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From YouTube: Urgent Community Vaccine Advisory Committee Meeting #7
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A
C
I
want
to
welcome
you
to
a
previously
unscheduled
meeting
of
the
community
vaccine
advisory
committee
and
I'm
very
very
grateful
to
all
of
you
for
pausing
and
whatever
you're
doing
in
your
incredibly
busy
days
to
join
us
for
a
conversation
to
respond
to
an
emerging
issue
that
we
wanted
to
make
sure
to
share
with
you,
keep
bring
you
into
the
loop,
keep
you
all
up
to
speed
and
and
communicate
the
the
latest
update
to
you
and
then
also
get
your
feedback
and
your
thoughts.
C
So
thank
you
so
much
for
being
available
and
the
purpose
of
this
meeting
is
to
update
and
respond
to
some
late-breaking
information
coming
out
of
the
the
federal
government
and
the
cdc
in
regards
to
vaccine
and
vaccine
prioritization.
C
And,
and
so
I
will
allow
my
my
co-host
today,
the
the
role
of
dr
erica
pond
will
be
played
by
dr
tomas,
aragon
and
dr
aragon.
Can
will
co-host
the
meeting
and
and
also
help
to
share
some
of
this
information,
but
before
we
dive
into
the
the
meat
and
potatoes
of
the
meeting,
I
want
to
first
give
dr
aragon
an
opportunity
to
welcome
everyone
and
then
we'll
jump
into
bobby,
reminding
us
about
the
the
rules
and
the
guidelines
for
the
meeting.
D
Things
are
happening
so
fast
in
the
country
in
california,
the
hospital
surge,
the
infections,
the
deaths
that
are
happening
so
we're
we're
in
a
real
critical
time
right
now,
because,
while
things
are
getting
worse,
we
know
we,
we
have
vaccine
supply,
that's
going
to
be
getting
better
with
the
changes
in
administration,
we
expect
more
vaccines
to
become
available.
D
The
two
key,
the
two
key
things
that
will
be
coming
out
is
one
is
to
prioritize.
Vaccinating
people
who
are
greater
than
65
and
also
part
of
part
of
the
guideline
will
be
vaccinating
people
with
medical
conditions.
If
they're
between
the
ages
of
16
to
60
65.,
we
haven't
seen
the
specific
guide
the
guidelines,
yet
california
was
already
moving
in
this
direction,
to
focus
or
prioritize
older
age
groups,
and
one
of
the
reasons
why
this
is
important.
D
The
vast
majority
of
patients
that
are
being
hospitalized
are
older
persons
and
also
the
icu
admissions,
and
the
deaths
are
happening
with
older
persons,
and
we
have
to
also
recognize
that
the
majority
of
persons
who
end
up
in
the
hospitals
are
people
who
are
highly
impacted,
so
primarily
latinos
african-americans,
low-income
persons
from
the
highest
impact
of
the
communities
are
the
ones
who
are
in
the
hospital
so
the
way
that
we're
going
to
impact
the
surge
is
by
having
by
lifting
and
prioritizing
the
the
older
older
age
groups,
and
the
other
thing
that
happens
is
that
when
the
hospital
systems
are
this
impacted
when
you're
going
into
surge
when
you're
canceling
other
other
procedures
when
you're
reducing
access,
it
impacts
the
whole
community
everybody's
impacted
when
you
can't
access
medical
care
because
of
the
surge.
D
So
this
is
a
really
important
area
and
we
want
to
do
it
in
a
way
that
honors
all
the
hard
work.
That's
already
been
done.
The
development
of
the
framework,
the
phases
the
tears,
and
how
can
we
do
it
in
a
way?
That's
very
simple
and
the
surgeon
general
said
earlier.
Simplicity
stays
live
so
and
so
that's
what
we
want
to
do,
I'm
going
to
go
ahead
and
stop
there,
because
I
know
folks
are
going
to
go
ahead
and
introduce
some
of
the
discussion.
That's
happening
so
the
the
framework
and
how
we're
thinking
about
it.
D
C
Thank
you
so
much
dr
eragon
and
bobby.
If
you
could
walk
us
through
the
meeting
guidelines.
Just
to
start
us
off.
A
Great
thank
you
and
thank
you
from
me
to
all
of
you
for
just
changing
your
entire
schedule
for
this
afternoon
and
being
with
us.
I
just
want
to
remind
everybody.
A
few
things
of
the
rand
the
hand
raise
icon
has
now
moved
to
the
reactions
a
section
of
your
toolbar.
A
So
when
you're
ready
to
make
comments-
which
I
know
you
will
be,
please
find
it
there.
I
want
to
thank
our
two
asl
interpreters,
who,
on
very
short
notice,
also
joined
us
vicki
kennedy
they've
been
with
us
for
all
of
our
live
meetings
and
we're
very
happy
to
have
them.
The
public
is
listening
both
in
english
and
spanish,
on
the
call
call-in
telephone
line
and
also
the
live
stream
is
up
and
running
just
so.
You
know
at
our
last
meeting
we
had
over
2000
individuals
viewing
the
live
stream.
A
Public
comments
are
welcome.
We
will
not
be
presenting
a
summary
of
public
comments
today,
since
the
meeting
was
called
on
short
notice,
but
we
do
have
a
meeting
next
wednesday
january
20th
and
public
comments
will
be
summarized
and
presented
at
that
meeting
and
again
for
members
of
the
advisory
committee.
If
you
have
any
technical
questions
with
zoom,
if
you
put
them
in
our
chat,
we
will
do
our
best
to
help
you
navigate
the
zoom
platform.
So
thank
you,
dr
burkharis.
C
Thank
you
so
much
bobby,
and
if
we
move
forward
with
the
slides,
I
think
we've
already
made
some
opening
comments.
So
we'll
jump
right
into
the
proposal
that
we
are
asking
that
that
we
are
presenting
today,
which
is,
as
you
heard
previously
from
dr
aragon.
C
We
the
the
cdc
we
heard
today
that
the
cdc
has
a
plan
to
prioritize
people
and
place
a
greater
priority
on
age
in
terms
of
who
is
getting
access
to
the
vaccine,
and
so
immediately.
Before
this
meeting,
we
had
a
meeting
with
the
drafting
guidelines,
work
group
to
think
about
how
do
we
want
to
incorporate
and
update
our
current
recommendations
in
light
of
the
upcoming
cdc
guidance,
and
I'm
just
going
to
check
in
here
really
quickly
bobby?
A
Well,
I
think,
maybe,
if
the
two
of
you
could
do
it
together,
it
would
be
great.
So
rob
would
you
like
to
start
or
would
you
like,
dr
burkharis,
to
start.
E
I'm
happy
to
tag
team
any
in
any
way
with
dr
burke
harris
I'll
I'll
have
her
how
about
she
can
start
and
I'll
I'll
go
through
the
the
main
details.
C
Wonderful,
wonderful,
so
if
you
all
will
remember-
and
I
I
and
looking
at
the
the
proposal
that
is
listed
here,
if
you
all
will
remember
this-
looks
very
very
similar
to
our
slide
of
the
plan
for
tier
for
for
moving
forward
with
phase
1b.
C
The
the
difference
here
is
that,
where
it
says
65
65
plus
years
previously,
it
said
75
plus
years
right
and
what
is
being
proposed
today
is
to
expand
tier
1
of
phase
1b
to
include
those
who
are
65
and
older
right.
So
to
include
that
and
then
we
would
continue
to
have.
There
would
be
no
change
in
the
the
prioritized
sectors
in
terms
of
food
and
ag
education
and
our
first
responders
and
and
as
we
think,
about
the
implementation.
C
Some
of
the
cons,
implementation
considerations
that
we
would
like
our
vaccinators
to
keep
in
mind
would
be
thinking
about.
You
know
if
there's
if,
if
we're
moving
swiftly
vaccinating
folks-
and
we
certainly
have
you
know
enough
vaccine-
then
we
then
there
would
be
no
issue
of
further
subprioritization.
C
However,
it
at
if,
if
counties
or
vaccinators,
are
seeing
a
potential
of
of
inadequate
supply,
really
thinking
about
prioritizing
those
who
are
older,
so
those
who
are
75
plus
before
those
who
are
in
the
the
the
65
to
74
range.
I
I
see
that
the
slide
says
64
to
75,
but
I
know
that
it's
65
to
74.
C
C
So
if
it's
feasible
then
also
prioritizing
those
with
underlying
medical
conditions
and
part
of
the
reason
why
I
say
you
know,
for
those
who
have
the
capacity
or
if
it's
feasible
is
that
many
of
you
may
be
aware
of-
and
we
talked
about
in
our
last
meeting-
the
state
really
pushing
to
ramp
up
and
and
have
some
of
these
larger
vaccination
events
so
that
we
can
really
get
doses
in
arms,
and
that
has
been
the
priority.
