Vaccination efforts are shifting increasingly to smaller community-based sites, including schools. Credit: Amir Aziz

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Last week, The Oaklandside launched a free text number where anyone can ask our newsroom questions about getting vaccinated in Oakland and Alameda County. Some reached out to us because they were confused about special access codes, which were meant to help people of color, especially Black and Latino residents in communities that have been hardest hit by COVID-19, find and book vaccine appointments. 

“I’ve seen a code going around…supposedly because there were not enough people signed up for the Coliseum vaccines. Is that true or was the code intended for high-risk people?” asked one texter who signed up for our service.

As many outlets have reported, misuse and even abuse of these codes have been major problems since the California Department of Public Health began generating them for use at federally funded vaccination sites in Oakland and Los Angeles in February. The state sent them to over 1,000 community groups to share with residents of color that are most vulnerable to infection, hospitalization, and death due to COVID-19. But in reality, the codes quickly got passed around among far less vulnerable people, and community organizations were finding that their constituents were having enormous trouble booking appointments. 

Now, the state says it’s halted the program and is changing its approach. “We’re going to go away from group codes to individual codes,” Gov. Gavin Newsom said last Thursday, referring to the fact that the first batch of codes shared by the state could be used an unlimited number of times, as opposed to a code that only one person can use one time. “We don’t like to see those abuses,” the governor said. On Monday, Blue Shield of California, which is based in Oakland, took over the state’s vaccine rollout, which will include new recommendations for prioritizing hardest-hit communities.

We wanted to look back at what went wrong with the first attempt, whether there were cases in which the codes worked the way they were intended, and what lessons could be learned from those examples.

We spoke with several people who used codes that weren’t meant for them to better understand their motivations and what they did or didn’t understand about the codes going in.

We also checked in on a program in Oakland that’s successfully helping at-risk residents in East Oakland get vaccinated without relying on codes at all.

“How am I allowed to do this?” Confusion reigned over code use at the Coliseum 

A mass vaccination site opened at the Oakland Coliseum on Feb. 16. Credit: Amir Aziz

Darrel Ng, a communications advisor for the California Governor’s Vaccine Task Force, told The Oaklandside that the state “provided codes to some of those community groups that represent the hardest hit” in order “to ensure we are reaching into the most at-risk and most impacted communities.” The codes are “only intended for use by impacted communities,” he said, and “if these codes are improperly used by those not in these groups, appointments will be canceled to make sure the appointment slots go to those who need them most.”

In reality, untold numbers of people outside those groups were able to easily make appointments and get vaccinated. We spoke to several East Bay residents who aren’t in high-risk communities of color and don’t meet the current eligibility criteria—because they’re under 65, or they don’t work in healthcare, long-term care facilities, childcare, education, emergency services, or food and agriculture—but were sent a code anyway, usually by a friend or acquaintance. They were able to successfully schedule an appointment at the Oakland Coliseum, which is currently administering about 42,000 doses a week, by simply entering the code at My Turn, the state’s online booking portal.

Naomi, a Rockridge resident in her 30s, said she had no idea that the codes, like the one she used to get an appointment, had another purpose. She viewed her appointment as an opportunity to help care for her mother who is in cancer treatment. 

Another Oakland resident, a white, healthy male in his 40s who is not currently eligible to get the shot under state and county guidelines, received a code in a private message from a friend. Within a few hours of receiving the text, he booked a same-day appointment at the Coliseum and received the first dose of the Pfizer vaccine. It wasn’t until later that he learned he took advantage of a code that wasn’t meant for him. 

“If the text I received with the code had said ‘do not share,’ I would have listened to that,” said the man, who asked to remain anonymous.

Another currently ineligible Oakland man who wished to remain anonymous acknowledged feeling unsure about whether he was doing the right thing when he booked his appointment using a code he’d received from a friend. When he went to the Coliseum to receive his shot, he said he asked one of the clinicians on-site there, “How am I allowed to do this?” He said he was assured by the staffer that they could accommodate his appointment and that they needed to fill excess appointment slots fast to avoid wasting vaccine doses.

