| Image by Joe Livernois
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By Joe Livernois
It was big news when it happened. About three weeks ago, to great acclaim, CVS Pharmacy agreed to redirect its COVID-19 vaccination program from the Monterey Peninsula to Salinas after Monterey County officials complained publicly that people in certain Salinas neighborhoods needed the vaccine more than people on the Monterey Peninsula.
The result was that vigilant Peninsula residents with enough internet skills to navigate the CVS online appointment system drove to Salinas to get their vaccinations, because available slots at the Salinas CVS weren’t being filled quickly enough by people who lived in the neighborhood.
While the intentions were pure, the results probably weren’t what county officials had hoped when they urged CVS to move its vaccine program to Salinas. And the disappointing results illustrate the continuing disparity in Monterey County’s overall response to the virus despite focused, conscientious efforts to remove obstacles in getting vaccines where it is most needed.
‘The vaccine rollout so far has been a glaring example of systemic inequalities perpetuating ongoing disadvantage,” said Monterey County Supervisor Wendy Root Askew, board chair. “I hope that our teachers are studying this and use it as a real-life example of system inequalities that continue to harm our most vulnerable communities.”
Added Dr. Edward Moreno, the county’s health officer, “There are some areas here where we’re seeing that there are some differences, where the number of people in a particular race and ethnic group are perhaps under-vaccinated.”
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Moreno’s staff started drilling down on the statistics this week, analyzing the percentage of vaccines administered to people by ZIP codes against the infection rates by neighborhoods. Those numbers indicate that the population in most areas of the Monterey Peninsula have a low rate of infection, but are receiving vaccinations at a much greater rate than residents in the Salinas Valley, which is suffering the brunt of the deaths and illnesses.
“The vaccine rollout so far has been a glaring example of systemic inequalities perpetuating ongoing disadvantage” Monterey County Supervisor Wendy Root Askew
For instance, the 93940 ZIP code for the heart of Monterey represents about 2 percent of all infections, but 11 percent of the people who live there have already received vaccinations. Compare that to residents in the 93905 ZIP code of East Salinas, where 21 percent of all of Monterey County’s positive cases have been reported but where only 8 percent of the residents have received vaccinations.
Representatives from the county Health Department, Salinas hospitals, the agricultural industry and health care agencies have been aware of the disparities from the start, and have been trying to provide better access to vaccinations to Latinos and farmworkers living in the Salinas Valley, with mixed results.
Monterey County Supervisor Chris Lopez pointed out, for instance, that appointments for vaccines are quickly snatched up by people who are constantly online, and that those appointments are posted during the day, when farmworkers and others are working. “It makes it really hard for (working) folks to get an appointment,” he said.
The CVS rollout of its vaccination is a good example of the problem.
Last month, while vaccines were still relatively scarce, CVS announced it received a big stash of the Moderna serum from the federal government and that it would start injecting residents from its stores in Monterey and Carmel. Almost immediately, the Board of Supervisors dashed off a quick letter urging CVS to move the immunizations to Salinas.
The rationale was that the vaccine should go into the arms of vulnerable people living in areas hit hardest by the pandemic. The Monterey Peninsula accounts for only about 13 percent of all the positive cases recorded in the county, compared to 46 percent in Salinas. Two ZIP codes in East Salinas — 93905 and 93906 — account for nearly 39 percent of all the infection cases in the county.
The two zip codes are among the most densely-populated communities in California, with a large community of Latino farmworkers who are considered essential workers.
Soon after the Board of Supervisors’ letter spun out of the printer, CVS announced it would indeed move its vaccination clinic from Monterey and Carmel to its Boronda Road location, smack in the middle of the 93906 ZIP code. CVS was lauded for its responsible corporate decision-making and local politicians stepped forward to lay claim for making things right.
But while the Boronda Road location does administer vaccines to Salinas residents, a growing number of Monterey Peninsula residents with the time to troll the internet looking for appointments were making the 30-minute drive to East Salinas to get their shots.
Four of the six people in the post-inoculation ‘waiting room’ at the Salinas CVS location were from the Monterey Peninsula.
The Monterey Peninsula residents who found their way to Boronda Road weren’t technically “cheating.” Many of them went to CVS to get around the restrictions that Monterey County had placed on older Monterey Peninsula residents. Until Wednesday, vaccines the county controlled could only be used to inoculate people over the age of 65 who live in ZIP codes outside of certain Monterey Peninsula cities. But the county doesn’t control what CVS does with the vaccine it received directly from the federal government, so the pharmacy had no residential restrictions.
