Patience, perseverance, and partnership fuel our progress as 93.2% (626,684) of residents over the age of 12 have received at least their first COVID-19 vaccine dose, and we see promising signs of continued reduction in the prevalence of the virus in San Mateo County and in our region. 

It is good to see each week increase the vaccination rates and protection among our patient populations that have now reached 68% for San Mateo Medical Center (18,086 to go), 78% for Aging and Adult Services clients (1,529 to go) and In-Home Supportive Services workers 69% (1,979 to go), and 67% for Behavioral Health and Recovery Services (2,920 to go). Closing the gaps for the people we serve has been our highest priority and also among our greatest challenges, and we appreciate the ways our staff and partners have been thoughtfully raising awareness and creating paths to vaccination opportunities wherever possible.

The Latest

In addition to focusing on increasing vaccination rates in our hardest to reach populations, we continue to prepare for the roll-out of booster doses, while awaiting the conclusion of the processes undertaken by the federal and state agencies responsible for reviewing the scientific data and issuing related guidance. The Food and Drug Administration (FDA)’s Vaccines and Related Biological Products Advisory Committee (VRBPAC) voted last Friday to recommend authorizing a booster shot for recipients of the Pfizer-BioNTech COVID-19 vaccine who are 65 years of age and older or are at high risk of severe COVID-19. This followed a vote by the committee overwhelmingly recommending against a Pfizer-BioNTech booster dose for all persons ages 16 and older. The committee engaged in lengthy discussions throughout the day, scrutinizing whether COVID-19 booster doses are needed to maintain protection against the virus and for whom. The FDA must decide whether to act upon the VRBPAC recommendation, which is expected over the coming days. The U.S. Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP) is scheduled to meet this week to recommend how exactly the extra doses should be used. The Western States Scientific Safety Review Workgroup, of which California is a member, will consider these recommendations to inform our next steps. In the meantime, health care providers and local pharmacies are already providing third doses of Pfizer’s COVID-19 vaccine to residents who are considered immunocompromised.

Additionally, we understand that Pfizer and Moderna will request authorization from federal authorities for vaccines for children ages 5-12 by mid-October. We are planning for our role in reaching these youngsters alongside the roles the larger health care systems (Kaiser, PAMF/Sutter, Dignity, Stanford) expect to play in vaccinating their patients and assessing and addressing other important health issues. We appreciate the strong partnership with Superintendent Nancy Magee to coordinate any school-based vaccination efforts that may be a part of the best approach to reaching as many young kids as possible, as well as the work with many youth-focused community-based organization partners positioned to trustfully reach youth and their families.

Our most recent experience of the virus in San Mateo County

Our 7-day lagged average reported September 20th was 9.8 new cases per day per 100K in the population, which is down from the 11.5 figure I shared a week ago. This is an average of 76 new COVID-19 cases per day, compared to 90 per day in my last report. Our cases dashboard allows one to see the number and relative proportion of cases among young people, which remains similar to what I reported last week.

We have also included a link on our website to the County Office of Education’s web page that lists links to each of the School District’s dashboards.

I am glad to report that hospitalizations due to COVID-19 in San Mateo County have dropped to a census of between 39 and 30 patients each of the last seven days. Special appreciation to our San Mateo Medical Center ED/ICU/Inpatient staff who have cared for our daily share of patients with complications of COVID-19 while also continuing to care for many other patients who deferred care over the course of the pandemic but cannot any longer.  We have supported between 19 and 31 residents to isolate safely in our Alternative Housing Site hotels each day of the last seven days.  We continue to monitor test positivity both countywide (1.8%) and in the Healthy Places Index lowest quartile census tracts (2.5%). Our testing was reported by the State at 800 tests per day per 100K population. 

Vaccination update

We continue to urge that COVID-19 vaccination for all who are eligible is the most important action to take to protect oneself and the community. While we are seeing demand at our “radically convenient” clinics declining, we continue to see slow but steady progress each week. The State immunization registry report of September 19th showed that 93.2% (626,584) of our total eligible County population aged 12 and older have received a COVID vaccine.  Our updated estimate of the number of unvaccinated eligible San Mateo County residents is now 45,000 (a decrease of 4K since last week’s report). 

We see that we have reached 81.6% 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. While the following communities still show vaccination rates below 80%, we are continuing to learn from partners involved in the outreach effort in these communities and are trying to get to more specific estimates of our remaining unvaccinated population since we know population estimates in smaller communities can be less precise. While we get a better understanding of the remaining unvaccinated, we continue to provide targeted pop-up and weekly vaccine clinics to reach residents in these specific communities and leverage trusted community partners to promote vaccine confidence messages. 

Communities under our goal of at least 80% vaccinated

Geographic Community as of 9/19/2021	# of 1st and single dose vax given by any entity in past 7 days	% vax with 1st or single dose	Estimate # eligible unvax
Broadmoor	7	70.4%	1,403
El Granada	2	66.2%	1,881
Loma Mar*	0	68.6%	54
Moss Beach	1	52.9%	1,460

*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.

Of the total county residents who have been vaccinated, 58.6% are people of color, 36.2% are white, and 5.2% 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%. However due to data collection and reporting limitations these estimates are likely under reporting our true reach in each of the racial/ethnic groups as approximately 88,900 residents are still categorized as “unknown” or “other.”

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 9/12/21	% age 12+ vax as of 9/19/21	% increase since 9/12/21	Estimate # eligible unvax
Black / African American	61.5%	62.0%	+0.5 percentage points	6,816
Hispanic	59.6%	60.4%	+0.8 percentage points	68,755*
Multiracial	55.1%	56.3%	+1.2 percentage points	9,245
Native Hawaiian / Pacific Islander	63.3%	63.9%	+0.6 percentage points	3,531

*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.

As we wait for further guidance on COVID-19 vaccine approvals for youth and expanded eligibility for booter shots, we remain focused on increasing the reach of the vaccine in the communities and populations that still need to attain at least <80% vaccination rates.

All Together Better,
Louise F. Rogers