The Oaklandside reached out to the California Governor’s COVID-19 Vaccine Task Force to ask about the state’s approach to handling excess vaccine doses at federally funded vaccination sites like the Coliseum, and whether people who aren’t eligible nor in high-risk communities can use these codes to prevent vaccine waste, but we received no comment.

Frank Mansell, a FEMA representative, told The Oaklandside that the goal of health workers at the Coliseum site is to anticipate the amount of vaccine needed based on the number of appointments and to “produce only as many syringes as needed. We do not open the gates at the end of the day. If you do not have an appointment set up or identification, you will not be permitted onsite.”

A Berkeley resident, Emily, who also received a vaccination code from a text thread, was assured by a friend who works at a county-run vaccine site that the code was legitimate and guessed that the code was part of a zero-waste plan. Emily used the code to make an appointment that same day.

“The process at the Coliseum was incredibly smooth, but light on verification. Once I had the appointment, no one asked about my eligibility or the code.” Only later, she said, did some of her friends who also received a code learn that they were intended for people in highly vulnerable groups. At that point, she said, those friends canceled their vaccination appointments.

“I’m frustrated that I was able to unknowingly take a dose from someone who needs it more, and that I thought I was doing the right thing, even though I clearly wasn’t,” said Emily. 

Emily and other anonymous residents we spoke to who received a code assumed that the state’s online vaccination booking portal, My Turn, would turn them away if they weren’t actually eligible. “The primary reason I assumed it was legitimate was that the intake form requires you to submit [information], all of which I answered truthfully, and I was still able to secure an appointment.”

To confirm eligibility, My Turn asks registrants to submit information about their age, occupation, and county of residence. But it currently doesn’t require people signing up to prove anything else about themselves at the point when they type in an access code. At no point was Emily, or others like her who used a code, barred from scheduling an appointment.

In a press conference on Feb. 23, Governor Gavin Newsom addressed the misuse of the codes and said the state is aware of the loophole. The solution, Newsom said, is “to go away from group codes to individual codes and we’re working with the counties on that.” Newsom did not clarify if My Turn’s accessibility code bypass feature would be updated with additional security questions. 

Darrel Ng confirmed for The Oaklandside that group codes are being phased out in the next day or two in favor of single-use codes. These new individual codes will expire after a single-use instead of the group codes which can be used multiple times. The state will continue to distribute individual codes to community organizations within California counties, and those organizations will be responsible for making sure they get to the right people. 

Lacking guidance from the state, local organizations created their own systems to protect access

Beginning in February, the state public health department generated access codes and passed them on to local community organizations in Oakland and Los Angeles, which were then tasked with distributing them to people who are most vulnerable to COVID-19 so that they could more easily find and book appointments at federally run vaccination sites in those cities.

Native American Health Center in Fruitvale received access codes from the state before the Coliseum site opened, but with no guidance or clarification on how to distribute the code equitably and securely. So Native had to come up with its own system.

“We took it upon ourselves to create the phone bank that allows for people to pre-register for appointments,” said Greg Garrett, Chief Operating Officer for Native American Health Center. “It’s more time- and labor-intensive but it was critical to us to be able to control the equitability of the distribution process.”

At the Native American Health Center mobile clinic, codes are only given to pre-registration appointment holders in-person. Once an appointment holder is on-site and their information has been verified by clinic staff, they are walked through the official My Turn registration process and given an access code. Native’s model of using a phone bank to pre-schedule vaccination appointments was so successful at protecting the codes that two other mobile sites replicated the process.

After receiving codes from the state, La Familia Counseling Service was also able to successfully deliver vaccine doses to high-risk residents of Hayward, as well as Cherryland, San Leandro, and San Lorenzo, at a mobile clinic this week. According to its CEO, Aaron Ortiz, the organization has depended on “promotores”—trusted Spanish-speaking community members—to conduct outreach and identify vaccine-eligible individuals. 

“Having those codes sent to community-based organizations like La Familia and Native American Health Center needs to continue so we can get the vaccine to the most marginalized groups. It’s not just the digital divide we’re up against, it’s the language barrier too,” said Ortiz. 

