Many of the Bay Area’s hardest-hit neighborhoods have been left out of the state’s new equity-focused vaccine distribution scheme, frustrating local officials and community clinics racing to vaccinate the region’s most vulnerable populations.

California’s list of more than 400 priority ZIP codes — for which the state will reserve about 40% of vaccine supplies — encompasses several lower-income neighborhoods such as Oakland’s Fruitvale, North Richmond and San Francisco’s Tenderloin district. But notably absent are other areas where residents have contracted and died from COVID-19 at high rates, such as East San Jose, East Palo Alto, Hayward, San Rafael and Concord.

SAN JOSE, CALIFORNIA – MARCH 05: Galdino Ruvalcaba, 38, of San Jose rolls up his sleeve before receiving a COVID-19 vaccination shot at a new mass vaccination location at the Aloha Roller Rink at Eastridge Mall in East San Jose, Calif., on Friday, March 5, 2021. (Dai Sugano/Bay Area News Group) 

In all, just 10 Bay Area ZIP codes made the list — and not a single one is located in Santa Clara, San Mateo or Marin counties. Contra Costa has just one ZIP code listed, while Alameda has three and San Francisco two. Sonoma and Santa Cruz are likewise entirely absent.

“It’s criminal,” said Santa Clara County Executive Jeff Smith. “It means people in our county at greatest risk of the pandemic will be getting less vaccines than people in counties that have done a worse job with dealing with poverty and health risk issues for years.”

California Health and Human Services Secretary Dr. Mark Ghaly first announced the new vaccine plan, which is linked to reopening the economy, on Wednesday and released the full list of targeted ZIP codes late Thursday. The state is setting aside 40 percent of its available vaccine for those ZIP codes; as soon as it has delivered 2 million shots, restrictions will loosen to allow counties to move more quickly through the reopening system.

The state based the list on a health equity metric known as the California Healthy Places Index, which ranks census tracts based on income, education levels, health care access and other factors. Yet many communities that expected to be included — and where case rates remain high — were left out.

Santa Clara County’s 95122 ZIP code in East San Jose, for instance, has 1,358 cases per 10,000 residents — more than double the county’s rate and more than 50 percent higher than the overall California case rate. Gilroy, which like the 95122 ZIP is majority Latinx, has a case rate of 1,318 cases per 10,000 people. The state considers neither to be priority ZIP codes.

Meanwhile in Contra Costa County, officials flagged three ZIP codes — 94801, 94804 and 94806 — earlier this month for a vaccine partnership with John Muir Health using what it believed was the same “Healthy Places” criteria as the state, said former mayor and community activist Genoveva Calloway. Yet only the 94801 ZIP code covering North Richmond appeared in the state’s list. Alameda County’s Hayward and unincorporated Cherryland and Ashland are likewise on their own.

The majority of the priority ZIP codes are in Southern California.

In a press call Friday, Ghaly said that he had fielded “similar questions” from various counties about their zip codes not being included. He did not offer them additional vaccine, but said, “We’re working to ensure that all counties with the supply of vaccines they receive target the zip codes that are hardest-hit within their county.”

“I was very, very, very surprised,” said Andrea Schwab-Galindo, CEO of Tiburcio Vasquez Health Center. “How does this work? Who’s planning for this? I get that they won’t be able to please everyone, but at least be clear about it.”

Around the Bay Area, community clinics and providers have been working to prioritize vulnerable communities with drop-in sites, mobile clinics and door-to-door outreach. Yet those efforts have been hampered by scant supplies that the new rollout is partially aiming to ease.

On Friday, Santa Clara County nearly had to cancel a drop-in vaccine event in San Jose’s Alviso neighborhood because of limited vaccine doses, said Reymundo Espinoza, CEO of partner organization Gardner Health Services. The assurance of extra vaccines from the state would have been a boon.

“I can’t keep up with the demand. I’ve stretched my staff to the point where I can’t do it anymore, and I keep getting requests, ‘Can you go here, can you go there?’ to get people vaccinated,” Espinoza said.

Complicating matters is the state’s new contract with insurance giant Blue Shield, which began overseeing vaccine distribution as of March 1st. In their first public address Friday, Blue Shield officials said that they planned to bring all counties into their centralized system by the end of March. After assessing the total supply from the federal government, Blue Shield will funnel doses to counties based on their eligible populations by ZIP code, with enough vaccine reserved to ensure that the priority ZIP codes receive a double share.

Mike Callagy, San Mateo County’s manager, said that he’d gotten word from Blue Shield that the partnership will change little about how vaccines are now being distributed locally. But without a clear explanation as to why places such as East Palo Alto and Daly City didn’t make the state’s list, he’s wary of the weeks to come.

“We have those vulnerable pockets of communities here, and a life is a life,” Callagy said. “We should be getting doses to take care of people here, just like the rest of the state.”

San Jose City Councilwoman Magdalena Carrasco — whose district includes parts of East San Jose — said she and other South Bay officials are working to get an explanation from the state. On Friday, she helped open a vaccination site at East San Jose’s Eastridge Mall to better serve the nearby community.

SAN JOSE, CALIFORNIA – MARCH 05: Restaurant servers Kiely Chang, 18, center, and her sister, Ashley Chang, 20, wait in the 15 minutes observation area after getting a COVID-19 vaccination shot at a new mass vaccination location at the Aloha Roller Rink at Eastridge Mall in East San Jose, Calif., on Friday, March 5, 2021. (Dai Sugano/Bay Area News Group) 

“It’s like, what the heck, man?” Carrasco said. “Allow us to make the decisions about where the essential workers are and send it where it’s needed. Don’t handcuff us, don’t pigeonhole us, don’t decide for us. We’re going to know better who’s in our backyard.”

Staff writer Leonardo Castañeda contributed reporting.