Soon social media and Nextdoor on the Monterey Peninsula were filled with “I Got Mine at the Salinas CVS” posts; Peninsula residents were checking the online reservation system obsessively, snatching up appointments as quickly as they became available.
Which is why I was able to saunter into the Boronda Road CVS just before noon last Saturday to get my shot, even though I live in a ZIP code that was expressly excluded from getting county-allocated vaccine. I saw no Latinos in my line to get the vaccine, and four of the six people in the post-inoculation “waiting room” were from the Monterey Peninsula.
Rob Eaton, 72, registered at the Salinas CVS soon after the vaccine became available. He said he would have preferred to have received the vaccine at the CVS in Monterey, just down the hill from his Monterey home. “It took a couple of tries to get through for the appointment on the iPad, but then it was in and out in about 20 minutes,” he said. “They asked my age and didn’t care about anything else.”
Meanwhile, on Tuesday, a younger Latina friend who lives and works in schools in the Salinas neighborhood most impacted by the virus was turned away from her appointment at her neighborhood Safeway pharmacy because she did not meet the county’s criteria. (Unlike CVS, Safeway receives its vaccine from the county.)
Because CVS doesn’t report to the county Health Department, there is no data available about who is getting vaccines at the Boronda Road site, or where they’re from.
Moreno and others have described Herculean local efforts to get the vaccines distributed as equitably as possible. Agencies including the United Way, Clinica de Salud, the Community Foundation for Monterey County and local health organizations have stepped up outreach efforts.
“When you have systemic discrimination and inequities within the system, it makes it really hard to overcome,” said Root Askew. “So it’s taking some very intentional effort on the part of … our healthcare system to ensure that vaccine is getting where it needs to be to have the greatest impact.”
Moreno said he believes the disparities will eventually even out in the weeks to come, as vaccines become more readily available. The Board of Supervisors this week asked the Federal Emergency Management Agency to open a mass vaccination site in the county, and supervisors say they would like the site located in or near the East Salinas neighborhoods.
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You write that people weren’t technically cheating by “trolling” the internet to find appointments at CVS, even though they were not yet eligible under the County rules. I disagree— CVS may have been sloppy about who received the vaccine, but individuals should know better. You either live in the designated zip codes or you don’t. They should not have been allowed to make appointments or should have been turned away at the vaccination site.
I’ve run into vaccinated people from Pacific Grove and Carmel who in my view pushed out others by going to Santa Cruz and Santa Clara counties for vaccinations. And I’ve read about some who travelled to Monterey for vaccinations from cities in the Central Valley. This phenomenon is not limited to California— according to the NYT, other states say people are traveling hundreds of miles outside their communities because they are unwilling to wait their turn.
While it would be great if vaccine distribution was more efficient among our counties, or that the vaccinators enforced the county rules, or that people weren’t so entitled in their pursuit of an appointment that they push out those who should be getting them, I’ve learned to relax a bit about it. More vaccines are coming and all we can do is to regularly check the online sites on the county webpage. Within 3-4 months we’ll all be protected. Meanwhile, our herd immunity is increasing— even if they’re not the ones who most deserve them.
CVS is under a Federal contract and is not subject to the Board of Supervisors reprioritizing the Federal priority scale or the State’s mandates. As far as having CVS distribute in Salinas I believe that was a no brainer and should have been done to begin with. As to the figures presented in the article I refer to the old saying, “figures can deceive and those who wish to deceive you figure”. You must note that, if 8% of the population in the 93905 area code is vaccinated, then things are pretty good. Why? Because, only 8.9% of the population in Salinas is 65 and over, according to the US Census. Therefore, almost all of the 65 and over population has had at least one shot according the VOMB figures. But, this may not account for Migrant farmworkers who are hard to count. If you look at the cities of Monterey and PG, which were pushed to the back of the bus by the Supervisors and have 65 and over populations of 18.2% and 27.5% respectively I can understand why they are traveling to get vaccinated.
The real question here is, are those who are at most danger and were responsible for spreading, to the most extent, the virus into the Salinas and other communities via the Ag Community, being vaccinated? I believe we owe it to these workers and ourselves to bring safety to them via vaccination. Not one artichoke, asparagus spear, or zucchini should be picked unless a Migrant farmworker can show they were vaccinated. If not, they should be treated locally so they will not spread the virus. This is not an act of discrimination but one of common sense and and self preservation. We need to protect those who feed us and we need to be inclusive and not exclusive in the way we carry out the program of bringing safety to our community. It can all be done if we use common sense instead of knee jerk, ethnophobia, divisive rhetoric and decision making. After all, we are all in this together and need to work together to conquer the problem regardless of who you are or where you are from. .