C
The
governor
has
charged
us
with
that
mandate,
and
that
is
something
that
we
are
implementing.
So
as
we're
seeing
some
of
these
larger
mass
vaccination
sites,
it
may
be
more
challenging
in
those
settings
for
the
the
vaccinators
to
be
confirming
a
medical
history
if
they're
not
in
the
patient's
medical
home
or
they
don't
have
access
to
the
to
the
medical
record.
So
that's
the
reason
why
it
says
underlying
medical
conditions
that
increase
risk
as
feasible
and
rob.
Is
there
anything
that
I
that
I
missed
or
anything
you
want
to
add.
C
And
there's
one
other
piece
that
I
want
to
add,
which
is
that?
What
we
understand
in
terms
of
the
guidance
from
the
cdc
was
the
guidance
focused
on
prioritizing
older
individuals,
those
65
and
older,
and
then
also
there
was
guidance
around
prioritizing
those
16
through
64,
with
underlying
medical
conditions
that
increased
risk
of
severe
covid19.
C
Currently,
in
our
current
phase
tiers
system,
those
individuals
are
in
phase
one
c,
and
at
this
time
the
the
drafting
guidelines
work
group
agreed
that
it
makes
sense
to
continue
to
to
leave
that
group
in
phase
1c.
C
For
the
reason
being
that
when
we
look
at
the
numbers
currently,
it
would
be
roughly
an
additional
potentially
10
to
15
million
individuals.
C
And
if,
if
that,
if
that
group
were
added
so
so
when
we
think
about
expanding
phase
1b
to
add
an
additional
15
million
to
what
is
currently
already
eight
and
a
half
million
and
bumping
up
with
those
65
and
older
to
be
increased
further,
then
that
becomes
really
an
implementation
challenge
right
and
so
we're
looking
at
just
in
terms
of
the
sheer
numbers.
C
Maintaining
that
16
to
65,
with
underlying
health
condition
that
increased
risk
of
severe
covet
19,
particularly
in
looking
in
light
of
the
data
that
shows
that,
currently,
with
the
surge,
the
individuals
that
are
most
likely
to
be
hospitalized.
Those
who
are
really
limiting
our
hospital
capacity
still
continue
to
be
our
older
californians.
C
Those
who
are
65
and
older,
and
so
I'll
pause
there
and
give
an
opportunity
for
dr
aragon
or
dr
schechter
to
to
add
any
additional
comments.
E
Dr
burke
harris
rob,
this
is
rob
schechter
again.
I
just
want
to
point
out
a
typo
in
the
slide,
which
is.
E
A
I
can
make
the
suggested
changes
or
you
can
say
them
and
then
I'll
fix
them,
while
we're
talking.
E
Yeah,
so
apologies
given
reflect
a
reflection
of
of
not
the
thought
that
went
into
it,
but
the
the
pace
in
in
our
working
today
that
the
as
I
think
is
pointed
out
in
the
chat
the
congregate
settings
refers
to
other
tiers
and
not
to
this
tier.
So
t
tier
1b
remains
an
age-based
group
plus
plus
the
the
three
occupational
sectors,
but
not
not
the
congregate
settings
within
tier
one
and
as
well
as
the
the
numerical
typo
that
dr
burke
harris
mentioned
about
the
about
the
ages.
D
C
So
at
this
point
I
I
see
that
we
have
a
number
of
questions
in
the
in
the
chat
and
we
want
to
open
up
the
the
conversation
I
see.
Hands
are
being
raised
as
as
as
we
speak,
so
I
think
it
would
be.
We
can
go
ahead
and
jump
into
a
conversation
about
this
and
I'm
not
bobby.
I
will
leave
it
to
you
in
terms
of
calling
out
the
chat
versus
the
questions
in
the
chat
versus
the
the
hands
raised.
A
Yeah
yeah
I'm
just
trying
to
do
too
many
things
here
at
once,
and
I
don't
want
to
disconnect
the
zoom
so
just
give
me
one.
Second,
please.
C
C
A
Okay,
so
here
we
go,
I
apologize
for
that
delay.
Let's
start
with
anthony
wright
and
then
we'll
go
to
denny
chan
and
then
mary
mckeon
and
then
dr
tong,
and
then
we'll
we'll
keep
it
up.
F
Thank
you.
Well,
you
can
expect
to
go
first,
but
but
first
of
all,
thank
you
for
your
work
and
and
the
quick
response
and
the
opportunity
to
comment.
F
I
you
know
it
is
noteworthy
that
you
know
actually
california
had
actually
been
moving
toward
age-based
approaches
and
something
that
I
think
we
thought
was
compelling
based
on
both
icu
use
and
the
need
to
reduce
that,
as
well
as
equity
between
seniors
and
different
types
of
facilities,
and
just
the
clarity
and
simplicity
that
it
provides
to
the
public
for
knowing
where
they
stand
and
the
I
think
so.
I
I'm
generally
in
favor
of
this
of
of
of
this
movement
and
prioritization.
F
I
just
I
do
I
to
the
extent
that
we're
all
in
the
this
is
a
very
tough
conversation
about
trade-offs
and
from
the
from
the
slides
from
earlier
sessions.
This
indicates
that
adding
the
a
65
plus
category
seems
to
add
3.5
million
people.
F
If
it
was
my
calculation
from
earlier
slides,
is
that
right
and
you
know,
is
there,
do
we
have
the
both
the?
What
is
our
sense?
It's
hard
to
make
this
decision
without
any
sense
of
either
the
logistical
operations
to
be
able
to
support
that
increased
amount
or
what
we
expect
the
supply
to
come
in
over
whenever
this
will
be
triggered
on,
and
then,
if
that's
the
case,
then
how
do
we
do
this?
You
know
these
prioritization.
F
I
actually
signed
her
up
for
a
vaccine
this
week
this
weekend
and
I
had
to
go
through
like
an
online
form
and
uploading
documents
and
things
that
my
mom,
you
know
would
not
have
been
able
to
do
by
herself,
and
I
just
want
to
just
understand
how
we
are
going
to
deal
with
a
pop
with
a
making
sure
that
we're
taking
care
in
a
not
only
culturally
but
technologically
competent
way
to
the
population
that
we
want
to
get
exactly.
Thank
you.
E
I
can
I
can
try
and
fill
in
a
couple
of
those
blanks
the
addition
of
the
65
plus,
in
addition
to
the
the
65
through
74,
in
addition
to
75,
plus
that's
probably
around
four
four
and
a
quarter
million
californians
and
the
pace
of
of
vaccine
at
this
point
appears
to
be
somewhere
in
the
range
of
two
million
doses
for
california.
E
In
january,
we've
heard
mixed
messages
from
the
federal
government
about
when
supplies
might
increase,
whether
that's
by
the
end
of
this
month
or
into
next
month
and
then
with
additional
vaccine
formulations,
possibly
to
follow
so
for
the
the
the
addition
of
the
the
four
million
does
mean
weeks
to
weeks
to
months
of
additional
vaccine.
A
Okay,
thank
you,
rob
and
that
was
anthony,
wright's
health
access,
so.
A
That
the
members
of
the
public
watching
know
who's
speaking,
let's
go
to
denny
chan.
G
Thanks
bobby
hi,
everyone
happy
new
year,
denny
chan
from
justice
nation.
I
I
wanted
to
first
of
all
say
thank
you
for
pulling
this
meeting
together
to
get
our
input
on
re-looking
at
what
1b
might
look
like
and
appreciate
the
speed
with
which
everyone
is
acting.
You
know,
as
advocates
for
older
adults,
we
generally
are
supportive
of
using
age
as
a
criteria
and
figuring
out
what
the
allocation
mechanisms
or
framework
would
look
like.
G
We
really
need
to
make
sure
that
to
some
of
the
comments
that
have
already
been
said
in
the
chat
that
we
are
exhausting,
that
before
we
really
get
to
1b
we've
heard
of
a
number
of
issues
in
this
meeting
and
other
places
where
smaller,
long-term
care
facilities
just
aren't
getting
the
shots
and
whether
that's
you
know
because
of
the
partnership
issues
or
other
issues,
it
really
needs
to
be
considered
before
we
even
start
talking
about
people
in
the
community.
G
So
I
would
really
urge
you
know,
sort
of
greater
attention
there
and
on
the
issue
of
risk,
you
know
a
number
of
the
cvac
members
did
write
to
the
drafting
guidelines
committee.
