Oakland flu vaccinations get off to a slow start

Every year, James McCabe prepares for flu season like clockwork. He manages the adult immunization program at the West Oakland Health Council and East Oakland Health Center. In February, he submits orders for flu shot supplies. By early June, he clears space in his refrigerators, sets them to the ideal storage temperature of 40 degrees Fahrenheit and waits for manufacturers to begin distribution. 

Working as a pharmacist for over 30 years, he’s learned to maneuver nearly every challenge that comes with treating the seasonal flu—from supply shortages to vaccine distrust—but no experience could’ve possibly prepared him for the present moment. “This is no ordinary flu season,” McCabe says. 

With COVID-19 shifting the industry to telehealth, healthcare workers like McCabe can no longer rely on routine checkups and in-person doctor visits as opportunities to vaccinate their patients. In Oakland, several healthcare providers are already reporting that, at the current pace, they’ll likely vaccinate fewer patients than last year. 

The struggle to immunize patients for the flu comes at a time when doctors nationwide have warned of a ‘twindemic’ threat: a surge in COVID-19 cases converging with a severe flu season. As Oakland residents head into the winter months when flu cases normally rise, half of the “twindemic” scenario is already taking place. Over the past week, Alameda county saw 369 new COVID-19 cases, up 95%. Many of the clinics in Oakland that are struggling with flu immunizations primarily serve Black and Latinx populations, two groups that, according to the CDC, suffer from the highest rates of flu-related hospitalizations. 

McCabe is frustrated and worried by the potential for the pandemic to further exacerbate existing health disparities. During an ordinary flu season, McCabe reaches 20% of his patient population. He wishes those numbers were higher. This year, his clinics have increased patient outreach via robocalls and text messages, but even with that, he expects fewer people to be vaccinated. “We have to deal with the anxiety that a lot of our patients have, especially the elderly, about coming into any kind of clinic setting,” McCabe said. 

Dr. Lisa Winston, an epidemiologist at the University of California San Francisco, understands the reasons for patient anxiety but warned against skipping out on the yearly flu shot. “It’s important to get vaccinated for the flu every year because the flu can be quite a dangerous disease, but this year is particularly important,” Dr. Winston said. A severe flu season would “put a strain on testing resources and healthcare systems” due to the overlap between the symptoms of the two respiratory diseases, she explained. 

La Clínica de La Raza health center, which serves a large immigrant population in Oakland’s Fruitvale District, did not provide numbers on flu doses they’ve given out, but reported lower numbers than last year. Dr. Katherine D’Harlingue, a pediatrician at the clinic, said, “there does seem to be more questions about the influenza vaccine this year than in previous years—asking if they should get it this year or not, worried we are somehow giving them the COVID shot.” 

D’Harlingue’s observation isn’t an anomaly. Many healthcare providers are worried that the highly politicized environment around COVID-19 is making patients second guess vaccines. Signs already point to a decline in the trust of recommendations from public health officials. A recent Pew research survey found that 51% of Americans would get a COVID-19 vaccine if it were available today, down from 72% in May. 

It’s an issue Dr. McCabe believes is directly impacting his work as an immunization specialist. “The political climate has created a degree of suspicion and doubt regarding the CDC recommendations. Some people won’t get a COVID-19 vaccine because they have concerns over safety and efficacy, and likewise, it spills over to their views on the flu vaccine,” McCabe said.

At Roots Community Health Center, COVID-19 is impacting their flu vaccination program in other ways. Throughout the pandemic, Roots has served as a free testing site for Oakland’s hardest-hit communities on the city’s east side, but they have yet to start their flu clinics. Jamaica Sowell, director of program and policy at the center, said that  as of Oct. 14, they haven’t begun flu operations because they’re still “working with the county in receiving their vaccine supply.” The reason for the delay is unclear. Officials from Alameda County’s Public Health Department didn’t respond to Oakland North’s request for an interview. The CDC recommends that people get vaccinated by the end of October, prior to the peak of flu season. 

Northern California’s largest healthcare provider, Kaiser Permanente, has vaccinated about 20%  of its membership in Oakland. Normally, they reach 50% by the end of the year. Kaiser’s media relations officials said their doctors remain optimistic and are “hoping to exceed that number.” 

While fewer Oakland residents are visiting hospitals and clinics this year due to COVID-19, corner drug stores are hoping to fill the void. Walgreens pharmacies are seeing this reflected in early trends. Jessica Masuga of Walgreens Pharmacy Communications did not share data but said, “we’ve seen an early increase in customer demand. We believe demand for flu, pneumonia and other immunizations could be as much as 30-50% higher this season.”

Alameda County Public Health Department last discussed the flu season during a board meeting on Sept. 14, when officials said they expect higher vaccination numbers this year. They have not provided an update on vaccination progress. The County Board of Supervisors met again earlier today, but flu season was not on the agenda. 

The above image was taken before the COVID-19 pandemic.