San Francisco reports first local COVID-19 vaccinations as officials warn ICU capacity could be exhausted in early January

Julie Stolte, director of clinical disease control and prevention at the San Francisco Department of Public Health, told the Health Commission on Dec. 22, “Vaccines are here and were administered, for the first time in San Francisco this morning at ZSFG,” calling the event a ‘‘historic moment’’ for the city.

Stolte and her co-presenters walked commissioners through the federally and state-guided rollout plan. She said the federal Advisory Committee to the FDA and the CDC’s Advisory Committee on Immunization Practices recently recommended emergency use and prioritization; the state’s framework focuses Phase 1a on health-care workers and residents of skilled nursing and long-term care facilities. “Phase 1a allocation for COVID 19 vaccine is focused on, essentially health care workers,” Stolte said.

Dr. Andy Tenner, who described federal pharmacy partnerships with CVS and Walgreens for on-site vaccination of skilled nursing facilities, told the commission the city’s first allocation is about 12,675 Pfizer doses and that Moderna allocations are expected once the company receives EUA. He explained the two-dose requirement and cold-chain needs and said DPH purchased three ultra-low-temperature freezers with combined on‑hand capacity he described as storage for about 600,000 doses. “This is a 2 dose vaccine…it requires going back to those sites a second time to administer the second dose,” Tenner said.

Commissioners pressed officials on data and tracking. Tenner said the department considered the state platform (PrepMod) but “ended up deciding to go with our Epic platform,” which will provide the functionality needed to document vaccine recipients and interface with other providers. Stolte added that dose reporting to the California immunization registry is required and that the registry will transmit to federal systems.

Grant Colfax, the department director, framed the vaccine news amid a severe local surge. He said San Francisco has nearly 19,000 diagnosed COVID-19 cases with 167 deaths and a case rate of 26.9 per 100,000. Using command-center forecasting, Colfax reported the city is projecting it could run out of current intensive care unit beds on January 5, 2021, without changes in transmission. “If we model this out, we’re projected to run out of current intensive care unit beds on January 5, 2021,” he said.

Colfax stressed that vaccines will not immediately blunt the current surge and urged residents to adhere to stay‑at‑home guidance and avoid holiday gatherings. He said a 40 percent reduction in the reproductive number through distancing, masking and avoiding gatherings could substantially lower hospitalizations and deaths.

Commissioners also asked about staffing implications of vaccine reactogenicity and outreach to outpatient clinics. Officials recommended staggering doses across teams to avoid simultaneous absences and noted outpatient and primary‑care clinics fall into subsequent tiers of Phase 1 allocation once acute‑care hospital workers and long‑term care sites are served.

The Health Commission received the briefing and held public comment; no members of the public spoke on the update during the meeting. The city and DPH will continue to refine allocation and logistics as weekly and biweekly federal and state allocations arrive.