To
say
that
you
know.
We
really
hope
that
the
state
will
take
seriously
a
recommendation
to
prioritize
home
and
community-based
services
users.
This
is
a
known
population
of
the
state.
It
is
a
high-risk
population.
G
There
are
people
who,
but
for
the
hcbs,
they're
receiving,
would
be
in
a
nursing
facility
where
they
would
get
the
shot
under
1a,
and
I
think
it's
just
a
very
compelling
and
and
including
that
population
would
in
no
means
sort
of
balloon,
the
figure
to
some
of
the
numbers
that
were
said
earlier.
I
think
it's
still
a
much
more
manageable
number.
G
The
state
has
these
people's
information,
and
so
it's
a
very
small
universe
of
people
who,
when
we're
thinking
about
risk
and
we're
thinking
about
who
really
needs
those
shots
when
we're
thinking
about
equity.
You
know
these
are
all
low-income
people
who
are
on
this
program.
G
It
is
a
way
this
is
an
opportunity,
for
you
know,
people
to
not
be
divided
by
age
or
disability
or
condition,
and
this
is
really
an
opportunity
where
we
can
use
sort
of
a
known
universe
of
people
and
prioritize
them
based
on
sort
of
the
risk
that
they
have.
So.
Thank
you.
A
H
Hi
everyone
I'm
mary
mccune
and
I'm
with
the
california
dental
association
and
for
right
now.
I
think
I
really
want
to
urge
the
committee
to
to
focus
on
flexibility
with
this.
What
we've
seen
with
phase
1a
is
that
we've
collapsed
all
these
tiers
for
a
couple
different
reasons,
but
it
also
allows
flexibility
for
these
points
of
distribution
to
just
get
everyone
who
wants
the
the
vaccine
and
can
get
there
in
time
to
get
there.
A
Thank
you
mary
for
that,
as
we
go
to
dr
tan
after
dr
tom
will
go
to
dr
wasserman
and
then
we'll
go
to
andy
and
then
we'll
go
to
susan
tomorrow.
I
Thank
you
bobby.
This
is
henry
tan
chief
diversity
officer
at
uc,
davis,
health
and
also
representing
the
cma.
I
really
appreciate
the
responsiveness
that
that
the
state
and
and
colleagues
are
are
working
on
this.
I
I
just
want
to
say
and
and
lend
my
support
to
the
prioritization
of
vulnerable
communities
using
a
place
based
index.
I
I
I
Thank
you.
Thank
you
bobby.
I
just
I
just
wanted
to
just
emphasize
again
that
you
know
with
vulnerable
communities.
I
think
that
they
don't
necessarily
fit
into
the
to
the
tier
system
and
so
incorporating
a
place
based
index.
As
we've
talked
about
last
week
is
so
critical.
I
I
think
it's
also
really
important
to
keep
in
mind
the
longitudinal
perspective,
particularly
with
a
vulnerable
community
since
because
of
the
his
historical
barriers
that
you
know,
vulnerable
and
minoritized
communities
may
not
actively
seek
out
vaccinations
because
of
fears
and
other
structural
barriers,
and
so
by
proactively,
identifying
communities
using
a
place-based
index.
We
can
be
more
proactively
and
tailor
our
outreach
to
the
communities
and
thereby
improve,
in
the
long
term
trust
with
with
these
communities.
I
That
said,
I
think
that,
as
we
prioritize
vulnerable
communities,
we
may
not
actually
see
them
come
to
the
infrastructure
that
we
build.
That's
not
a
sign
that
we
should
give
up.
It's
a
sign
that
we
need
to
just
move
in
the
direction
of
building
trust,
and
so
it
needs
to
start
early
and
need
to
be
sustained
throughout
this
process.
A
Thank
you,
dr
todd,
we'll
go
to
mike
wasserman
now
and
then
we'll
go
to
andy.
J
You
know
I
served
on
the
national
academy
committee
and
there
was
a
reason
we
put
nursing
homes,
assisted
livings
and
group
homes
together,
not
only
the
residents
but
the
frontline
staff,
and
I
the
data,
shows
people
who
work
in
those
settings
have
been
working
in
the
most
dangerous
job
in
the
country
for
the
last
10
months.
J
The
problem
right
now
we've
been
delayed
in
getting
the
nursing
homes
vaccinated,
but
even
more
concerning
is
the
assisted,
living
facilities
and
group
homes,
not
only
for
older
adults,
but
for
the
disabled
community
who
live
in
a
lot
of
these
facilities
as
well,
are
at
risk
of
being
left
behind,
in
our
haste,
to
get
the
vaccine
out
to
everyone
else,
and
so
what
we
we
rec,
we
put
out
a
list
of
recommendations
and
shared
them
with
the
vaccine
task
force.
J
Last
week,
the
biggest
this
has
all
been
a
problem
at
the
federal
level
they
rolled
this
out
the
wrong
way.
They
got
cvs
and
walgreens
to
be
responsible.
They
had
no
business
doing
that.
If
we
want
to
get
every
all
this
residents
and
a
large
number
of
the
staff
in
nursing
homes,
assisted,
livings
and
group
homes
vaccinated,
we
must
immediately
engage
all
of
the
long-term
care
pharmacies.
J
All
of
the
pharmacies
out
there
that
work
can
work
with
in
collaboration
with
cvs
and
walgreens.
This
is
not
about
anyone's
making
money
or
any
anyone's
market
share.
This
has
to
be
about
all
hands
on
deck,
getting
the
vaccine
into
the
arms
of
those
people
who
live
in
nursing
homes,
assisted
living
group
homes
and
the
people
who
care
for
them
and
I'll
add
one
specialized
category.
J
People
with
alzheimer's
disease
don't
wear
their
masks,
they
don't
physically
distance.
You
can't
keep
them
in
their
rooms.
The
vaccine
is
the
only
thing
we
have
for
them
and
many
of
those
live
in
assisted
living
facilities,
memory
care
units,
group
homes
and
nursing
homes.
Right
now,
there
are
assisted
living
facilities
that
are
not
signed
up
to
get
the
vaccine
till
march
and
there
are
many
assisted
living
facilities
that
aren't
even
signed
up.
Yet
that
is
completely
unacceptable.
J
It's
not
our
fault
that
this
ended
up
this
way,
but
we
have
no
choice
but
to
fix
it
because
the
federal
government
didn't
put
us
in
a
position
to
get
it
right.
I
think
the
state
is
ready
to
do
this.
I
think
once
we
get
those
folks
vaccinated,
then
I'm
willing
to
talk
about
all
the
other
categories,
because
these
are
the
folks
who
have
been
dying.
2
200
people
died
last
month
alone
in
long-term
care
in
the
state
of
california.
C
So
just
a
minute,
dr
westman,
I'm
sorry
I
don't
mean
to
interrupt
you,
but
I
want
to
clarify
the
intent
of
your
statement
because
it
is,
is,
is
your
statement
a
concern
about
adding
those
65
to
74
to
tier
1b,
or
is
your
statement
more
a
state
of
concern
about
the
implementation
of
phase
1a
so.
J
C
Yeah,
I
I
want
to
be
clear
that,
just
because
the
focus
of
this
meeting
is
to
attend
to
and
address
and
update
all
of
you
and
seek
your
input
on
the
feedback
around
the
the
emerging
cdc
guidelines
and
the
the
the
notion
of
the
state
of
california,
adding
65
plus
to
tier
1b
does
not
mean
that
we're
abandoning
our
commitment
to
input.
You
know
thoughtfully
and
effectively
implementing
our
our
vaccination
strategy
for
tier
1a.
C
I
agree
with
you
that
we
can
walk
and
chew
gum
at
the
same
time,
and
but
I
I
the
thing
that
I
want
to
make
sure
that,
for
the
purpose
of
of
this
conversation
and
and
to
ensure
that
this
is
a
that,
as
as
folks
share
their
their
input,
that
there's
not
a
perception
that
we're
abandoning
our
our
current
system
and
it
there
were
a
couple.
I
want
to
speak
to
it
because
there
are
a
couple
of
questions
in
the
in
the
chat
of
you
know.
C
Does
this
mean
that
california
is
moving
away
from
a
priority
system?
Does
this
mean
that
we,
you
know?
Where
are
we
in
the
tears
right
now,
and
I
just
I
want
to
be-
I
want
to
respond
briefly
to
some
of
those
questions
in
terms
of
where
we
are
right
now
is
that
everyone
is
in
phase
1a
right.
