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March 12, 2021

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March 12, 2021 Secretary Dr. Mark Ghaly California Health and Human Services Agency 1600 9th St # 460 Sacramento, CA 95814 Secretary Yolanda Richardson California Government Operations Agency 915 Capitol Mall Sacramento, CA 95814 RE: Urgent Need for Changes in California’s Vaccine Formula to Integrate Hardest-Hit Communities in the Bay Area Dear Secretary Ghaly and Secretary Richardson: The undersigned urge you to address a critical disparity and inequity in the latest state vaccine distribution plan unveiled late in the week of March 1st. While we applaud and support the intent to expand equitable access to the vaccine, the newly announced vaccine equity metric leaves behind many underserved communities and vulnerable individuals in the Bay Area that have been hardest- hit by the COVID-19 pandemic. This formula must be changed to adequately supply vaccines to those in our state that need it the most. The current metric allocates 40 percent of available doses of the COVID-19 vaccine to 8 million California residents for the communities in the lowest quartile of the “Healthy Places Index” which translates to 446 zip codes across our state. Even though the Bay Area accounts for 20 percent of the population of California, only 2 percent of Bay Area residents fall under the affected zip codes determined through this newly established vaccine metric. Only 10 zip codes in the Bay Area are prioritized through this formula, while 79 zip codes in Los Angeles County and 39 zip codes in San Bernardino County have been identified. Most prioritized zip codes fall in Southern California while most counties in the Bay Area - Santa Clara, San Mateo, Marin, Sonoma and Napa – have no zip codes prioritized through this formula and only 4% of San Francisco residents, 3% of Contra Costa County residents and 7% of Alameda County residents fall in those zip codes that are prioritized. 1,2 The formula excludes zip codes in the Bay Area that have infection rates that are nearly twice that of the state’s overall rate.3 This is clearly not an equitable approach to vaccine distribution and one that is completely disadvantaging the Bay Area. This is a matter of life and death for our community. This plan needs to be restructured and recalibrated immediately. Peer-reviewed research demonstrates that wealthier households in California are getting vaccinated at nearly twice the rate of lower income households that are at a higher risk of becoming infected.1 While targeting low-income households for vaccine priority is a needed approach to ensure equity, the Healthy Places Index was developed from census tract data, not zip codes, and, thus, the current approach unfortunately exacerbates geographic and other inequities rather than addressing them. For instance, while Santa Clara County currently has no zip codes prioritized through the currently Healthy Places Index formula that targets the lowest quartile, the county, in fact, includes a dozen census tracts in the lowest quartile. In San Francisco County, at least 7 census tracts in the lowest quartile do not fall under the only two zip codes prioritized through this formula. Targeting zip codes leaves behind those that have been disproportionately impacted in zip codes that have affluent neighborhoods directly near lower-income communities. Areas across the Bay Area, places that have been disproportionally impacted by higher rates of COVID-19 such East Palo Alto, Hayward, the Mission District and Bayview District in San Francisco, Marin City, portions of San Rafael and Santa Rosa, Concord, and East San Jose, have all been left out of the vaccine prioritization formula. Bay Area counties, including local governments, community clinics, health and hospital systems, and trusted community-based messengers, have a proven history of working collectively to address the root causes of health inequity, including the socioeconomic and racial divides that have become more visible to many during the current COVID-19 public health emergency. To ensure a fair, equitable, and culturally competent vaccine rollout, the state must identify and address structural and systemic inequalities in our public health systems and reconsider the current approach to the allocation of these precious and scarce life-saving vaccines We thank you for your service to the community during these difficult times and for your consideration of this urgent request. 