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States across this country are deciding who gets vaccinated next, and they're trying to move quickly while also trying to be fair. In California, the tension between equity and efficiency has led to a question - when do farmworkers get their vaccinations? Here's April Dembosky of KQED.
APRIL DEMBOSKY, BYLINE: This summer, when many Americans went to work in their pajamas at their kitchen tables, Vicente Reyes went out to the grape fields in the Central Valley of California.
VICENTE REYES: Other Americans have been able to shelter in place at home. We still keep working. Without our work, there wouldn't be any food.
DEMBOSKY: California produce, meat and dairy gets shipped all over the country and the world. Two-thirds of the nation's fruits and nuts come from California. This is why Reyes believes agricultural workers should be next to get the coronavirus vaccine.
REYES: If there would be a shortage of food, then there would be more chaos.
DEMBOSKY: Studies show food workers are at high risk of contracting the coronavirus and dying from it. Because of low wages, they often live in crowded conditions or drive to work sites in crowded trucks. Seventeen percent of California ag workers say they've never been to the doctor. Reyes says they can't afford it.
REYES: We just try to walk it out or, like, try to find home remedies to get better.
DEMBOSKY: State officials have waffled about who to prioritize next for a vaccine, essential workers like these - farmworkers, teachers and emergency responders - or elderly people 65 and up. For now, they decided not to decide. They prioritize them all. That's at least 12 million people. With limited vaccine supplies, it's falling to the state's 58 counties to make the final decisions on exactly who, when and how - like how do you get vaccines that need to be stored at minus 94 degrees out to rural farmworkers?
KIM SARUWATARI: We know that once you take it out of the deep freeze, it's good for five days.
DEMBOSKY: Kim Saruwatari is the director of public health for Riverside County. They're organizing mobile clinics.
SARUWATARI: So take a smaller amount, take it out to those farmworking communities, administer everything we have, get more and take it out and keep going until we get everybody covered.
DEMBOSKY: But smaller counties with less money may find this daunting, even impractical. Dr. Eric Sergienko is the public health officer in Mariposa County, the home of Yosemite. To him, it doesn't make sense to vaccinate farmworkers first because the current vaccines require two doses.
ERIC SERGIENKO: If it were just a single shot, I think we would be able to wrangle with logistics fairly easily. But seeing as we have to find that person either 21 days or 28 days later, that adds a layer of complexity.
DEMBOSKY: Farmworkers are mobile and often undocumented. They could be working or living in a different place one month later. Sergienko says the most effective strategy could be to wait.
SERGIENKO: Don't let the perfect be the enemy of the good.
DEMBOSKY: Sergienko is weighing other concerns, too. His county has just one hospital and no ICU.
SERGIENKO: If we have someone who's really sick who needs an ICU bed, they get flown or get an ambulance ride to a tertiary care facility either in Fresno or Modesto.
DEMBOSKY: And hospitals there have been overwhelmed in the recent surge. To him, it makes sense to vaccinate elderly people first because they're the ones most likely to need critical care.
SERGIENKO: And the more people I keep out of the hospital, the better the people that are actually hospitalized will do.
DEMBOSKY: Some other counties with large farmworker populations are taking a similar age-based approach to the frustration of farmworker groups. They're pushing officials to develop a centralized state-based strategy for vaccinating food workers.
For NPR News, I'm April Dembosky in Oakland.
(SOUNDBITE OF BALMORHEA'S "BEHIND THE WORLD") Transcript provided by NPR, Copyright NPR.