At least one other group, the Alameda County Office of Education, was given codes after requesting them directly from the state. The superintendent of Alameda County Schools initiated contact with the state’s office of emergency services and asked for help in getting the vaccine to the county’s educators and school employees, particularly those working in areas with high COVID transmission rates.

On Feb. 17, the county education office was given 24 hours notice that FEMA and Cal OES, the state’s office of emergency services, would be setting up a mobile vaccination site at its Hayward headquarters. The mobile site was in place for three days and administered a total of 750 doses to a targeted group of educators, custodians, teachers, and employees who work directly with students and families in the Oakland and Hayward public school districts. 

A group code, which could be used by multiple people, was generated for use at that mobile site. The county education office got in contact with a list of prioritized Alameda County education employees and invited them to make appointments through a portal called SignUp Genius. 

Crucially, no codes were given out at this point. 

The group code was shared only once the appointment holder actually showed up at the mobile clinic in Hayward. Site staffers walked guests through the My Turn registration process and, at that point, helped them enter the code under close supervision.

Michelle Smith McDonald, communications director for the Alameda County Office of Education, said this two-step process was deliberately put in place to prevent the kind of misuse and confusion that has plagued vaccinations at the Oakland Coliseum. “We didn’t want to disseminate it—we wanted to protect the code,” she said. She also suspects that the smaller size and scope of this mobile site was key to keeping the code within the intended population. “It’s not possible to do a large-scale operation,” she said. 

Now, as the state moves away from unlimited-use group codes and toward replacing them with one-time-use codes for individuals, the Alameda County Office of Education confirms that they “already have a batch of individual codes” from the state. McDonald praised the efforts of Oakland schools for the “huge data operation happening now” to make sure the ACOE is targeting employees by priority level and getting the codes to those who need them most. They plan to distribute individual codes starting this week.

Going beyond codes to reach the most vulnerable communities

The COVID-19 vaccine site at Fremont High School opened to serve community members in East Oakland who are considered high risk for COVID-19. Credit: Amir Aziz

Accessibility codes aren’t the only method the county and state are using to reach at-risk groups. County-run vaccination sites, or Points of Dispensing (PODs), are carefully administering doses to avoid waste and to make sure the doses are going to those who are actually eligible. Neetu Balram, public information manager for Alameda County’s health department, told The Oaklandside that “to date, we have not wasted a single dose or vial of the vaccine in any of the county-operated PODs. We monitor open vials and reconcile drawn doses approximately two hours prior to a POD closing down to ensure open vials don’t go unused.” 

Balram also confirmed that the county turns to waitlists of people who already have upcoming appointments scheduled “who can respond quickly if we have doses left after our appointments.” However, this does not mean the county will give leftover doses to just anyone. Those on the waitlists and with appointments must meet the eligibility criteria. “We do not vaccinate people out of tier,” says Balram.

Oakland Frontline Healers, a coalition of community-based organizations, is helping bridge the equity gap in the vaccine rollout by focusing its efforts on specific, hard-hit zip codes in East Oakland. The organization was launched at the start of the pandemic to provide relief through its network of community affiliates, like Roots Community Health Center and Building Opportunities for Self-Sufficiency.

Marcus Harris, a project coordinator for Oakland Frontline Healers, told The Oaklandside that OFH is working directly with Alameda County to “help create equity around the COVID-19 vaccination process by providing eligible community members with support and access to have the opportunity to get vaccinated.”

Information sharing about the vaccine is a primary focus for OFH. They provide COVID and vaccine resources at food distribution sites for Oakland residents in need and are also working with Alameda County to provide outreach, appointment assistance, and resources for a community vaccine site at Fremont High School in East Oakland. The coalition, said Harris, is able to directly reach the targeted communities that the accessibility codes were meant to help.

The county vaccine site at Fremont High School is reserved for residents and employees of specific Oakland zip codes. In addition to the zip code, there are multiple criteria to be eligible for a vaccine at the Fremont site, including age, employment, and residency.

Harris said that OFH and the organizations within the coalition follow a “for us, by us model.” Rather than rely on an outside organization to swoop in and provide relief to the community, he said, the coalition is making sure that “we are given the capacity to do it ourselves.”

Sohayla Farman

Sohayla Farman is a freelance contributor for The Oaklandside.