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PROVIDENCE, RI – Public health officials have been sounding the alarm bells for months, complaining that they don’t have enough support or money to quickly put COVID-19 vaccines up to speed. Now, the slower-than-expected start to the biggest vaccination effort in U.S. history proves them right.
As they strive to accelerate the fire, state and local public health departments across the United States cite a variety of obstacles, including a lack of leadership from the federal government. Many officials fear that they will lose precious time during the height of the pandemic, and delays could cost lives.
States lament a lack of clarity on how many doses they will receive and when. They say more resources should have been spent on education campaigns to allay the concerns of people who fear getting vaccinated. And although the federal government recently approved $ 8.7 billion for the immunization effort, it will take time to reach places that could have used the money months ago to prepare to deliver more vaccines. effectively.
Such complaints have become a common refrain in a country where public health officials have been left largely alone to resolve complex issues.
“The recurring theme is the absence of a national strategy and the attempt to pass the responsibility down the line, lower and lower, until the poor who receive it have no one else to send it to. bullet, ”said Gianfranco Pezzino, who was responsible for public health in Shawnee County, Kansas, until his retirement last month.
Operation Warp Speed, the federal immunization program, had promised to deliver enough doses to immunize 20 million people in the United States as of December. He missed that target and by Friday around 6.6 million people had received their first shot. About 22 million doses have been delivered to states.
The American Hospital Association has estimated that 1.8 million people need to be vaccinated daily from Jan.1 to May 31 to achieve systemic immunity by the summer. The current rate is less than over a million people per day.
President-elect Joe Biden on Friday called the deployment a “travesty,” noting the lack of a national plan to pump up doses and reiterating his pledge to administer 100 million shots in its first 100 days. He did not share details and was due to discuss the effort this week. His office announced a plan to release most doses immediately, rather than keeping second doses in reserve, the more conservative approach taken by the Trump administration.
The Trump administration defined its primary role as developing coronavirus vaccines and delivering them to states, which would then take over and ensure that vaccine doses travel “the last mile” in the arms. Each state has had to develop its own plan, including issuing guidelines for who gets vaccinated first. Several health experts have complained about this approach, saying it leads to confusion and a patchwork response.
“Let’s just say I was disappointed with the way they handled the testing, and the rollout of the vaccine reminded me of how disappointed I was when they handled the testing,” said Dr Mysheika Roberts. , health commissioner in Columbus, Ohio.
Several public health officials and experts say they believe some of the early problems are disappearing. Marcus Plescia, chief medical officer for the Association of State and Territory Health Officials, said the slow start shouldn’t be surprising given the immense scale of the task.
“It was not going to be transparent,” he said.
Still, Plescia said the federal government could have done more ahead of deployment – such as unlocking billions of dollars earlier to help with staffing, technology and other operational needs.
An ongoing investigation by the Associated Press and Kaiser Health News has detailed how state and local health services have been underfunded for decades. Public health officials have warned since the spring that they lack the staff, money and tools to deploy a vaccine. The money wasn’t approved until the end of December.
The distribution of vaccines involves a long and complex chain of events. Each dose should be followed. Providers need to know how many staff they will need. Eligible people should be made aware of their vaccine schedule, considering vaccine handling requirements and the need to observe people for 15 minutes after the shot – while respecting social distancing.
It is difficult to plan too far in advance because the number of doses the condition receives can fluctuate. Hospitals cannot get all their workers vaccinated on the same day due to possible side effects and staffing issues, so they must be spaced out.
Rhode Island health officials said it could take up to seven days for doses to be distributed to people once they are received. Officials in several states, including Rhode Island, Pennsylvania, Kentucky and New Jersey, said the lack of supplies was one of the biggest obstacles to getting more people vaccinated.
Some communities have seen large numbers of medical workers delaying the vaccine, even though they are on the front lines. Columbus, Ohio, had lower-than-expected demand among priority groups, including emergency medical workers.
A public education campaign could have helped alleviate the reluctance of healthcare workers that slowed the rollout of the first vaccines, said James Garrow, spokesperson for the Philadelphia Department of Health. Instead, for months officials talked about how quickly they were developing the vaccines – which didn’t help alleviate concerns that it might not be safe.
“There just weren’t any good messages about security and the adequacy of security protocols,” Garrow said.
The federal government has done little to provide information resources that local authorities can tailor to their own communities, to address the concerns of people such as pregnant women or black men living in rural areas, Dr Michael said. Osterholm, an infectious disease expert at the University. from Minnesota, who is a member of Biden’s COVID-19 advisory committee.
“You don’t need 50 different states to do this kind of work. What you want is an assortment of information sources that cater to different populations that any state can use, ”Osterholm said. “That’s what we don’t have at the moment.”
Some states are getting creative. Oregon hosted a mass vaccination event at the state fair with help from the National Guard. The governor said he aimed to vaccinate 250 people per hour. New Jersey plans to open six vaccine “megasites” where officials hope more than 2,000 people a day can eventually get vaccinated.
But without a federal plan, such efforts can boil down to “throwing spaghetti at a wall to see what sticks,” said Chrissie Juliano of the Big Cities Health Coalition, which represents metropolitan health departments.
What is needed is a national, wartime-style effort to distribute the vaccines to as many people as possible, several experts said. Medical emergencies can be covered 24 hours a day, seven days a week, said Pezzino, who is also a senior researcher at the Kansas Health Institute. Why not make vaccinations available according to this schedule?
“It’s possible. It’s doable,” he said. “I don’t see the level of urgency, the sense of urgency in anyone here. And it’s really, honestly, that’s the only thing that could make a difference.
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