Essential California: Why the vaccine honor system matters

Vaccination site in a gym
A COVID-19 vaccination site in the Villa Intermediate School gym March 15.
(Brian van der Brug / Los Angeles Times)

Good morning, and welcome to the Essential California newsletter. It’s Wednesday, March 17, and I’m writing from Los Angeles.

As my colleagues Colleen Shalby and Hayley Smith report, millions of Californians with disabilities and underlying health conditions are now eligible for a COVID-19 shot, but officials will be relying more than ever on public trust and honesty to make sure the doses get to those who need them most.

[Read the story: “California’s huge COVID-19 vaccine expansion relies on trust. Will cheaters stay away?” in the Los Angeles Times]

Unlike previous vaccination tiers that focused on certain jobs or age groups — factors that required documented verification at vaccine sites — disabled and high-risk Californians will be asked to self-attest to their eligibility, meaning they won’t be required to show documentation from a doctor.


It’s a decision that potentially leaves space for fraud in a system that’s already been plagued by line-cutting. But it’s also a choice intended to protect the most vulnerable Californians.

Advocates say eliminating strict medical documentation barriers benefits those who are most at risk, and helps ensure equity in the vaccine administration process.

“The rollout for disabled people needs to have the lowest burden and the fewest barriers, so that people don’t have to prove things in order to get access to something we need,” said Charis Hill, a writer, speaker and chronic disease advocate in Sacramento. Hill told me they would rather risk that some people cheat than make it harder for disabled people who qualify to get vaccinated.

Think about who can easily access a doctor’s note and how much time it might take. For example, as Colleen and Hayley write, a person with a concierge doctor could easily secure a doctor’s note within a day, while a person who is uninsured or underinsured, or doesn’t have a regular healthcare provider, could be left without the needed documentation.

Dr. Aaron Kheriaty, director of the medical ethics program at UC Irvine and a member of the vaccine task force in Orange County, told my colleagues that implementing stricter requirements like doctors’ notes would have overwhelmed medical offices and, more significantly, left large swaths of people out in the cold.

Héctor Manuel Ramírez, a Chatsworth disability rights advocate who serves on the board of Disability Rights California, described requiring documentation as a significant challenge that would put a disproportionate burden on Black, Latino and Native American communities — the same communities “that are being decimated right now,” he said.


Ramírez started to dread going on social media in recent months, as the pandemic’s wrath filled his feeds. “I can’t even go on Facebook anymore, ‘cause it’s like, ‘We’ve lost this person, this person has died,’ nonstop,” he said. He has lost four family members to COVID-19 over the last year. All four were disabled or had underlying health issues.

Californians with disabilities and underlying health conditions were briefly deprioritized for vaccine distribution in January, when the state abruptly scrapped its tiers in favor of a purely age-based rollout. The decision sparked confusion, distress and anger, and the state reversed course in response to the outcry from advocates in the birthplace of the disability rights movement.

Ramírez said his organization had pushed the Newsom administration not to require documentation, and praised the governor for ultimately listening to disabled constituents.

Officials have implored Californians who don’t qualify not to cheat the system. Vaccine sites staffers have routinely encountered people using forged documents to try to get shots during prior eligibility periods, as Colleen reported last month. Even with safeguards and verification requirements, people determined to take advantage of the system will find a way to do so.

But ultimately, some degree of fraud is far preferable to a system whose safeguards shut out the most vulnerable.

Ramírez said the crushing sadness of his Facebook feed had started to lighten in the last couple of days, as his peers in L.A. County and across the state began to post about securing appointments and getting their shots.

“I think tomorrow, when I go get my shot at 9 o’clock in the morning, I’m going to cry,” he told me on Tuesday night, his voice dense with emotion. He would cry for his brother, who died as vaccines were beginning to roll out in January, and everyone else he had lost. But he would also “cry for happiness.”

And now, here’s what’s happening across California:

Riverside, Ventura, San Diego counties join others moving into red tier: California’s coronavirus canvas is taking on a distinctively red hue this week, with 10 more counties — including San Diego, Riverside, Sacramento, Ventura and Santa Barbara — escaping the most restrictive rung in the state’s color-coded reopening road map. Los Angeles Times

Gov. Gavin Newsom on Tuesday said expects the Republican-led effort to recall him from office to qualify for the ballot and amplified his attacks against the campaign’s lead proponents in nationally televised interviews. Los Angeles Times

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As Hollywood reopens, can movie theaters fully recover from the pandemic? Los Angeles — home of the movie business and the nation’s biggest box office market — is the last major metropolitan area in the U.S. to reopen indoor theaters. Los Angeles Times

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Democrats loved Katie Porter when she bashed Trump. Now she is making them squirm. This is a story about a high-profile California representative’s House committee assignments, but it doubles as a fascinating primer on the power struggles, relationships and inside-baseball politicking behind those assignments. Los Angeles Times

Rep. Katie Porter holds a town hall meeting
Orange County Rep. Katie Porter is a progressive serving in a Republican-leaning, Irvine-centered district that the GOP is targeting for a pickup in 2022.
(Genaro Molina / Los Angeles Times)

Two people were arraigned on misdemeanor charges for egging House Speaker Nancy Pelosi’s San Francisco brownstone. As a condition of their release, the judge barred the duo from carrying eggs anywhere except out of the grocery store. Mission Local


Former prosecutor announces bid to challenge first-term Orange County D.A. The race is poised to test the climate for justice reform in a county that has historically favored tough-on-crime policies. Los Angeles Times

Eight killed in shootings at three Atlanta-area massage parlors: Eight people, including several women of Asian descent, were shot to death Tuesday at a string of Atlanta-area massage parlors, raising fears that the victims were targeted because of their race. Los Angeles Times


Two people died after a massive explosion set off by fireworks at an Ontario house rocked a residential neighborhood, prompting a large response from firefighters and law enforcement. Los Angeles Times


How California theme parks will enforce out-of-state visitors ban: When they reopen, theme parks will be required to limit ticket sales to in-state residents under revised state guidelines. Orange County Register

A poem to start your Wednesday: “California” by Rafael Campo.

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Los Angeles: cloudy with some intervals of sunshine, as a treat, 64. San Diego: partly cloudy, 63. San Francisco: gray, 54. San Jose: gray, 61. Fresno: mainly gray, 66. Sacramento: very gray, 63.


Today’s California memory comes from Ralph De La Parra:

I remember going with my father to shop at Grand Central Market in downtown Los Angeles in the late 1940s and early 1950s. We would drive from our house in Boyle Heights and park on the street up on Bunker Hill, which in those days had a lot of large private homes and apartment buildings. We would then take Angels Flight down to Hill Street and the market.

If you have a memory or story about the Golden State, share it with us. (Please keep your story to 100 words.)

Please let us know what we can do to make this newsletter more useful to you. Send comments, complaints, ideas and unrelated book recommendations to Julia Wick. Follow her on Twitter @Sherlyholmes.