As Los Angeles County health officials prepare for the massive undertaking of administering COVID-19 vaccinations to millions of residents, the county’s chief science officer vowed Thursday the process would be done equitably based on health priorities, not on power or prominence.

“Equity is a fundamental principle here,” Dr. Paul Simon said during an online media briefing. “We want to make sure all people have access, and that those that are at greatest risk either because of higher risk of exposure, or greater risk of severe illness because of chronic health conditions or other factors have more immediate access to the vaccine.”

He stressed that initial doses of the vaccine will be strictly designated for health care workers and staff and residents of long-term care facilities. The county anticipates receiving nearly 83,000 doses of the Pfizer vaccine as early as next week, with the allotment then distributed to nine ultra-cold storage sites for subsequent delivery to 83 acute-care hospitals.

Those hospitals will then prioritize the administration of the doses, following state guidelines developed in consultation with U.S. Centers for Disease Control and Prevention. Vaccines for long-term care staff and residents will be distributed via a federal contract with CVS and Walgreens.

Simon said that after the initial distribution, the county expects to receive roughly 250,000 more doses the following week, and another 150,000 the week after that, with weekly deliveries of up to 250,000 doses anticipated beginning in the new year.

After the distribution to health care workers and long-term care staff and residents is completed, under “Phase 1A” of the plan, Priority will then move to “essential workers” and then people at highest risk of severe illness from the virus, such as seniors or those with underlying health conditions.

But Simon noted the judgment of who is considered “at risk” could become a matter for debate.

“That probably is going to become an important consideration when we really start to roll things out — when we move beyond the highest-risk groups into groups where the risks may be a little bit more uncertain or there are larger areas of gray,” he said. “And there, I think, we will do our best to prioritize, be as transparent as possible. I don’t think we’re going to be doing validation checks with each person as they float through the line, so I think there is sort of an honor system to some degree. But we will do everything possible to make sure we are doing this in an equitable manner, tending to the risks and making sure that we maximize the benefits.”

He noted specifically in response to a media question, that elected officials will have no special advance priority to the vaccine, unless they fall into a high-risk category.

The timing of when the vaccine will start to become available to more of the general population remains a mystery. Simon said that while the vaccine offers a glimmer of hope about a potential end to the pandemic and lockdown orders, the county is still in the midst of a dangerous surge in cases, so residents should expect to see restrictions continuing for months.

“I am very concerned,” he said of the county’s current case surge and burgeoning hospitals. “I’ve worked in public health for 30-plus years. I’ve never been more concerned than I am right now.

“And so we’re not even close to being able to move back out (of restrictions),” he said. “I think over the next several months we’ll get a better understanding of when we can begin to open things up. We’ll get a better understanding of how well the vaccine works in the real world. How well it works in a clinical trial … is different than how well it works sometimes in the real world.”

He said the administration of the vaccine will be a “massive undertaking the scale of which many would argue is unprecedented given the time emergency.” But he said a major factor in moving the county closer to “herd immunity” and an eventual return to normalcy will rely on people actually agreeing to be vaccinated.

“We recognize many folks have concerns about the vaccines and may be hesitant to be vaccinated,” Simon said. “As we implement the county plan to vaccinate literally millions of Angelenos, it will be critically important that we address this vaccine hesitancy with accurate, understandable, culturally sensitive and linguistically appropriate information, relying on trusted community leaders to help deliver these messages.”

Officials in Long Beach, which maintains a health department separate from the county, said Thursday the city anticipates receiving an initial allotment of up to 3,900 doses of the Pfizer vaccine, and ultimately up to 11,600 doses of the Moderna vaccine, which is still awaiting federal approval.

The city intends to largely follow the same priorities in distribution as the county, with health care workers topping the list. Long Beach officials estimated that doses will become available to the general public by early summer.

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