With COVID-19 vaccines still in short supply, prioritizing who gets them and when becomes, as Yolo County’s health officer said Tuesday, “a zero sum game.” “Whenever you expand eligibility for one group, you take away vaccines from another group,” Dr. Aimee Sisson told the Board of Supervisors. Up until last week, there was no game involved — the state was requiring counties to prioritize residents 65 and older before moving on to the rest of the Phase 1B, Tier 1 cohort: essential workers in food and agriculture, education and childcare, and emergency services. For the last few weeks, Yolo County has been doing exactly that: using its limited allotments of doses to vaccinate seniors throughout the county. But the state has since authorized counties to open up vaccinations to everyone in Phase 1B, Tier 1, and as a result, some counties have begun vaccinating teachers with the goal of getting students back in school, while others have begun targeting farmworkers and first responders. Yolo County, however, has kept to the 65+ standard, opening vaccinations to all county residents in that age group regardless of insurance. Large clinics in West Sacramento last week and in Woodland and Davis this week will insure thousands of the county’s seniors are inoculated. Meanwhile, smaller clinics are targeting rural communities such as Esparto, Madison and Knights Landing, where seniors may be undocumented or lack access to sign up for vaccines online. After a number of Davis residents drove out to those clinics last week, they are now reserved for residents of those areas only. As for prioritizing the 65-and-over group for those doses, Sisson has repeatedly explained the rationale this way: Individuals in that age group are 141 times more likely to die from COVID-19 than those under 50, and preventing deaths remains the public health priority. But there’s another group that has a higher-than-average death rate as well. “We know that Hispanics are over-represented in Yolo’s cases and deaths,” Sisson said Tuesday. “Hispanics,” she said, “account for at least 41 percent of cases and 36 percent of deaths but only 32 percent of Yolo’s population.” Meanwhile, “69 percent of all COVID-19 deaths among Yolo County residents ages 50 to 64 are among Hispanics,” she said. At particular risk are farmworkers — around 7,000 of whom will be in the county for the upcoming harvest season. The vast majority, Sisson noted, are Hispanic, and also at increased risk of exposure to the virus because their work can only be done in person and often requires being within six feet of co-workers. That’s why some in the county — as well as on the Board of Supervisors — are urging that farmworkers be prioritized along with seniors for vaccines. Supervisor Angel Barajas of Woodland expressed frustration about what he saw at recent rural vaccine clinics where “more affluent individuals who do have healthcare, who do have healthcare providers, actually cut in line and received a vaccine where maybe that vaccine should have gone to somebody in West Sacramento or Knights Landing or Esparto and Madison. “What is our priority as a county? Is it really just to give it to everybody and anybody? Because if that’s the case, you know historically those who are more privileged, affluent and have access to resources are going to get those,” he said. But farmworkers, he said, “need it the most.” “What we should do is really look at providing vaccines for ag workers and low-income disadvantaged communities,” Barajas said. His comments were echoed by nearly a dozen people who provided comment during Tuesday’s board meeting. “With the farmworkers arriving in the next few weeks, we are in a time-sensitive situation,” said Emily Henderson, a former assistant to Supervisor Don Saylor. Yolo County’s Latinos, she said, represent around 30 percent of the county’s population and 43 percent of Yolo’s COVID-19 cases, but only 13 percent of those who have been vaccinated. “I’m concerned that spending six to eight weeks to complete vaccinations for those over 65 will have unacceptable impacts on our predominately Latino farmworkers who are the backbone of Yolo’s community and critical to our ag sector,” said Henderson. “I would like to urge the board and Dr. Sisson to direct staff to vaccinate farmworkers of all ages, concurrently with the 65-plus population.” Likewise, UC Davis Professor Natalia Deeb-Sossa urged “Yolo County officials to immediately begin vaccinating farmworkers who are already here regardless of age.” Farmworkers, she said, often ride to work together, work in proximity and have no potential for remote work. They also have a lower life span than the average American, said ApoYolo founder Anoosh Jorjorian, “as low as 49 years.” The farmworker population also skews older than other worker populations, she said, “so they are already elders in their community.” “They are still working. They are essential workers. So they are still getting exposed to the virus by being out in the fields with their team trying to keep us fed during this pandemic.” Supervisor Jim Provenza of Davis suggested sub-prioritizing farmworkers ages 50 to 64, placing them in the same tier as everyone 65 and over, something Sisson said she and the vaccine advisory committee could discuss. Barajas indicated focusing on farmworkers 50 to 64 would be an acceptable compromise but suggested focusing on the farmworker community as a whole prior to concluding the 65-and-over age group. “We need to really look at this as, ‘Who is our priority?’ Is it those who don’t have healthcare and don’t have access? Or is the county’s focus everybody? Because teachers do have healthcare… their labor organizations do have that connection to these hospitals where they can work something out and get their vaccinations quickly. “We do have to hone in to the farmworker population. And whether in the next two weeks we have it specifically for 50 to 65 or in the next four to five weeks, we expand it to all farmworkers… we have enough justification and data and statistics to show that ag workers deserve the vaccination as soon as possible.” And while the county does expect to focus its vaccination efforts primarily on underserved populations in the future — when vaccines are plentiful and large healthcare systems can focus on their own members — for now the county remains the largest provider of vaccinations. Of the nearly 27,000 first and second doses administered to Yolo County residents thus far, more than half were provided by the county’s health department. Dignity Health, Kaiser Permanente, Sutter Health and UC Davis Health have administered a combined 12,308 first and second doses to county residents. Meanwhile, no decision was made on Tuesday about where farmworkers will fall on the vaccination schedule, but Sisson did lay out the farmworker vaccination plan that has been created thus far, elements of which include: * Allowing vaccination without appointments * Vaccinating oldest members of multigenerational households now * Minimizing transportation barriers by vaccinating at the workplace or migrant centers * Reserving appointments at community clinics to avoid competition with those with more access to technology * Offering clinics at night and on weekends.