategic community effort underway to distribute what vaccines we do have to those who meet the criteria.
 
Let me review what we have been doing with vaccinations.  Per Public Health Guidelines, we have been vaccinating Phase 1a people, which has meant vaccinating people employed in healthcare, particularly those with frequent face-to-face contact with patients and, consequently, close exposures to COVID patients or environments in which COVID is prevalent.  We have vaccinated most of our own (Sansum Clinic’s) staff and to help our County as a whole get through Phase 1a, we have also vaccinated an additional 400 or 500 healthcare workers who do not work for Sansum Clinic. We have been doing this to help get the community to the point that patients could be vaccinated. 
 
It is great news that we have reached the next phase which will allow us to begin vaccinating patients.  The problem now is the amount of supply of vaccine we have compared to the amount of demand for vaccine.
 
Let’s talk about supply.   Other than COVID-19 vaccines set aside to use as second doses for people who already received their first shot, and vaccines reserved for healthcare workers we already committed to immunize, we only have a few hundred doses to begin vaccinating patients at this time.   We have been receiving 500 to 800 doses a week from the Public Health Department. It looks like that number may begin to increase soon, but for now, demand is exceeding supply.
 
Let’s talk about demand.  We all have a gut instinct that there is a lot of demand!  From our experience in offering vaccine to eligible people, it seems like 70% or so will want it.   Again, those are healthcare workers, who may or may not reflect the general population of patients.  In our records, we have more than 7,000 patients age 80 or above.  We have more than 12,000 above the age of 75, and nearly 28,000 patients who are age 65 and above.
 
So, we have several hundred doses of vaccine on hand, with less than a thousand per week that we are receiving and, in just the 80 and over population, more than 7,000 patients.  The State has now created the impression that over 65 (again, 28,000 patients for us!) can just get a vaccine, but this quick supply vs. demand analysis tells us that it will be some time before we can offer vaccine to that entire population.
 
Where does that leave us?  We have done vaccination clinics and found that we think we can do 300-400 on a weekend day.   (We can go faster in an empty building, due to post-vaccine observation and social distancing requirements, but this is about 1/6 the speed of a pre-COVID flu clinic.)  We are not sure how fast we can operate with an older population.  We are holding a focus group/vaccination clinic with a small representative population to see how we can do that as safely and efficiently as possible.  We also hope to be able to give vaccine at the same time as in-office visits with primary care doctors, which will help capacity.  But, we don’t have the supply to do that now.    
 
While there is such a disparity in the demand and the amount of supply we have, and until we have a larger reliable future supply, we will break the “over 65 and eligible group” into smaller subgroups based on age alone.  We have found it is extremely difficult to try to weigh whose medical issues are more dire than someone else’s such that they should go into another age bucket.  Consequently, we will use age alone. It is possible we may adapt this approach in the future, at a time when vaccine supply is not a limiting constraint.
 
We had begun scheduling a very small number of patients age 80 and older because we had some openings as we completed vaccines reserved for healthcare workers.  At that time, we thought the cut-off in age would be at age 80 and we wanted to begin vaccinating our patients as soon as possible.  We will complete that very small sample.  Now that patients age 75 and older are eligible to receive a vaccine, we will focus on that expanded age group, which of course also includes those over 80.
 
We will continue to communicate about which age groups of patients are eligible for vaccination as vaccine supply and appointment availability allows.
If your age group is eligible for vaccination at Sansum Clinic, you will receive notification to schedule your vaccine on MyChart when your subgroup (based on age alone) within that age group becomes eligible. Without a doubt, being signed up for MyChart will be the best way to receive COVID-19 updates, including vaccine availability. You are signed up for MyChart, which is why you are receiving this email, but since everyone is talking about COVID-19 vaccines, we thought this was worth mentioning.  Patients who do not have a MyChart account will receive a postcard when they become eligible to schedule a vaccine.
 
The good news is there are other groups in the County receiving vaccine shipments, including Santa Barbara Cottage Hospital, Lompoc Valley Medical Center, and the Santa Barbara County Public Health Department. 
 
We hope that: (1) reliable supply will increase; (2) we can form partnerships with others in the community so that we can get through this as quickly and with as little chaos as possible.
 
Again, we want to get everyone vaccinated as quickly as possible and we will keep you posted with the next step.
  
Kurt Ransohoff, MD, FACP
CEO, CMO
Sansum Clinic
 
P. S.  Please visit  COVID19.SANSUMCLINIC.ORG for up to date information on COVID-19 vaccinations and testing at Sansum Clinic, including answers to many of the questions we are receiving regularly from our patients.  Thank you.






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Sansum Clinic · PO BOX 1200 · Santa Barbara, CA 93102-1200 · USA