This last week brought continued progress in reaching our residents with the vaccine as well as more actions at the federal and state levels that influence our local COVID-19 landscape. 

The Latest

We are thrilled to learn of the Food and Drug Administration’s (FDA) full approval of the Pfizer vaccine following many months of emergency use authorization. It is extraordinary to contemplate how much has been accomplished, 91.7% of eligible residents reached, under the emergency use authorization since the first vaccinations rolled out in San Mateo County in January, less than eight months ago. We are hopeful that residents who have been hesitant and had questions about the vaccine until now will gain confidence and take action to protect themselves and their loved ones and receive vaccinations. 

As I update information on our vaccination progress, I want to note that our website vaccination dashboards will soon be updated to reflect new refined/improved population estimates from the State Department of Finance. This update will result in changes to some vaccination reach percentages countywide and within several age, geographic and race/ethnicity categories. Our strategies remain unchanged to increase the reach of the vaccine, closing gaps in vaccination rates, and prioritizing the communities and populations that still have to attain <80% vaccination rates. The updated estimates from the Department of Finance will improve our understanding of which communities are under-reached and lagging compared to the progress countywide.

Our most recent experience of the virus in San Mateo County

Our 7-day lagged average reported August 23rd is now 14.8 new cases per 100K in the population, slightly lower than the 16.2 figure I shared last week. This is an average of 115 new COVID-19 cases per day compared to 126 new cases per day last week. This is the first week in several weeks that seems to signal plateauing, but transmission remains high. We continue to monitor test positivity both countywide (3.7%) and in the Healthy Places Index lowest quartile census tracts (5.2%). Our testing was reported by the State at 627.5 tests per 100K/day in our population. 

As we support school partners across the county in the safe reopening of classrooms that are enabling students to reconnect and learn together, we recognize that many parents are learning about positive cases among students and needing to adjust based on guidance to quarantine. With the leadership and support of Nancy Magee and the County Office of Education, schools’ safety measures are strong, and escalation and communication pathways are in place. Like the young people, we are learning together and grateful for the patience and caring that ripples across classrooms, after-school programs, athletic fields and households.

The daily number of residents requiring hospitalization due to COVID-19 was at or above 50 most days last week, with 20 or more in the ICU. The vast majority of those hospitalized are unvaccinated. We continue to provide isolation and quarantine support in two hotels, with 37 residents needing this support to protect themselves and their households last Friday. This capacity is important in supporting our hospital and other hospital partners to be able to discharge patients when safe, so they continue to have capacity available to meet the needs of other patients with COVID-19 and other health care needs.

Vaccination update

We continue to urge that COVID-19 vaccination is the most important action to take to protect oneself and the community and we continue to see progress each week. The state immunization registry report of August 22nd showed that 91.7% of our total eligible County population aged 12 and older have received a COVID vaccine (611,224). Of those who have received any COVID vaccine, a large percentage, 89.3%, have completed their vaccination series. We have decreased our estimate of the number of unvaccinated eligible San Mateo County residents from 60,000 when I last reported to you on August 17th to around 55,000. You can see from the table below, that a significant number of the remaining unvaccinated are our patients/clients, but we continue to see progress each week:

Client Group (updated 8/18/21)	# of 1st and single dose vax given by any entity in past 7 days	% vax with 1st or single dose	Estimate # eligible unvax
San Mateo Medical Center	342	65%	19,429
Aging & Adult Services	46	78%	1,568
Behavioral Health & Recovery Services	58	64%	3,151
IHSS Workers	19	69%	1,951
IHSS Clients	42	78%	1,269
Homebound	4	78%	554

We also see that we have reached 79.0% of those ages 10 and over in our lowest quartile Healthy Places Index census tracts overall and we continue to focus on raising the lowest of these. This week we continued to make significant progress in both East Palo Alto and North Fair Oaks and inched closer to our 80% goal. We are so appreciative of the persistent efforts of many partners to support this progress also reinforcing the potential for every other community in San Mateo County! 

Communities under our goal of at least 80% vaccinated

Geographic Community as of 8/22/2021	# of 1st and single dose vax given by any entity in past 7 days	% vax with 1st or single dose	Estimate # eligible unvax
Broadmoor	22	69.1%	1,462
East Palo Alto	329	78.6%	5,288
El Granada	20	65.2%	1,941
Loma Mar*	0	68.6%	54
Moss Beach	8	51.9%	1,492
North Fair Oaks	92	79.3%	2,504

*Vaccinations by city are calculated by geocoding and aggregating self-reported addresses by city or town. Population estimates are less precise for areas with small population.

Pop-up clinics remain a strong strategy to move us closer to achieving our vaccination goals and we have 61 clinics either completed or moving forward.  

Of the total county residents who have been vaccinated, 58.3% are people of color, 36.4% are white, and 5.3% are of unknown race/ethnicity. We continue to focus our efforts on increasing vaccination rates among Black, Hispanic and Pacific Islander communities in which rates are still below 80%. 

Race/Ethnicity Groups under our goal of 80% vaccinated

Note: Due to data collection and reporting limitations these estimates are imprecise and likely reflect under-reporting of reach in each racial/ethnic group given the number of residents who self-identify as “other,” “multi-race” or for whom race/ethnicity data was not collected by the vaccinating entity. 

Race / Ethnicity	% age 12+ vax as of 8/15/21	% age 12+ vax as of 8/22/21	% increase since 8/15/21	Estimate # eligible unvax
Black / African American	62.0%	62.8%	0.8 percentage points	6,332
Hispanic	55.5%	56.5%	1.0 percentage points	76,273*
Multiracial	45.2%	45.9%	0.7 percentage points	13,108
Native Hawaiian / Pacific Islander	61.2%	62.1%	0.9 percentage points	3,636

*This is an over-estimate of the number of Hispanic residents to be reached as it exceeds the total number of residents to be reached; however, we see this is as our largest community under-reached by COVID-19 vaccination among the groups that are still below 80% vaccination rates.

We also see from the data dashboard that certain age groups are still below 80% vaccination. We continue to focus on reaching the 85+ population, where we’ve reached 64.7% (8,737 remaining unvaccinated). Since the 12-15-year-old group became eligible, 71.8% have already been vaccinated with their first dose and we continue to partner with County Office of Education and schools to provide convenient vaccine opportunities for youth and their families. 

All Together Better,
Louise F. Rogers