C
Every
every
every
county
is
in
phase
1a
right
now,
and
different
counties
and
different
different
facilities
have
have
different
capacity
in
terms
of
their
ability
to
move
to
phase
1b,
and
so
some
are
ready
and
rearing
a
go,
and
some
are
still
well
within
the
process
and
and
really
working
out
some
of
the
some
of
the
challenges
to
implementing
phase
1a
right
and
learning
from
that
process,
and
so
that
is
that
is
where
we
are
just
to
speak
to
some
of
the
questions
in
the
chat.
C
But
I
also
just
want
to
assure
you
that
that
you
know
we're
we're
working
together
to
solve
multiple
challenges.
At
the
same
time,
including
surge,
including
you
know,
are
working
on
our
different
tiers
of
planning
for
vaccine
allocation
and
and
and
and
this
is
what
we're
doing
so,.
A
K
Sure
hi
andy
imperato,
with
disability
rights
of
california.
You
know
I
want
to
support
what
denny
said.
Dr
burke
harris.
I
recognize
the
that
none
of
this
is
straightforward
or
easy,
but
the
the
sense
that
I
have
is
the
feds
told
us
to
place
a
higher
priority
on
people
over
65
and
people
16
to
64,
who
are
at
severe
risk
of
bad
consequences
from
kovid,
and
we
decided
to
leave
the
16
to
64
year
olds
in
1c,
because
it's
10
to
15
million
people.
K
So
I
guess
my
question
is:
can
we
find
a
subpopulation
of
16
to
64
year
olds
in
the
state
who
clearly
have
equity
concerns
related
to
access
to
health
care
related
to
being
forced
to
interact
with
direct
support
workers
who
may
or
may
not
be
you
know,
wearing
masks
and
socially
distancing
and
get
services
to
a
sub-population
of
in-home,
supportive
services,
recipients
or
regional
center
clients?
Those
are
two
very
discreet
populations
that
we
can
identify
and
I
to
me
the
analysis
is
similar
to
the
healthy
places
index.
K
These
are
populations
that
historically,
do
not
have
access
to
quality
health
care
are
at
increased
risk
of
severe
consequences
of
covid.
We
don't
have
great
data
on
their
health
risk
because
they're
not
studied
and
that's
you
know,
we
shouldn't
be
punished
for
the
fact
that
the
medical
field
does
not
do
a
good
job
tracking.
How
these
things
affect
people
with
intellectual
disabilities.
K
So
I
just
I
really
want
to
urge
you
to
think
about.
Is
there
a
subpopulation
of
folks
with
disabilities
who
belong
in
tier
one
phase,
1b
under
vulnerable
communities
using
hpi
or
equivalent
or
underlying
medical
conditions,
that
increase
risk
as
feasible
for
ihss
and
for
regional
center?
It's
much
more
feasible
because
we
know
who
these
people
are.
We
know
where
they
live
and
we
know
how
to
get
the
vaccine
to
them.
A
Thank
you,
andy
we'll
go
to
susan
and
then
after
season
we'll
go
to
debra,
shade
brianna
and
then
charles
bakke.
L
Hi,
this
is
susan
demouris,
with
the
alzheimer's
association
and
one
thing
that
our
state's
doing
exceptionally
well
is
tracking
data,
and,
as
of
today,
75
of
all
fatalities
in
our
state
have
been
65
and
older.
So
this
this
direction,
you
know
we
support
this
direction.
L
Age
is
also
the
greatest
risk
factor
for
alzheimer's
disease
and
when
you
take
it
down
to
the
next
level
of
data
that
we
collect
50
to
64,
that's
94
of
all
fatalities
in
our
state,
and
we
heard
earlier
about
hospitalizations
and
icu
use,
and
so
I
haven't
seen
the
slide
that
shows
the
age
breakdown
there,
but
I
think
we've
been
hearing
that
it's
risk,
exposure
and
equity
are
the
is
what
we've
been
hearing
this
week:
the
risk
of
an
adverse
or
fatality
a
fatal
outcome.
L
The
question
that
I
have
is
when
we
expand
to
65
plus,
as
the
chat
indicates,
that's
millions
of
new
californians.
What
is
the
pathway,
keeping
it
simple
with
our
messaging
and
communication?
L
People
are
contacting
public
health
departments
that
are
already
overwhelmed
and
they're
contacting
their
physician
while
we're
trying
to
offload
the
health
care
system.
So
how
can
we
advise
people
on
where
they
should
get
started
about
a
vaccine
when
it
opens
up
to
an
additional
few
million
people
when
they
read
this
in
the
newspaper.
A
Great
question
rob:
do
you
think
you
could
answer
that
question
or.
D
D
D
This
is
just
going
to
be
part
of
the
part
of
the
answer,
but
we
need
to
have
a.
We
need
to
have
a
wave
where
people
can
can
have
access
to
the
information
and
be
able
to
know
how
they're
going
to
be
to
be
vaccinated,
so
this
is
in
in
the
works
right
now.
So
that's
one
area,
the
other
important
area
is
going
to
be
working
with
the
health
systems.
D
D
It's
not
going
to
be
sufficient
to
depend
on
the
health
systems
even
on
the
mega
pods,
because
there
are
a
lot
of
parts
of
california
that
if
we
don't
go
out
and
do
the
community
outreach
we're
not
going
to
reach
those
populations,
and
so
those
are
areas
that
we
do
have
to
work
on,
so
that
we
can.
We
can
do
that
right.
It's
going
to
really
take
the
partnerships
with
the
with
the
local
health
departments
and
communities
to
really
make
that
make
that
happen.
D
A
Rob
does
that
mean
you
want
susan
to
repeat
her
questions.
L
All
right
sure,
so
when
we
add
a
couple
additional
million
people,
65
and
older,
the
questions
we've
been
receiving
at
the
alzheimer's
association
is.
Do
I
contact
my
doctor?
Will
I
be
notified?
Do
I
go
to
my
county
public
health
department?
Should
I
drive
to
one
of
the
mega
sites
and
we
don't
know
where
people
should
get
started
and
so
any
any
direction
about
where
they
begin?
L
There
will
be
a
lot
of
questions
and
people
are
calling
their
public
health
departments
and
their
doctors,
and
not
maybe
they're,
calling
the
wrong
place.
E
So
thank
you
again
for
repeating
the
question
and
at
the
moment
it
will
require
more
more
effort
and
that
that
effort
by
the
by
your
constituency
and
by
persons
to
to
to
locate
but
increasingly
through
the
automated
tool
dr
aragon,
is
described
that
the
the
state
is
is
working
on
some
similar
local
solutions.
E
Outreach
by
health
plans,
appointment
systems
by
health
systems,
appointment
online
appointment
mechanisms
and
they'll
be
increasing
capacity
over
the
next
weeks
for
individuals
to
more
quickly
and
easily
get
those
get
those
answers
about
when
and
where
and
to
to
and
to
make
those
appointments.
But
now
now
there
is
a
burden
on
on
individuals
to
reach
out
to
to
their
providers
and
the
health
departments.
C
If,
if
I
can
jump
in,
if
I,
if
it's
helpful
and
dr
schechter
told
me
if
I'm
getting
anything
wrong,
but
what
we'd
like
to
do,
I
I
think
the
goal
is
to
make
it
as
easy
as
possible
for
folks
to
be
able
to
get
access
to
the
vaccine
right,
and
so
what
that
means
and
that
it
means
that
it's
not
going
to
be
one.
It's
oftentimes
not
going
to
be
one
simple
system
for
every
single
person.
C
So,
for
example,
folks
who
are
we
know
from
talking
with
the
leaders
at
large
health
systems
like
kaiser
and
sutter
that
they
are
prepared
to
to
head
into
phase
1b
by
notifying
people
when,
especially,
if
there's
an
age
based
system
right,
everyone
date
of
birth
before
x,
notify
notify
the
patient.
Oh
you
know,
kaiser
has
a
vaccine.
Sutter
has
a
vaccine.
We
can.
C
We
can
you
know
it's
it's
your
time
to
come
in,
come
in
and
get
the
vaccine
right,
but
clearly
that
doesn't
that
system's
not
going
to
work
for
folks
who
are
who
don't
have
a
health
care
home?
Who
are
so
so
we
want
to
make
available
these
large
megapods,
where
you
know
anyone
can
come
and
get
access
and
and
and
sign
up
and
get
their
shots.
C
Similarly,
I
think
that
there
are
going
to
be
some
circumstances
for,
for
example,
community,
more
vulnerable
communities,
communities
that
are
harder
to
reach
or
where
the,
where
the
department
of
public
health
is
going
to
be
doing,
the
outreach
and-
and
in
some
cases
you
know,
partnering,
as
as
we
talked
about
partnering
with
community-based
organizations
to
let
individuals
or
groups
know
that
that
it's
it's
their
opportunity,
their
access
to
to
the
vaccine
right.
