SAN DIEGO (KGTV) -- San Diego County’s updated vaccine guidelines are among the most expansive in the state, allowing the majority of county residents to begin vying for limited vaccination slots.
But the guidelines, which are meant to provide access to people with high-risk conditions, are so broad that many elite athletes also qualify.
At least 34 of the players on the San Diego Padres’ 40-man roster now qualify for vaccination, including Manny Machado and 22-year-old star shortshop Fernando Tatis, Jr.
That’s because on Monday, San Diego County began offering vaccination appointments to individuals with a body mass index of 25 or above, the clinical definition of “overweight.” BMI is a measure of height and weight, and although it is widely used in the medical community, it can be thrown off by athletes with low body fat and high muscle mass.
Nearly 60 percent of San Diego County residents have a BMI of 25 or more.
None of California’s other 20 largest counties have set a BMI threshold as generous as San Diego County, according to a review by ABC 10News. The largest county with similar guidelines is Merced, with a population less than one-tenth the size of San Diego’s.
Most counties have adopted the state’s guidelines to extend access to people with a BMI of 40 or above, the definition of severe obesity. San Francisco County is allowing people with a BMI as low as 30 to get a shot, which is the clinical threshold for obesity.
“We don’t compare what we do to what other counties are doing,” said county spokesman Michael Workman.
Workman said county health officials elected to include a list of conditions identified by the Centers for Disease Control and Prevention as potentially associated with a higher risk from COVID-19.
Studies have repeatedly shown that obese people with BMI over 30 fare far worse against COVID-19, but the evidence is mixed for overweight people. A CDC study out this month showed overweight people have a higher risk of needing mechanical ventilation once hospitalized, but the study did not find they were at greater risk of winding up in the hospital in the first place.
In all counties, the state allows wiggle room for a wide range of unspecified underlying conditions that might place someone at extreme risk for COVID-19. Many counties encourage individuals to seek their doctor’s advice on whether they qualify, although written documentation of an underlying condition is not required.
“Providers will use their clinical judgement to vaccinate individuals aged 16-64 who are determined to be at the very highest risk,” said Michelle Corson, a spokeswoman for Kern County Public Health.
Some advocates have criticized the state-issued guidelines as too vague. For example, in most counties, it’s unclear if individuals with asthma qualify.
San Diego County has removed most of the guesswork, granting access to an extended list of qualifying conditions not enumerated by other counties like moderate-to-severe asthma, hypertension or high blood pressure, and people with BMIs as low as 25.
But in doing so, the county has rapidly expanded access to the majority of residents at a time when vaccines are still scarce. Approximately 33 percent of adults in San Diego County are overweight and another 26 percent are obese, according to the CDC. About one in four San Diegans have high blood pressure. One in twelve U.S. adults have asthma.
Even the county admits it doesn’t have an estimate on the number of newly eligible San Diegans. And new doses of the Johnson and Johnson vaccine won’t arrive until the end of this month, Workman said.
“The last thing we want to do is make things too narrow, so I think the officials at the county wanted to have a broader umbrella, a broader denominator, to allow more people to qualify,” said Dr. Christian Ramers of Family Health Centers of San Diego, a member of San Diego County’s Vaccine Advisory Group. “And we are going to work through all these people in the next several weeks.”
On Tuesday, County Health and Human Services Director Nick Macchione revealed 26 percent of San Diego residents have received at least one shot, which he said was the state's highest vaccination rate.
Among seniors 65 and older, 73.4 percent have gotten at least one dose. Every nursing home resident in San Diego County has been fully vaccinated, Macchione said.
Macchione said the county was on track to meet its goal of a 70 percent vaccination rate “well before” July 1.
Dr. Ramers said San Diego is in a different position than other counties and can err on the side of expanded access.
“We’re in a situation where demand exceeds supply, but pretty soon we’ll be in a place where supply will exceed demand and we need to address people with a little bit of hesitancy,” he said.