Kaiser Permanente, big player in California vaccine effort, has had trouble vaccinating own members

Reviewed by Emily Henderson, B.Sc.Mar 4 2021

As managed-care giant Kaiser Permanente assumes a prominent role in California's new covid-19 vaccination strategy, it is drawing mixed reviews from members across the country for the way it has run its own vaccine program over the past two months.

Conversations with 10 Kaiser enrollees in five states — Colorado, Washington, Virginia, Maryland and California — revealed a common frustration: difficulty snagging an appointment. Many also described receiving sporadic and sometimes confusing information from the company, though some said Kaiser has been doing better recently.

All of those who spoke to California Healthline were over age 65. Many were long-standing Kaiser members and, aside from the vaccine rollout, had mostly positive opinions of the health system. Some ended up going elsewhere for their shots; others said they would wait for Kaiser because its services were familiar to them and they felt more comfortable going there than to another site. (KHN is an editorially independent program of KFF, which is not affiliated with Kaiser Permanente.)

Kaiser's CEO, Greg Adams, acknowledged the frustrations of his company's California patients in a Jan. 30 email, explaining that the health system had received only a small fraction of the vaccine supply it needed.

Members did not blame Kaiser for the lack of vaccines, noting that insufficient supply has been the bane of providers across the country. But Kaiser could have been quicker to administer the vaccines it did receive and should have communicated more clearly about the shortage, they said.

Nino Maida, a San Francisco resident who's been a Kaiser member for 14 years, said he couldn't figure out why he was unable to get an appointment. "The frustration lasted about a month, until I got a clear indication from Kaiser that any waiting was due to a lack of vaccine," said Maida, 74. "I thought they were being very inefficient instead of just poor at communicating."

A Kaiser spokesperson defended the company's communication strategy, saying that a page on its website (kp.org/covidvaccine) provides detailed answers about vaccine eligibility and appointments, and that a link prominently displayed on Kaiser's homepage directs people there. The organization sends regular emails to members with information about their eligibility and instructions on how to set up an appointment, and call center operators also can answer members' questions, he said.

Clearly, Kaiser Permanente isn't the only organization encountering vaccination roadblocks. Sutter Health, the large Northern California health system, for example, may have to cancel 95,000 vaccination appointments because it doesn't have enough vaccine on hand, company spokesperson Amy Thoma Tan said Wednesday.

But Kaiser, which is both an insurer and medical provider, has drawn particular scrutiny because of its size and because it has been chosen to play a significant part in state efforts to speed covid vaccinations.

The company, which covers 12.4 million people in the U.S., including 9.3 million Californians, was also fined nearly $500 million for workplace safety violations early in the pandemic.

A memorandum of understanding with the state, released last week, stipulates that Kaiser will be part of a vaccination provider network assembled and overseen by Blue Shield of California, which signed a contract on Feb. 1 to administer the statewide inoculation plan. Kaiser will also serve as an adviser to Blue Shield to help the state meet its goal of expanding vaccine access to the most vulnerable communities, the memorandum says.

Under the agreement, Kaiser will receive no state funds. It will operate two mass vaccination sites — one at San Francisco's Moscone Center, the other at California State Polytechnic University-Pomona, in Los Angeles County — and "may consider the establishment of future mass vaccination sites" that would target rural Californians and those with historically lower vaccination rates. Importantly, Kaiser will vaccinate members and nonmembers, as it has already been doing on a smaller scale.

The memorandum acknowledges the supply constraints Kaiser has faced, saying the state "shall ensure that Blue Shield understands that Kaiser is dependent on sufficient supply of the vaccine."

Kaiser did not start vaccinating people age 65 and older — in line with state guidelines — until well after other providers had begun doing so. And some longtime Kaiser members were disappointed by the lag.

"It is not good PR to have week after week of news showing the four largest health care providers in Northern California, and Kaiser is the only one still working on staff and people over 75 years old," said Elizabeth Wieland, 66, of Elk Grove, California, a member for 30 years.

When Kaiser sent an email to patients on Feb. 13 encouraging them to "get vaccinated somewhere outside Kaiser Permanente" if possible, it felt as if they were "throwing in the towel," Wieland said. "It's 'fend for yourself.' Not what I would have expected, but that seems to be the new normal."

On Feb. 20, Adams sent an update to members informing them the supply outlook had improved, because "the state has increased Kaiser Permanente's weekly vaccine allocation to better match the number of members we serve." As a result, the CEO said, Kaiser was able to start scheduling appointments for people 65 and up.

Kaiser is also vaccinating people 65 and up in Washington state, Virginia and Georgia, a spokesperson said.

Member complaints were not only about the slow rollout. Members said that Kaiser sometimes posted key vaccination information in hard-to-find places, and that they often heard things by word of mouth before they heard it from the company. Some said that, once they managed to sign up for a vaccination, they were promised email updates that never arrived. Still others said that, after getting on Kaiser's vaccination waiting list, they were suddenly bumped further back in the line with no explanation.

Janet Vorwerk, a retired Kaiser operating room nurse who lives in a suburb of Denver, said that when she got on Kaiser's waiting list in January, she was No. 20,991 in line. On Feb. 15, she dropped all the way down to 9,989, then inexplicably bounced up to 11,258 two days later, which she said was "so disheartening." As of last Friday, she was No. 10,269.

"I don't understand how the numbers are getting jacked around, up and down," said Vorwerk, 66. Still, she blames the circumstances more than she blames Kaiser. "I understand where they're coming from," she said. "You can't pull a vaccine out of your backside. But at the same time, it would be good to have a better idea of when it might happen."

Some members said Kaiser's performance has improved recently.

For Tom Spradley, an 84-year old resident of Citrus Heights, California, initial frustration with Kaiser gave way to a happy ending. He said he called Kaiser for an appointment about a month ago and was on hold for two hours before giving up. He then started checking Kaiser's vaccine page every day for updates, but said none came for several days.

Finally, he was able to get an appointment for himself and his wife at a Kaiser site in Sacramento, about 20 minutes away. The appointment, he said, was a model of efficiency. They got their first shots and were scheduled for second doses March 12.

"After a week of bad information on getting a shot, I think they have really come through, and I was really impressed by the job they did," Spradley said.

This story was produced by KHN, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.