C
And
so,
although
the
answer
doesn't
sound,
simple,
the
the
goal
there
is
to
have
the
the
process
for
the
for
the
individual
to
be
as
simple
as
seamless
as
possible.
Is
that
helpful.
L
It
it
is
helpful,
I
think,
on
our
back.
You
know
our
vaccinate
58
it.
It
will
be
very
customized
by
location.
M
L
And
I
think
also
people,
you
know
some
of
the
older
adults.
I'm
thinking
you
know
specifically
to
the
alzheimer's
community
may
not
be
comfortable,
may
not
be
physically
able
to
go
to
one
of
the
mega
sites
or
comfortable
going
to
those
venues
because
of
the
spread
of
kova
depending
who's
accompanying
them.
E
A
People
taking
this
along
here
so
let's
go
to
deborah
and
then
brianna
and
the
charles
and
then
I
know
we
have
a
number
of
other
people
who
would
like
to
speak,
and
I
think
I
have
all
of
you.
N
Ever
shade
here,
representing
the
california
school
board
association,
so
I
think
I
understand
the
simplicity
of
you
know,
65
and
older.
I
think
that's
what
we
were
trying
to
achieve
with
our
cares
act.
You
know
money
to
families
that
needed
it
without
having
you
submit
forms
that
you
have
to
get
it.
I
think
we
need
to
have
a
similar
complex,
but
when
you
put
additional
4.2
million
into
the
next
round
and
then
add
sub
prioritizations
to
it
inc
complexity
in
that
model,
it
is
really.
N
I
think
there
will
be,
if
not
the
same
but
more
issues
as
we
start
to
expand
this.
So
I'm
just
curious
about
some
of
the
effort
that
could
be
done
to
expand
that
group
into
the.
I
think
we're
talking
you
know
11
12
million
for
that
group.
N
So
if
anybody
can
respond
to
those
two
sort
of
areas,
because
in
approving
this
I
just
want
to
ensure
clearly
I
want
education
to
be
able
to
get
vaccinated
so
that
we
can,
you
know,
continue
educating
our
youth,
but
I
understand
the
issues
with
age
and
how
they
are
affecting
our.
You
know
our
health
system.
C
So
deborah
that's
a
great
question
and
the
I
will
dr
aragon
or
dr
schechter.
If
you
want
to
jump
in,
I
will
start
by
simply
saying
it's
part
of
the
conversation.
What
we
understand
is
that
for
for
some
counties
and
some
sites
right.
C
We
want
to
vaccinate
as
many
people
as
possible
we
want
to.
We
want
to,
and
we've
established
a
prioritization
system.
That's
that's
focused
on
those
who
are
most
vulnerable
and
the
likelihood
of
being
hospitalized
and
the
risk
of
overwhelming
our
health
care
system
right,
and
so
that's
the
part
of
the
reason
for
that
age-based
prioritization.
C
But
we
also
want
to
allow
enough
flexibility
so
that
we
are
ensuring
that
doses
aren't
wasted
right,
and
so
we
want
to
have
to
get
those
doses
in
arms
and,
at
the
same
time,
so
we're
having
a
kind
of
a
prioritized
tiered
system,
but
at
the
same
time
making
sure
that
we're
not
so
rigid
that
we
are
potentially
you
know
letting
certain
doses
go
to
waste
and
that's
what
we're
hearing
in
terms
of
conversation
with
our
local
health
jurisdictions.
C
And
so
for
that
reason,
that's
the
reason
why
what
you
see
is
it's
a
kind
of
a
very
straightforward
guidelines
to
everyone,
which
is
here's
tier
one
of
phase,
one
b,
it's
65
plus
plus
these
three
sectors
right
and
then
the
the
next
part
is,
if
you
are
facing.
C
If,
if
you
are
facing
significant
restrictions
on,
you
know
further
restrictions
on
the
number
of
vaccines,
if
you
really
don't
have
enough-
and
you
are
looking
at,
how
do
we
sub-prioritize
right,
then
here
are
the
guidelines
of
how
to
do
that
right,
and
so
that
is
something
that's
going
to
be
very
difficult
to
do
if
you
are
in
a
mega
pod
and
you
you're
at
dodger
stadium,
and
so
so
that's
not
where
that's
going
to
happen.
C
But
if
you're
in
you
know
a
small
county
and
you
have
limited
doses,
you
can
say:
okay,
we
are
in
this
phase
and
we
are
prioritizing
those
75
plus
because
we
just
have
a
very
limited
supply
of
vaccine,
and
so
that's
the
way.
That's
the
way
that
it
that
guidance
is
intended.
D
D
We
just
need
more
vaccine,
and
so
that
was
sort
of
that
was
really
the
the
rate
limiting
step,
and
so
it's
one
of
these
situations
where
we
we
want
to
plan
with
the
assumption
that
eventually
there's
going
to
be
a
lot
of
vaccine
coming.
So
we
don't
want
to
be
in
a
situation
where,
all
of
a
sudden,
we
have
a
lot
of
vaccine
and
we
can't
get.
D
We
can't
get
it
out
so
and-
and
we
want
to
make
sure
that
we
address
the
issue
of
the
highest
risk,
hospitalization
icus
and
deaths
and
the
impact
that
has
on
society
in
general
and
so
and
so
the
feedback
that
we
got
is
the
first
system
is
too
complicated.
It's
slowing
us
down
got
to
be
keep
it
simple.
Simplicity
is
going
to
save
lives
and
be
prepared
for
a
vaccine
supply
chain.
D
A
O
O
Million
doses
and
300
million
people
we
could
all
be
right
now
shopping
online,
but
since
this
happened
literally
today
and
the
surge
happened
more
or
less
since
more
or
less
since
the
beginning,
let's
say
of
the
year,
we're
in
uncharted
territory.
O
So
we
really
would
like
to
get
everyone
vaccinated
and
as
quickly
as
possible,
but
we
have
people
dying
at
40
000
a
day.
I
think
I
heard
for
the
in
the
country.
I
mean
that's
just
that's
mind-boggling,
so
that
that's
why
we're
having
this
meeting?
That's
why
you
know
there
will
be
some
some
areas
that
won't
get
it
exactly
the
way
they
want
it.
But
we
have
to
just
have
a
degree
of
understanding
and
I'll
also
say
compromise.
A
Thank
you,
dr
brooks.
Let's
go
on
to
brianna
and
then
charles
and
then
we'll
go
to
carol
green.
R
Sure
thank
you
brianna,
with
lhcc
representing
the
local
nonprofit
medical
health
plan.
So
I
think
in
every
conversation
you've
had
I've
asked
questions
about
logistics
and
where
we
are
today
is
exactly
why
so,
we
on
the
payer
side
have
been
sitting
here
with
the
information
that's
needed
to
reach
people
and
watching
it
a
little
bit
in
panic
of
we
can
re.
We
know
how
to
find
65
and
older.
We
know
how
to
identify
people
with
comorbidities
and
conditions.
R
We
know
how
to
slice
and
dice
the
data
to
get
to
the
populations
that
need
it.
The
most,
I
think
to
dr
etagon's
point:
the
delivery
system
does
this
every
day
and
we're
ready
and
we're
willing,
and
it's
been
waiting
for
that
green
lightness
signal
to
go,
do
what
we
can
do
and
what
we
do
the
best.
So
I
think
that
this
approach
and
loosening
it
up
so
that
we
can
get
out
there
and
get
shots
in
people's
arms
is
absolutely
the
right
thing
to
do.
R
You
know
focusing
on
this
population.
I
think
someone
else
said
it.
It
meets
the
risk.
You
know
it
meets
the
risk
where
it
is.
It's
an
equity
lens
between
the
payers.
You
know,
individuals,
65
and
older,
I
would
presume,
are
in
medicare,
there's
a
payer
source,
there's
a
data
source
for
to
find
them
comorbidities
payer
source
provider
data.
Just
from
a
practical
perspective.
R
This
is
an
approach
that
we
can
get
out
there
and-
and
maybe
we
can
show
some
success-
that
will
build
credibility
and
will
build
more
support
if
we're
able
to
get
out
there
and
show
that
we
can
do
this.
The
other
thing,
I
would
add,
is
from
a
medical
plan
perspective.
A
medical
lens
is
an
equity
lens,
so
I
think
once
we
get
there,
that
would
be
terrific.
A
Thank
you.
I
would
just
like
to
remind
everybody
if
you
could
keep
your
comments
as
succinct
and
to
whatever
point
you're
trying
to
make.
