Orange County is rolling out COVID-19 vaccines at a faster pace compared to much of the state, and Southern California.The county is providing vaccine doses at a rate of 132 per 1,000 residents, versus about 127 per 1,000 residents statewide, according to California Department of Public Health data. Those figures could in fact be higher, factoring in distribution of vaccines by entities operating in the county that the state isn’t tracking. The county has attributed its successful rollout thus far to its ability to turn around doses on a dime, in part because of its Othena software application that is unique to the county, according to Lisa Bartlett, fifth district supervisor for the County of Orange. “We turn around vaccines overnight,” Bartlett told the Business Journal last week. “Once we know our allocation of doses for the week, we populate [the data into] Othena, and we start going right away.” About 89% of shots allocated to the county have been put into arms as of last Thursday.

Shots in Arms
The state allocates vaccine doses based on a range of factors, including doses left on-hand as well as population in specific tiers of distribution.
That means it’s up to counties to get shots into arms, in order to request additional supply from the state. Orange County has the bandwidth to do more and the track record to prove it, Bartlett said.
“We were the first county in Southern California to open vaccinations for seniors 65+,” Bartlett said, noting the Othena app allowed the county to start registering residents and making appointments at its Anaheim super site on Jan. 13.
By comparison, the state-run MyTurn website that is being piloted in San Diego and Los Angeles counties, among others, launched on Jan. 25.
“I’ll be the first to admit the new software wasn’t perfect, but the glitches have been mitigated and we’re making enhancements to the program,” Bartlett added.
Othena recently added Spanish and Vietnamese languages to the platform in the last two weeks. MyTurn, meanwhile, is currently limited to English and Spanish.

Changing Tide?
When compared to four large surrounding counties in Southern California—Los Angeles, San Diego, Riverside and San Bernardino—Orange County comes in second place in terms of distribution, only behind San Diego.
While San Diego outpaces Orange County in its distribution efforts, there’s a caveat—it’s also received a larger allocation from the state because it has more healthcare workers, according to Bartlett.
OC has approximately 183,000 healthcare workers, compared to about 352,000 in San Diego, according to county census data.
With the majority of OC healthcare workers nearing inoculation, according to multiple local hospitals, allocation is shifting based on the number of residents 65 or older in age.
“Now that we’re into the next phase and we’re starting to vaccinate the 65+ population, Orange County has a much higher population of seniors, so those numbers are reversing,” Bartlett said.
OC has about 544,000 seniors 65+, while San Diego has about 484,000 seniors age 65+, according to county census data.

Expanded Access
California enlisted Blue Shield of California, an Oakland-based insurance provider serving more than 4 million health plan members, to develop a new statewide vaccine distribution network that calls for wider distribution across pharmacies, community centers and pop-up sites.
The program “is another layer of bureaucracy” that will take time, Bartlett said, pointing out Orange County already has efforts in place to provide broader access to vaccines.
The county wants to open more super sites—which can distribute between 2,500 to 5,000 doses per day—and has been trying to expand access at its existing sites, Bartlett said.
For example, a disabled person can use a drive-thru lane at the super site at Soka University.
The county is working with community partners such as CalOptima and Latino Health Access to host mobile clinics. It also established a network of community health centers that will provide vaccinations across sites in Anaheim, Buena Park, Garden Grove and Tustin.

Public-Private Collaboration
Organizations with hospitals in three or more counties—known as multi-county entities—receive their own vaccine allocation from the state.
For example, UCI Health received approximately 21,825 doses from the University of California Health system as of Feb. 9.
“We’re actively vaccinating patients 65+ as well as those undergoing cancer treatments other immunosuppressive treatments,” said Nasim Afsar, chief operating officer of UCI Health.
UCI Health is in the process of moving toward a seven day a week schedule as supplies become available. Last week, it hosted events Wednesday and Thursday from 6 p.m. to 10 p.m. and Friday through Sunday from 8 a.m. to 6:30 p.m.
Others with their own distribution supply include Providence, which is only offering second-dose appointments at this time, and Kaiser Permanente, which is currently offering vaccines to residents 75+.
Some but not all of the multi-county entities’ efforts in OC are reflected in the 132 per 1,000 residents figure cited by the state, officials note.
Hoag Hospital and MemorialCare Health System also have received vaccines from the county, and are providing their own staff and volunteers to vaccinate at-risk seniors in wheelchairs, walkers and other people who might struggle to navigate the Disney parking lot in Anaheim, according to hospital officials.

Questionable Data
It’s been difficult to glean with 100% certainty how efficient counties are in distributing vaccines.
It’s been a great source of “frustration” at the county because it only has visibility into the Othena data. It doesn’t have visibility into vaccines given to multi-county entities or pharmacies, Bartlett said.
“We have very good data through Othena. We’re encouraging other health systems to use it, and some already are.”
While Blue Shield has yet to make clear how it will work with counties, pharmacies and health systems, Bartlett added she is hopeful the new network will improve data collection across the state.
“Hopefully the state is able to scrub the data to get good information. Otherwise, it’s one of those things—if it’s garbage in, it’s garbage out,” she said.

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