So far 3,318 of the 6,300 vaccine doses received by Napa County and its hospitals have been administered as part of phase 1A, Tier 1 of the vaccination process, County Public Health Officer Karen Relucio said at Tuesday’s County Board of Supervisors meeting.

That tier, dictated by guidance from the Centers for Disease Control and Prevention (CDC), includes staff and residents at hospitals, skilled nursing and assisted living facilities as well as paramedics and other emergency responders.

Vaccinations in that phase and tier, which began in late December, are so far going according to schedule, Relucio confirmed in an interview Wednesday. Both hospitals in the county have administered “hundreds” of doses, she said, and Napa State Hospital, a state–run psychiatric hospital, had administered well over 1,000 doses.

Queen of the Valley Medical Center in Napa is now up to about 1,100 administered doses, Chief Medical Officer Dr. Amy Herold said Wednesday evening. Twenty-eight patients at Napa State Hospital and close to 1,500 of its staff have received the first dose, a spokesperson for the hospital said.

The county is attempting to track vaccinations daily, Relucio said at Tuesday’s meeting, but data from healthcare facilities is “a moving target.” The county is actively working to improve its ability to track administered vaccines, she added.

Skilled nursing and assisted living facilities, including the Veterans Home of California at Yountville, are currently prioritizing staff, who most often transmit the virus to residents, for vaccinations. The Vets Home recently hosted a three-day clinic facilitated by Walgreens, in which “the majority of eligible skilled nursing residents and staff were vaccinated,” said Lindsey Sin, California Department of Veterans Affairs Deputy Secretary of Communications. A specific number of vaccine recipients was not available.

The county has also launched two vaccination clinics to assist with vaccinations at skilled nursing and assisted living facilities, according to Relucio. Those clinics have administered around 500 doses and are “finishing up tier one” of Phase 1A.

Starting next week, vaccinations will move to Tier 2 operations, including home health care, primary care clinics and urgent care clinics, she said.

In February, depending on the available supply, the county will move into Tier 3, which encompasses other healthcare settings including specialty and dental clinics, lab workers and pharmacy staff, Relucio said.

Tier 1 of Phase 1B, scheduled tentatively to begin in March, will prioritize county residents 75 years of age and older and first responders, as well as workers in education, childcare, “food and agriculture,” according to Relucio’s presentation.

Tier 2 of Phase 1B, set to begin in April, will make residents between the ages of 65 and 75 eligible, alongside shelter residents, workers in “critical manufacturing,” the incarcerated, the homeless and residents of “sheltering facilities.”

From there, eligibility widens: phase 1C includes residents 50 years of age or older, or residents between the ages of 16 and 64 with underlying medical conditions or disabilities. It also includes workers across essential sectors, including government operations, waste or water management and community service. That phase is forecast to begin in May, Relucio said, emphasizing these timelines are highly contingent upon the availability of vaccines and the infrastructure to administer them.

County residents under the age of 50 who are not essential workers and do not have pre-existing conditions should not expect to be vaccinated until at least the summer — June or July, Relucio added.

Vaccine rollout is made logistically complicated because of the procedure that must be followed upon administering the shot, experts have said. It takes time to explain the vaccine and its possible side effects to patients, who then may have additional questions. And each recipient must be observed for 15 minutes after they’ve been given the shot in case of allergic reaction.

Locally, the scale at which the vaccine needs to be given calls for more medical personnel than the county currently has available, Relucio said. The county this week in an effort to bolster its ranks put out a call for volunteers with medical backgrounds to assist the planned mass vaccination effort.

Queen of the Valley Medical Center has offered up “physical locations” for the effort, according to Chief Medical Officer Herold, but does not have the manpower “to mass vaccinate the community,” especially with the substantial increase in demand on existing resources amid the latest surge of COVID cases and hospitalizations, she said.

Internally, some staff have begun receiving their second doses, including Herold, who received her second shot on Tuesday.

Adventist Health St. Helena, which administered 800 first-round doses, is set to begin its second round late this week, according to President & CEO Dr. Steven Herber.

Relucio, speaking to supervisors Tuesday, emphasized the need for even vaccinated community members to remain cautious “until we have a larger swath of the community" vaccinated.

“Studies still have to be done about the infectivity after someone is vaccinated,” she said, referencing early data showed that while vaccines do tamp down the severity of coronavirus symptoms, they do not guarantee zero risk of infection. “We have to still continue to (take precautions).”

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