There
are
a
number
of
members
who'd
like
to
comment,
and
you
want
to
make
sure
everybody
that
wants
to
comment,
gets
a
chance,
we'll
go
to
charles
and
then
we'll
go
to
carol
green
and
then,
after
carol
will
go
to
kieran.
S
Thanks
bobby,
can
you
hear
me?
Okay,
yes,
right
great!
Thank
you.
I
appreciate
the
work
everybody's
put
in
and
all
the
comments
that
have
been
so
thoughtful,
both
in
the
chat
box
and
and
verbally
here.
I
I
want
to
agree
with
anthony
wright
from
health
accesses
initial
comments
at
the
beginning
that
you
know
this
is
kind
of
where
we
were
headed.
You
know
it's
a
slight
acceleration,
but
to
dr
burkhurst
burke
harris's
comments
and
my
colleague
at
lhpc
brianna
as
representing
the
california
association
of
health
plans.
S
I
said
at
the
beginning,
this
age-based
approach
is,
is
doable
and
and
the
data
is
there.
It's
been
said,
and
so
I
think
this
is
much
more
in
the
wheelhouse.
I
think
where
a
lot
of
concern
was
was
the
focus
on
picking,
apart
all
the
different
definitions
of
essential
workers,
which
is
data
that
we
didn't
have.
S
So
I
do
think
that
this
approach
makes
sense,
but
I
also
want
to
be
sensitive
to
those
who
are
concerned
about
being
left
behind,
and
I
also
think
that
you
know
as
we're
as
we're
looking
at
speeding
up
the
distribution
of
this
vaccine
through
channels
that
are
going
to
be
faster.
S
You
know
with
with
this,
reaching
out
to
these
tough
populations
difficult
to
reach
populations.
We
just
can't
lose
sight
of
that.
I
think
that's
what
you're
hearing
so.
Thank
you.
A
Thank
you,
charles.
Let's
go
to
carol,
don't
forget
to
introduce
yourself
and
then
we'll
go
to
kieran
and
then
to
jody.
P
Hi
carol
green
with
california
state
pta
just
a
couple
of
comments.
I
hope
that
in
this
new
plan,
we're
not
going
to
lose
sight
of
those
essential
workers
that
we
were
talking
about,
because
age
is
certainly
an
easier
way
to
get
people
in
and
through
the
lines
quickly,
but
if
we
have
those
people
that
have
been
also
working
in
the
grocery
stores
or
not
they're,
not
you
know
the
medical
workers,
but
the
grocery
store
workers,
teachers
and
educators.
P
If
we
want
to
get
kids
back
in
school-
and
you
know
the
first
responders
that
aren't
medical
those
those
we've
identified-
let's,
let's
remember
the
only
problem
is
that
when
you
add
this
big
group
of
people,
then
you
you
end
up
with
not
enough
vaccines.
P
I
want
to
tell
you
that,
while
I've
been
on
this
call,
I
just
received
a
text
from
a
friend
and
colleague
of
mine
who
lost
his
father
to
covet.
I
mean
just
now,
so
I
I'm
I'm
just
sharing
with
you,
because
this
is
we're
talking
about
real
people
and
real
lives
and
not
just
numbers.
So
I
just
want
to
share
that.
The
other
comment
I
have
is
about
equity.
I
live
in
san,
diego
county.
We
opened
petco
park
folks
lined
up
it
was.
P
It
was
1a,
it
was
medical
workers,
but
I
had
a
conversation
with
my
husband,
while
that
was
going
on
they're
medical
workers
that
have
cars
that
can
get
transportation.
That
can
be
there.
What
about
those
that
don't
have
cars?
What
about
this
next
group,
when
you
know,
let's
not
forget
about
the
people
that
are,
are
less
economically
able,
and
I
think
someone
mentioned
helping
his
mom
at
the
beginning,
get
through
this
when
we
open
it
up
to
65.
P
You
know
there
are
people
that
are
sharper
and
faster.
They
can
get
on
the
technology.
They
have
a
car
they're
going
to
get
in
line
first.
So
let's
remember
our
equity
lens
as
we
go
through
this.
Thank
you
very
much.
Thank
you
carol.
Thank
you.
C
Carol,
I
just
want
to
speak
to
that,
because
there
are
a
number
of
comments
in
the
chat
as
well,
and
in
fact
this
is
something
that
we
just
talked
about
with
the
drafting
guidelines
work
group
about
how
we
can
how
we
can
increase
our
scale,
get
the
those
shots
in
arms
and,
at
the
same
time
hold
a
very
strong
equity
lens,
and
so
that
is
something
that
we
are
working
on
and
it's
something
that
I
think
that
hopefully
we'll
be
able
to
present
more
information
to
you
at
our
next
meeting.
C
But
we
are
definitely
actively
in
process
in
really
thinking
about
how
do
we
operationalize
some
of
these
strategies
for
equity?
So
thank
you.
T
T
T
We
do
have
an
aging
population
in
our
prisons,
who
is
very
sick
who
has
been
dying,
and
I
really
would
urge
us
to
bump
that
up.
It's
also
not
hard
to
do.
People
are
all
in
one
place.
These
are
goes
without
saying
either
or
not,
people
can
go
to
tel
expo
to
get
vaccinated,
so
I
really
hope
we
can
put
some
more
priority
and
emphasis
on
that
population.
T
A
You
tomas,
could
you
comment
on
if
you
have
the
older
aged
prisoners
and
others
in
state
hospitals
who
are
in
this
age
group.
D
Yeah,
so
that
that's
a
that's
a
really
good
question.
I
was
on
a
call
this
morning
with
the
the
staff
in
correctional
facilities
who
are
actually
working
on
this
issue
and
they
do
have
a
they
have
what
it's
called
a
risk
score
and
they're
they're
very
happy
to
hear
about
the
age,
the
focus
on
age.
So,
yes,
absolutely
and
that's
one
thing,
that's
good
about
the
issue
of
age.
It
can
be
applied
universally
across
all
different
sectors,
including
including
correctional
facilities.
A
U
Thank
you,
jody
hicks,
representing
planned
parenthood,
affiliates
of
california.
I
echo
a
lot
of
what
everyone
has
said
in
terms
of
equity
and
reaching
vulnerable
communities,
which
has
been
the
concern.
I
think
what
I
want
to
add
and
again
simplifying
and
adding
65
to
this
group
is
a
good
one.
Any
flexibility
is
good.
I
think
one
of
the
things
I
would
say
is
as
we
we
move
into
implementation
and
looking
at
it
looking
through
an
equity
lens
and
getting
it
vulnerable
communities.
U
It's
really
important
to
first
acknowledge
that
for
an
implementation
for
those
communities
to
work,
we
have
to
acknowledge
that
the
structure
we
have
in
place
right
now
is
not
one
that
lends
to
an
equitable
access
to
care
and
all
of
the
barriers
that
those
communities
face
in
terms
of
access
to
care
not
going
away
for
this
vaccine,
there
isn't
some
magic
vaccine
vaccinators
that
are
there
and
ready
to
go
and
in
those
communities,
and
so
health
centers
like
ours
that
serve
those
communities
that
serve
mostly
medical.
Mostly
black
and
brown
communities
tend
to
be
under-resourced.
U
We
don't
have
electronic
health
records
that
can
parse
out
who's
a
farmworker
and
who's
a
grocery
worker.
We
do
know,
though,
that
the
communities
we
serve
are
vulnerable
for
all
of
the
reasons
that
we
know
that
they
are
whether
it's
housing
lots
of
essential
workers.
So
we
know
with
a
broad
stroke
we
can
move
into.
U
I
think,
is
the
best
way
that
we
can
get
at
a
broader
population
through
an
equity
lens
and
get
as
many
shots
done
as
possible
and
not
try
and
have
a
list
that
we
all
want
to
be
perfect.
But
then
we're
not
implementing
it
in
a
way.
That's
ensuring
that
we're
we're
keeping
people
safe.
A
Thank
you
jody,
let's
go
on
to
erin
and
then
we'll
go
to
mitch
and
then
we'll
go
to
matt
and
then
we'll
go
to
oroville
and
then
heather.
M
Everybody
thank
you.
This
is
aaron
carruthers
with
the
state
council
on
development
bodies.
Thank
you,
dr
brooke
harrison.
Thank
you,
dr
aragon,
for
your
quick,
fast
action
today
in
response
to
what
came
out
of
the
cdc
in
the
federal
government.
Thank
you
so
much
for
pulling
us
together
and
thank
you
for
the
opportunity
to
give
feedback
on
the
redrafted
tier
one
phase
phase
1b.
