Facing flak for putting homeless high on vaccine list, Calif. green lights vaccines for 65 and older

California health officials faced pushback over placing homeless people over most of the elderly population. Wednesday, that changed.

It was a ranking that left many public officials scratching their heads.

As California counties continue to distribute the Pfizer and Moderna coronavirus vaccines, one element of the distribution schedule caught the eye of many.


A high placement for homeless Californians, slated to receive the vaccine along side senior citizens aged 65 or older with underlying medical issues.

Following a press announcement of Fresno County’s high-volume vaccination center at the Fresno Fairgrounds on Tuesday, interim health officer Dr. Rais Vohra said he expected the county to open up the Phase 1B tier next week, starting with individuals aged 75 and older.

Ag workers will be next in line at the end of January.  

By March, the homeless population would be placed ahead of anyone under 65 who has an underlying condition, as well as all individuals aged 50-74 who do not have any preexisting health conditions. 

Vohra told The Sun that the tier placement comes from the state’s directive. 

“I wasn’t privy to those committee meetings,” Vohra said. “This is what the state gave us.” 

Vohra said if the decision was up to him, he would have prioritized vaccine distribution by age.

“When you think about a population health perspective, someone who lives at home alone regardless of age is at a lower risk than someone who lives with a bunch of other people where the virus can spread around,” Vohra said. “So I think from a population health perspective it kind of makes sense to protect against outbreaks and do congregate settings.” 

One day after Vohra made those comments, an unexpected switch arrived from Gov. Gavin Newsom and California public health officials on Wednesday.

California recalibrated its vaccine distribution path to allow any person aged 65 or older to receive the vaccine.

As for vaccinating the homeless, challenges abound in attempting to reach a difficult to pin-down population.

Given the distribution challenges and the speed in which the county desires to move through the tier system, not all homeless individuals will be required to receive the vaccine before the following tiers. They will simply have an earlier opportunity to receive it than other groups will. 

“These are really hard decision,” Vohra said. “We’re really not going to pick nits at that level. I think that whenever those tiers open up, even as early as next week, 65 and older, we’re going to basically just say, ‘Come on down. Get your vaccine, or work with your doctor to get your vaccine.’ 

“And then it will just be a matter of time working with all the shelter operators and the homeless shelters that we have here in Fresno County to try to get all those populations done.” 

Although the distribution schedule was set by the state, there is some room for flexibility. Most notable is the county’s inclusion of agriculture workers in Phase 1B, Tier 1. Initially those workers would not have been lined up to receive the vaccine starting at the end of January, but Vohra said the county lobbied the state to allow for a little local control. 

“They’re giving us a little bit of flexibility about what they can do,” Vohra said. “We really pushed them to say we’ve got to pull our ag workers up into January, because they wanted us to wait on that. And we said no, we’re going to just start them in January. And they were OK with that because they understand how important ag is to the Central Valley.”

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