Vaccine Roll Out… A Numbers Game

Vaccine Roll Out… A Numbers Game

Vaccinations in the U.S. began Dec. 14 with health-care workers, and so far 22.4 million shots have been given, according to a state-by-state tally by Bloomberg and data from the Centers for Disease Control and Prevention. In the last week, an average of 1.16 million doses per day were administered.  

It was unrealistic to assume that a nationwide, nay worldwide, roll out of a vaccine would be obstacle or hiccup free.  But here we are – approximately 6 weeks into the Coronavirus vaccine and according to the Bloomberg we have surpassed Biden’s timid 100-day goal of a million/day.  This is great news!

What can we learn from the largest vaccine rollout ever attempted in the history of the world?

News reports that the two biggest hurdles are vaccine supply and availability of skilled personnel to administer the vaccine. Supply issues are not a surprise given that the US needs a minimum of 54 million doses to vaccinate the 65+ years population and producing that much vaccine simply takes time.  Expectations that the vaccine supply would more than meet the initial demand were not realistic.  

News reports also highlight weak or lackluster planning efforts on the part of local jurisdictions.    As Michael Curry, Esq. of the Massachusetts League of Community Health Centers noted, “I don’t think any state was prepared.”  Some planning efforts were also downright dumb.  Jurisdictions have blamed the federal government (Trump) for a lack of resources to administer the vaccines such as the Mayor of Cleveland who said “that the problem is the lack of supply and time to build an infrastructure through which to distribute the vaccine.”  

Others, including Curry in Massachusetts, blamed a lack of a coordinated communication campaign about the vaccines.  “We have to have a strong media campaign, social media & traditional media to reach people and then package it in a way that we can introduce them to the efficacy and safety of this vaccine,” he said.  Given the vociferous criticism from citizens about the uneven roll out, citizens seem very well informed.  They are frustrated, not ignorant.  

But not every state has encountered these issues.  Why have states like West Virginia (WV) avoided these pitfalls?  It is useful to understand what states like WV did that allowed them to succeed in getting their most vulnerable vaccinated in record time.  As reported in Futurity, WV took a proactive approach and established a “whole of medical community” approach to accelerate vaccinations.  “…they …chose not to participate in the Federal Pharmacy Partnership…[but] used their organizational skills and connections to mobilize all the chain and independent pharmacies, not just CVS and Walgreens, to partner with nursing homes.”  The Federal Pharmacy Partnership was established to assist in the roll out of vaccines to long term care facilities.  It relies on a limited number of pharmaceutical networks to vaccinate nursing home residents which unfortunately “turned out to be much slower than expected, owing to limited staffing and paperwork issues that were not addressed in advance.”  WV “used the two-week waiting period after the FDA authorization of the Pfizer vaccine to do what it takes to match supply and demand. Unfortunately, most other states chose a passive approach and allowed small problems to turn into bigger ones.”

Does this fully explain why only 50% of the vaccines distributed have been administered? No but it provides insight into what type of thinking is necessary when one is dealing with a massive, unprecedented logistical challenge.  Understanding your environment and its unique challenges, being willing to think proactively and creatively to meeting those challenges, being adaptable when the inevitable hurdles occur, and focusing on results are what is needed.  Blaming and whining are time wasters.  From my local jurisdiction’s perspective, our greatest hurdle is lack of supply.  The jurisdiction has more than adequate capacity to administer the vaccine if the supply were available.  It’s a numbers game at this point.  There are just more people than doses.

Maybe Trump and/or Biden should have embraced a stronger martial program relying on the military and or national guard to administer the vaccines, setting up vaccination hubs in all 50 states manned by military personnel.  Unfortunately, even that approach would not have alleviated the supply issue. It just takes time to produce vaccines.  These are not widgets.  The numbers and production will unite.  Just not sure when.

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