M
Thank
you
for
finding
a
way
to
carry
over
from
our
last
meeting
to
find
a
way
to
put
the
equity
index
into
this
phase,
and
this
tier,
I
think,
that's
very
effective.
Also
regarding
the
underlying
medical
conditions,
building
off
of
what
denia
said.
M
What
andy
has
said,
there's
a
pretty
easy
way
to
operationalize
some
of
the
bigger
impact
for
people
with
disabilities,
who
would
be
impacted
by
the
underlying
medical
conditions
and
that
is
to
incorporate
people
who
are
receiving
hcps
services,
wouldn't
have
to
change
anything
here
in
the
two
years,
as
it's
written
just
as
the
way
it's
clarified
and
implemented.
That
number
is
is
much
smaller
than
a
million.
The
million
number
that
we
gave
you
is
actually
includes
people
who
are
16
and
younger.
M
So
that's
probably
the
the
biggest
number
on
the
outside,
and
so
I
just
wanted
to
see
and
ask
whether
or
not
there's
any
thought
to
include
that
and
operationalize
it
under
who's
considered.
Under
the
description
of
underlying
medical.
D
Conditions,
dr
schrechter,
do
you
do
you
have
any
comment
in
that?
I
I
I
don't
know
the
answer
to
that
question.
E
We'll
certainly
take
it
into
consideration
and
and
balancing
the
the
overall
health
risks,
the
specific
health
risks
of
developing
severe
co-19
disease
and
and
the
the
numbers
that
you
you
mentioned
in
in
trying
to
trying
to
balance
all
those
factors
so
appreciate
the
the
the
comment
and
the
concerns.
C
Yeah,
I
think
that
what
would
be
required
would
be
a
comparison
between
that
list
and
the
estimated
number
of
individuals
that
have
a
condition
that
is
listed
on
the
cdc
on
the
cdc
guidelines
as
significantly
increasing
the
risk
for
a
severe
covid
right,
and
so
as
we.
I
think.
That's
something
that
certainly
you
know
within
the
cdph,
the
cdph
team
can
do
and
look
and
see
what
is
the
the
actual
numbers
there.
So
we're
happy
to
do
that.
A
Okay,
thank
you,
as
always
for
a
very
thoughtful
comment.
Let's
go
on
to
mitch,
steiger
mitch,
don't
forget
to
introduce
yourself.
V
Thank
you
mitch,
steiger
with
the
california
labor
federation
and
as
labor
representatives.
This
is
an
incredibly
difficult
station
for
us
to
have
given
that,
as
others
have
mentioned,
moving
millions
of
people
farther
ahead
in
line
by
definition
means
millions
of
others
are
farther
back
in
line
and
we
represent
a
lot
of
those
people.
Probably
most
of
them
are
essential
workers,
and
so
it's
much
easier
to
have
this
conversation
among
us
on
a
zoom
call
than
it
is
to
look
one
of
those
workers
in
the
eye
and
say
you're
gonna
have
to
get
it
later.
V
You've
already
sacrificed
everything
to
keep
society
functioning
during
this
crisis,
and
now
you're
going
to
have
to
wait
even
longer
and
so,
but
given
that
the
arguments
in
favor
of
this
are
very
compelling
and
they
make
a
lot
of
sense,
but
looking
at
those
two
competing
directions,
you
know
we're
not
really
in
a
position
to
wholeheartedly
support
or
oppose
this
idea.
We
just
kind
of
wanted
to
make
a
comment
that
it's
really
important.
V
We
think
that
if
we
are
going
to
have
this
change
in
it,
where
we
do
push
workers
further
back
in
line
that
the
rest
of
the
system
really
needs
to
work
as
well
as
it
possibly
can.
So,
for
example,
if
workers
are
asked
to
move
back,
but
then
they
also
see
wildly
differing
approaches
from
one
county
to
another.
It's
going
to
just
really
compound
their
skepticism
of
this
whole
system
or
if
they,
you
know,
aren't
able
to
find
out
where
the
vaccine
distribution
sites
are.
V
If
any
of
these
other
concerns
do
come
to
fruition,
it's
going
to
be
really
heightened
if
we're
also
asking
millions
of
these
workers
to
move
back
in
line,
and
so
we
would
also
just
we
just
really
urge
again,
as
many
have
said,
some
sort
of
a
statewide
system.
You
know
real
clear
requirements
or
direction
to
counties
that
this
is
how
it
happens
as
much
clarity
as
we
can
have
online
in
terms
of
accountability
and
knowing
how
many
doses
have
gone
out.
V
C
Mitch,
thank
you
so
much
for
that
comment,
and
I
just
want
to
add
that
this
is
the
some
of
the
the
difficulty
in
having
this
conversation.
C
This
is
about
making
sure
that
I'm
actually
a
step
closer
to
getting
a
hospital
bed.
If
I
need
one
right
that
that
is
the
way
that
I
kind
of
I,
I
think
that
I
think
that
it's
hard,
because
obviously
we're
all
on
the
call
to
advocate
for
the
groups
that
that
you
know
you
all
are
here,
because
you
add
your
excellent
advocates
for
the
groups
that
you
represent
and
at
the
same
time
I
think
the
the
the
piece
that
I
I
want
to
emphasize
is
that
the
way
we
communicate
about
this
is
critically
important.
C
It
really
makes
the
difference
communication,
especially
when
the
still
the
most
powerful
tool
we
have
against
this
vaccine
is
our
behavior,
and
so
I
really
want
to
emphasize
to
to
everyone
on
this
call
how
powerful
our
language,
our
communication,
our
framing,
is
when
we
are
reaching
out
to
our
constituents
and
talking
about
hey.
You
know
what
we
have.
This
conversation
we're
looking
at.
You
know
the
65
plus
as
as
coming
in,
and
you
know
what
it's
actually
not
a
step
back
I
mean
listen.
V
If
we
do
adopt
it,
something
that's
a
little
bit
easier
for
our
members
to
accept,
but
just
wanted
to
make
sure
that
that
worker
perspective
was
out
there
and
that
this
is
something
that
will
be
no
matter
how
we
describe
it
and
no
matter
how
good
the
arguments
are
in
favor
of
it.
It's
a
very
difficult
thing
when,
when
you're
the
one
who's,
you
know
going
to
work
every
day,
putting
your
life
on
the
line
more,
if
you're
going
to
get
sick,
more
of
you
are
going
to
die
because
of
this
change.
C
A
W
Hello,
matt
luzay
with
seiu
california,
so
I
appreciate
both
the
comments
that
are
just
made.
W
You
know
I'll
just
say
for
seiu
has
nurses
on
the
ground
in
la
right
now
that
moving
faster
with
the
vaccine
distribution
is
incredibly
important
because
of
the
points
that
dr
harris
was
just
making
about
that
there
was
just
not
icu
beds,
nurses
are
and
healthcare
workers
are
at
the
breaking
point
right
now
and
so
moving
faster
is
incredibly
important,
but
I
I
would
be
remiss
if
I
didn't
lift
up
mitch's
comment
as
well
of
the
need
for
a
clear
process
and
clear
communication.
W
This
the
county
by
county
process
is
not
effective
and
it's
not
a
good
way
for
our
workers
to
know
when
they're
going
to
be
in
line,
and
we
need
to
have
clear
communication
of
when
they're
going
to
be
there,
that
the
the
the
lack
of
transparency
and
lack
of
knowing
that
the
unknown
is
causing
additional
stress
on
our
essential
workers
who
we
stood
on
their
shoulders
for
years
or
for
this
entire
pandemic.
So
just
want
to
make
those
two
quick
points.
So
thank
you.
Q
Yeah
hi
everyone,
orville
thomas
california,
immigrant
paul
immigrant
policy
center.
You
know
really
happy
dr
burke
harris
that
you
talked
about
communications
because
I
think
that's
something
that's
lacking
in
these
conversations
is
what
is
the
communication
strategy
we
keep
talking
about
it
every
week,
but
we
heard
last
week
about
a
cultural
communication
strategy.
Q
We
continue
to
talk
about.
How
do
we
message
it?
And
yet
every
newspaper
article
I
see
about
confusion
starts
with
a
lack
of
communication
strategy.
So
are
we
going
to
hear
one
from
the
public
health
department?
Are
we
hearing
it
from
the
governor's
office
because
sometimes
I
feel
like
we
talk
in
circles
and
we
get
it
as
advocates
and
we
have
a
limited
like
exposure
to
the
community,
but
the
larger
work,
the
million
dollar
work
needs
to
be
done
and
it's
not
happening.
C
Thank
you.
I
will
say
the
work
is
happening
I
want
to
acknowledge.
