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Monterey County COVID-19 vaccination clinics adapt to hesitancy, no-shows

Monterey County COVID-19 vaccination clinics adapt to hesitancy, no-shows

SALINAS – Though the number of vaccine doses received by Monterey County this week increased to 19,130,  they come just as clinics report a decline in demand.

That may be due in part to the Johnson & Johnson vaccine that was put on a temporary pause and suffered previous manufacturing issues, according to the Monterey County Health Department.

On Tuesday, the Monterey County Health Department said it would align itself with the California Department of Public Health and resume the use of the Johnson & Johnson vaccine, citing the “thorough and transparent assessment of the safety and effectiveness of the Johnson & Johnson vaccine” by the various entities such as the Centers for Disease Control and the Food and Drug Administration.

According to the CDC, to date, there have been only 15 confirmed cases of the rare clotting event among nearly eight million doses administered in the U.S., all in females ages 18 to 59 years. That means there is a risk of about two cases per one million doses overall and seven cases per one million among women between 18 and 59 years of age. For those who have a confirmed COVID-19 diagnosis, the risk of dying from COVID-19 is one in 56 in the U.S. And one in 114 in Monterey County.

But vaccination clinics have seen a drop in demand and are also reporting that a number are not showing up for their second doses of the Pfizer or Moderna vaccine.

The Johnson & Johnson vaccine requires only one shot and the Monterey County Health Department has reported it has not heard of any complications from the vaccine in the county.

But if within three weeks after receiving a Johnson & Johnson vaccination a person develops severe headache, abdominal pain, leg pain or shortness of breath, they should contact their primary health care provider.

“Since just over 50% of Monterey County residents (16 years and older) have received at least one dose of the vaccine, it is expected the demand will not be as great,” said Monterey County Health Department spokeswoman Karen Smith. “There are continuing efforts to reach those who are harder to reach.”

Smith said many things are being done to respond to vaccine hesitancy including the use of community health workers who have been deployed to the hardest-hit areas. They are members of the community who are trained and can answer questions people have as well as find out why they are hesitant.

“There is also a partnership to reach other groups such as the African-American community to address access and hesitancy,” said Smith.

A forum sponsored by the City of Seaside and the Seaside Vaccine Action Team in collaboration with Natividad hospital, took place Tuesday. The forum was held to provide education and dispel myths about receiving the COVID-19 vaccine.

Natividad hospital and Salinas Valley Memorial Healthcare System, as well as Montage Health, have also seen a decline in demand for vaccinations.

Natividad, along with the Monterey County Health Department, Salinas Valley Memorial Healthcare System, Montage Health and Mee Memorial Healthcare System, are encouraging Monterey County residents to get vaccinated through a new marketing campaign, said Hillary Fish, Natividad hospital spokesperson.

“The campaign, produced in English and Spanish, features staff from each of the four hospitals and first responders getting their COVID-19 vaccine,” said Fish. “The campaign encourages people to protect themselves and the people they love by getting the vaccine.”

Natividad started taking walk-ins for clinics last week including those at Palma High School and Hartnell College.

“Approximately 10% of the people being vaccinated at our clinics have skipped the second shot,” said Karina Rusk, Salinas Valley Memorial Healthcare System spokeswoman. “When there is a no show, we follow up and contact them in an effort to get them rescheduled. There are benefits to being fully vaccinated and the intended use and FDA emergency authorization was based on the two-dose application for Pfizer and Moderna.”

Rusk said Salinas Valley Memorial Healthcare System has seen about a 40% decline in the vaccination rate for the second dose. She explained that some people who do not return for a second dose express concern about the side effects of the second dose, or they feel the first dose gives them adequate protection. The Salinas Valley Memorial Healthcare System is using that information to expand its public outreach to address those concerns.

“We are still vaccinating approximately a thousand people a day, however first dose vaccinations last week dropped to about 500 shots a day,” said Rusk. “In addition to contacting everyone in our (Salinas Valley Medical Clinic) system, we have done direct outreach to another 40,000 people in targeted zip codes, are engaged in an aggressive social media campaign, conducting podcasts with physicians, utilizing our Healthcare System newsletter and our President/CEO Pete Delgado and Chief Medical Officer Dr. Allen Radner have done numerous videos to increase awareness and engagement.”

Adapting to the hesitancy and no-shows, some clinics have also started to accommodate walk-ins for vaccination.

Rusk said Salinas Valley Medical Clinic is accepting walk-ins at its vaccination clinics but those accommodations are based on vaccine availability and allocation, and people are encouraged to use the MyTurn appointment system or call 831-771-3885 to make an appointment for greater assurance of availability.

“We started accepting walk-ins to our clinics on Friday, April 23,” said Monica Sciuto, Montage Health spokeswoman. “With the decline in demand for vaccinations, we want to have multiple ways for those seeking the vaccine to get one. Some have struggled making an appointment online or being able to commit to a vaccine time due to personal time constraints. We want to make it as convenient as possible for our community.”

The health care organization is allowing walk-ins at first-dose clinics at Montage Wellness Center in Marina during designated hours.

“Community members can check the latest walk-in schedule at www.chomp.org/covidvaccine,” said Sciuto. “We still encourage people to make an appointment, if they can, to secure their time and reduce any potential wait times.”

Montage Health is tracking those it gave first-dose shots to intending to get them fully vaccinated or get a clear answer that they either do not intend to get the second dose or they got it elsewhere.

“We are providing assistance to those who may have trouble scheduling or rescheduling their second dose,” said Sciuto. “Given that CDC currently says there is no upper limit on the interval between first and second doses, we will not be categorizing people as declined unless they’ve informed us of a decision to forego it. At this time, less than 1 percent of those who have received a first dose from us have declined the second dose, this includes those who do not want a second dose and those who received their second dose at another clinic outside of Montage Health.”

According to Smith, the Monterey County Health Department’s Public Health Bureau currently has 3,000 doses of the Johnson & Johnson vaccine, which will be integrated back into vaccine clinics pending development of appropriate educational materials.

The Monterey County Health Department will make it clear on the department’s COVID-19 vaccine appointment website www.mcvaccinate.com and in other forms which vaccines are available at Public Health Bureau-run vaccine sites.

The Public Health Bureau has 1,440 doses of Pfizer and 500 doses of Moderna vaccine on hand. To date, local vaccine service providers have administered more than 9,000 doses of the Johnson & Johnson vaccine to Monterey County residents. It has been used for all populations generally and also for targeted populations such as homeless and homebound, where the benefits of needing to administer only one dose are significant.

The Visiting Nurse Association started providing free COVID-19 vaccinations for homebound individuals on Monday using the Johnson & Johnson vaccine. Contact VNA at 831-648-3777 and ask for the immunization clinic.

“It’s very important to get both doses (of the Pfizer and Moderna vaccine) because although the first dose conveys some immunity, you really need to get the second dose to get to a higher percentile of coverage and increasing immunity,” said Smith. “As variants start to show up, we want to fight off as much as we can and not allow the virus to replicate and change.”

Visit the Monterey County COVID-19 vaccination registration page at https://bit.ly/3xr7JfC for available clinics.

https://www.montereyherald.com/2021/04/27/monterey-county-covid-19-vaccination-clinics-adapt-to-hesitancy-no-shows/