1 Joaquin Palomino and Catherine Ho, “Only 2% of people in prioritized ZIP codes live in the Bay Area under California's vaccine equity plan,” San Francisco Chronicle. March 5, 2021, https://www.sfchronicle.com/local/article/New-vaccine-plan-largely-overlooks-Bay-Area-16004460.php. 2 Kellie Hwang, “10 Bay Area ZIP codes are on state's vaccine priority list. In Los Angeles, the number is 79,” San Francisco Chronicle. March 5, 2021, https://www.sfchronicle.com/local/article/Bay-Area-vaccine-maps-distribution- 16001301.php. 3 Fiona Kelliher, “Hard-hit Bay Area ZIP codes left out of state’s vaccine rollout scheme,” The Mercury News. March 5, 2021, https://www.mercurynews.com/2021/03/05/hard-hit-bay-area-zip-codes-left-out-of-states-vaccine-rollout- scheme/. Sincerely, Dave Cortese Ash Kalra State Senate, District 15 State Assembly, District 27 Mike McGuire David Chiu State Senate, District 2 State Assembly, District 17 Scott Wiener Philip Ting State Senate, District 11 State Assembly, District 19 Josh Becker Marc Berman State Senate, District 13 State Assembly, District 24 Nancy Skinner Alex Lee State Senate, District 9 State Assembly, District 25 Bill Dodd Kevin Mullin State Senate, District 3 State Assembly, District 22 Bob Wieckowski Evan Low State Senate, District 10 State Assembly, District 28 John Laird Marc Levine State Senate, District 17 State Assembly, District 10 Bill Quirk Timothy Grayson State Assembly, District 20 State Assembly, District 14 Buffy Wicks Rebecca Bauer-Kahan State Assembly, District 15 State Assembly, District 16 Community-Based Organizations, Non-Profits, and Small Businesses AACI Health & Wellness Abode Services Academic Coffee AdvancED Consulting, LLC African American Community Service Agency Aging Services Collaborative of Santa Clara County Airtronics Metal Products, Inc. Almaden Valley Counseling Service Alum Rock Counseling Center American Red Cross Northern CA Coastal Region AmeriCare Silicon Valley Amigos de Guadalupe Center for Justice and Empowerment Asian American Center of Santa Clara County Asian American Nonprofit Services Asian Americans for Community Involvement (AACI) Asian Law Alliance Bay Area Community Health Behavioral Health Contractors' Association (BHCA) Bill Wilson Center Boldly Me BookSmart Enterprises, Inc. Boys & Girls Clubs of North San Mateo County California Health and Human Services Agency California La Raza Lawyers Association California League of United Latin American Citizens (LULAC) California LULAC Council 3262 CANA-Carnaval San Francisco Cancer CAREpoint Carry the Vision Castellano Family Foundation Catholic Charities of Santa Clara County Center for Employment Training Immigration and Citizenship Program Center for Excellence in Nonprofits Chicano Latino Caucus Child Advocates of Silicon Valley CineLux Theatres City Year CJA Community Health Partnership Community Resources for Independent Living Community Services Agency Community Solutions CommUniverCity SJSU Conxion To Community Craft Roots Bar and Veggie Grill Cupertino for All Dicar Networks Dolores Street Community Services Escuela Popular Faith in Action Bay Area FalconX Inc Family Supportive Housing, Inc. Farmworker Caravan FFN San Jose Public Library Foundation for Climate Restoration Gardner Health Services Gavilan Joint Community College District GenesisSV Goodwill of Silicon Valley Grail Family Services Grass Farm Garden Accents Great Commission Association Green Foothills Healing Grove Health Center Health Trust Healthier Kids Foundation Hien Nguyen Corporation Hiland Consulting HomeFirst Services HOMEY (Homies Organizing the Mission to Empower Youth) Individual Indivisible San Jose International Children Assistance Network (ICAN) Julian St James Neighborhood Association Justice at Last Karat School Project La Raza Community Resource Center La Raza Roundtable De California Latinas Contra Cancer Latino Leadership Alliance Latino Leadership Committee Latinos United for a New America Law Foundation of Law Foundation Loaves and Fishes Family Kitchen LoretoQD's Brigade - Silicon Valley Lusamerica MAC Capital MACLA/Movimiento de Arte y Cultura Latino Americana Mekong Community Center Mental Health Systems, Inc META LLC Mexican American Political Association Mi Familia Minority Business Consortium Mission Economic Development Agency Mission Housing Development Corporation Mission Language and Vocational School Morgan Hill Chamber of Commerce Morgan Hill Responsible Growth Coalition MY HOME NAMI Santa Clara County Native Voice TV Next Door Solutions to Domestic Violence Nor Cal Fire North East Medical Services (NEMS) Our City Forest Our Mission, No Eviction Paramit Corporation Parents Helping Parents Parisi House on the Hill PARS Equality Center Pathway Society, Inc. Peninsula Family Service Peninsula Healthcare Connection PitStop Outreach Planned Parenthood Mar Monte Planned Parenthood Northern California Portola Family Connections Portola Neighborhood Association Project MORE Puente de la Costa Sur Ravenswood City School District Ravenswood Family Health Network Reedy Engineering, Inc. Representing East Palo Alto Roosevelt Parks Neighborhood Association RotaCare
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