I
think
we
can
do
a
better
job
in
in
communicating
that
to
you
all
and
having
that
be
a
kind
of
a
clear,
unified
piece,
but
the
work
absolutely
is
happening,
and
we
can
share
more
about
that
at
the
next
meeting.
X
Thank
you
bobby
and
thank
you,
dr
bergeris,
dr
schechter,
dr
aragon,
dr
dr
brooks
for
for
this
and
bobby
as
well
for
calling
the
meeting.
I
do
think
that
sometimes
that
in
I
often
I'm
just
trying
to
respond
in
chat
and
in
chat,
I
try
to
be
as
succinct
as
possible
and
it
always
looks
like
some
hostile
little
jab.
That
really
isn't
what
I
intend
so
having
the
chance
to
to
speak.
X
I
I
appreciate
that
I
actually
wanted
to
to
talk
a
little
bit
about
sort
of
some
of
those
intersectional
points,
and
I
I
think
sometimes
that
can
be
lost.
I'm
I'm
thinking
of
those
the
the
16
to
64
year
olds
with
with
conditions,
and
I
am
agreeing
with
aaron
and
danny
and
many
of
the
other
ones
before
that.
It's
not
just
everyone
with
any
possible
pre-existing
condition.
If
we
look
very
specifically
at
those
who
are
receiving
home
and
community
based
services,
someone
is
administering
those
services.
X
This
is
ihss
workers,
often
people
who
are
female
people
who
are
of
color.
It's
a
group.
It's
a
it's
a
pair
and
those
same
individuals
when
maybe
working
extra
hours
in
nursing
homes
or
or
with
other
people
with
disabilities,
and
there
is
a
risk
of
spreading
that
way
as
well.
It's
a
real
reason
to
reach
this
group.
X
Many
of
the
parents
who
are
taking
care
of
their
adult
children
with
disabilities
are
older
in
that
age
group
and
they
might,
if
something,
but
they
might
not
be
65
yet
and
if
they
get
sick,
their
children
well,
even
if
they
don't
get
covered,
will
also
be
going
to
a
hospital
because
they're
not
getting
the
care
that
they
should
be
getting
or
are
used
to
hitting.
So
there
is
a
lot
of
intersectionality
amongst
this
entire
group,
and
I
also
wanted
to
to
just
sort
of
raise
the.
X
The
I
mean
I,
I
appreciate
the
concerns
I
I
love
the
the
framing
of
that
we're
trying
to
keep
hospital
beds
open.
I
think
that's
that's
really
important
as
well,
and
just
for
all
of
us
to
really
think
through
how
we
can
communicate
it's
the
logistics.
X
I
mean,
obviously,
the
the
simplest
way
to
reach
people
would
be
first
come
first
serve,
but
that
seems
obviously
and
clearly
inequitable
so
thinking
through
the
logistics
at
this
very
practical
local
level
has
to
be
done
or
all
our
discussion
of
equity
is
not
going
to
achieve
it.
Y
Hi,
thanks
and
and
I'll
be
quick.
I
want
to
thank
everybody.
I
really
appreciate
this
conversation.
What
a
monumental
monumental
task
this
is
it's
exciting
to
see
the
conversations
move
to
further
phases
and
tears.
Y
At
the
same
time,
the
the
tier
that
we've
been
in
for
a
while
now
1a
has
assisted
living
residents
and
staff,
still
the
bulk
of
those
communities.
The
vast
majority
still
waiting
for
their
clinics
really
hoping
that
some
of
the
conversations
today
that
we
heard
about
at
marshalling
these
additional
resources.
Y
Directed
to
the
setting
is
reassuring,
so
it
was
very
good
to
hear
that.
I
appreciate
it.
Our
residents
and
families
appreciate.
It
also
wanted
to
echo
the
call
for
clarity,
one
of
the
things
we
hear
from
our
residents
and
their
families
and
our
workers
that
gets
confusing
is
when
counties
announced
that
they're
moving
on
with
big
clinics
for
1b
and
for
other
settings,
but
they
don't
have
a
date
for
their
shots.
C
Well,
thank
you
so
much,
and
I
want
to
thank
everyone
for
making
the
time
urgently
in
your
schedule
for
this,
for
this
meeting
all
but
three
members
attended
today.
So
again,
you
all
are
just
demonstrating
your
commitment
to
this
work
and
we
are
very
grateful
for
your
input.
C
I
think
what
I
I
want
to
reflect
back
what
I've
heard
in
this
conversation,
and
there
were
a
couple
of
major
themes
I
didn't
get
through
reading-
absolutely
everything
in
the
chat,
but
I
know
that
bobby
will
print
it
out
so
that
I
can
so
that
we
could
read
it
because
it
was
a
lot.
C
It
was
a
vibrant
conversation,
but
the
big
thing
that
I
heard
was
hey:
don't
forget
about
all
the
things
that
we've
been
talking
about
and
all
our
meetings
so
far
right,
don't
forget
about
how
how
important
it
is
for
us
to
be
prioritizing
equity
for
us
to
be
doing
strong
implementation
for
our
vulnerable
seniors
and
those
who
are
in
long-term
care,
skilled
nursing
facilities
and
other
types
of
facilities.
C
Don't
forget
about
our
folks
who
are
in
congregate,
settings
such
as
shelters
or
or
who
are
incarcerated,
and
I
I
wanna
emphasize-
and
I
I
I
want
to
just
you
know-
hold
for
folks
that
we
are
not
forgetting
about
those
things
and,
as
we
are
thinking
as
as
the
yeah
and
and
we
won't
and
we're
grateful
for
your
strong
reminder
and
that
these
are
key
priorities
as
we
are
moving
forward
in
this
work
and
and
we
hold
those
as
priorities
and
and
and
really
as
we
are
as
we're
looking
forward
as
we're
planning
forward
and
as
we're
responding
to
the
surge
and
the
data
and
the
information
that
we
are
getting
about.
C
Who
is
most
vulnerable
and
what
is
putting
our
healthcare
system
at
greatest
risk.
Right.
We're
also
hearing
that
we,
those
resources,
need
to
be
put
in
place
to
make
sure
that
we
are
effectively
vaccinating
those
who
are
in
phase
1a
to
make
sure
that
we
are
effectively
implementing
some
systems
with
a
thought
towards
equity,
and
that
this
is-
and
you
know
we
heard
this
is
hard
work.
C
This
is
sometimes
challenging
complicated
work
and-
and
we
recognize
that
and
are
not
losing
sight
of
the
logistical
work
that
it
takes
to
reach
hard-to-reach
populations,
and
we
also
understand
and
are
hearing
that,
for
you
know
as
as
we're
responding
to
the
the
public
health
emergency
and
the
challenges
that
we're
facing
in
terms
of
thinking
about
prioritizing
individual
65
plus
in
phase
1b,
that
that
it's
also
critical
for
us
to
recognize
and
and
think
about
how
we're
doing
our
messaging.
C
How
we're
doing
how
we're
communicating
that
to
others
and
that
a
key
part
of
maintaining
that
trust.
And
that
communication
is,
you
know
some
some
thoughtfully,
the
the
the
thoughtful
and
clear
rollout
of
the
current
plans
that
we
have
in
place.
C
And,
finally,
I
want
to
add
this
notion
of
a
question
about
how
we
can
be
more
specific
in
looking
at
those
who
are
16
to
64,
who
do
have
health
conditions
that
put
them
at
increased
risk
for
severe
coveting
disease
and
whether
or
not
we
can
take
another
look
to
understand.
C
You
know
more
precisely
what
that
number
of
individuals
is
and
whether
or
not
that
number
of
individuals
you
know
is
as
large
as
the
estimate
that
we
are
concerned
about
or
that
we're
using
in
our
decision
making,
and
so
all
of
that
we
will
take
back
and
bring
to
the
vaccine
advisory
committee
bring
that
to
for
the
purposes
of
decision
making
in
in
the
governor's
office,
and
with
that
I
I
want
to
thank
everyone
for
your
time.
I
appreciate
all
of
the
all
of
this
input.
C
It's
incredibly
valuable
to
us
and
we
look
forward.
The
next
meeting
is
going
to
be
on
january
20th
from
3
to
6
p.m,
and
so
we
look
forward
to
to
seeing
you
all,
I
believe,
that's
next
thursday.
If
I've
got
it
right
next,.
C
Wednesday,
sorry,
I
don't
have
my
calendar
for
me
next
wednesday
and
then
the
next
couple
of
meetings
after
that
are
february,
3rd
and
february
17th,
very
grateful
for
all
of
you
for
your
responsiveness,
as
we
are
responding
to
this
emerging
issue
and
grateful
for
your
input.