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“The 360” shows you various perspectives on the main debates and debates of the day.
What is happening
Public health officials across the United States have spent months developing strategies to distribute the first precious doses of the coronavirus vaccine. But now, just weeks after the vaccine’s launch, many of those initial plans have already been scrapped.
Initially, most states reserved the vaccine for frontline health workers and older people in long-term care facilities, anticipating that limited supplies would be the biggest obstacle to widespread immunization. But logistical bottlenecks quickly proved to be another major challenge. Many states have struggled to find eligible recipients for the vaccine supply they have, forcing life-saving doses to remain on the shelves and – in some cases – to be thrown away. As of Wednesday, only 53 percent of the 44 million doses of vaccine that have been distributed to states have been used.
In mid-January, the Trump administration released new guidelines recommending expanding eligibility to include all people 65 years of age and older and people with certain medical conditions – groups totaling more than 150 million of people. More than half of states have followed suit by establishing eligibility criteria based on age. But it created its own challenges. In some parts of the country, demand has significantly exceeded supply, causing long lines and confusion.
Why there is debate
The abrupt shift in distribution plans highlights a central tension that health officials have struggled with in shaping their strategies: should the goal be to protect those most at risk or to get vaccinated as much? as many people as possible?
Supporters of a targeted strategy say the top priority should be to reduce the number of deaths. Although they represent only a fraction of the nation’s population, residents of long-term care facilities like nursing homes account for more than 35% of COVID-19 deaths in the United States. Expanding vaccine eligibility to other groups before the most vulnerable are protected could lead to thousands of unnecessary deaths, some say. Getting rid of job-based eligibility will also put essential workers at risk who are most likely to contract and spread the virus, they say.
The drastic increase in the number of people seeking the vaccine is creating room for inequalities and even outright abuse, others say. Without targeted eligibility, well-connected people who are at risk of being at relatively low risk will be able to get vaccinated, while people with less access to health care, who are disproportionately people of color, will not. not.
Others say speed should be the # 1 goal, even if that means protection doesn’t go to those most at risk. Overly complex eligibility criteria based on people’s living situation or profession create confusion and stall the process. With some 250 million Americans needing to be vaccinated to achieve herd immunity, anything that slows the distribution will make the pandemic last longer, they say. It is also hoped that vaccine shortages will be less of a problem with the Biden administration promising to purchase an additional 200 million doses of the two vaccines currently in use and the possibility that more vaccines will be available in the near future.
And after
Public health experts hope the approval of new vaccines will help resolve many of the supply issues plaguing vaccine deployment in the United States. Special attention is given to a vaccine candidate from Johnson & Johnson, which requires only one dose as opposed to the two doses required for the Pfizer and Moderna vaccines already on the market. Johnson & Johnson announced promising results from its clinical trials on Friday and are expected to seek emergency approval for distribution in the United States as early as next week.
Perspectives
Focus on the most vulnerable
Speeding up vaccinations doesn’t mean giving up all the rules
“The increase in the volume of vaccinations does not necessarily have to come at the expense of administering doses to people most exposed to Covid-19. Because it is important to ensure that those vaccinated meet current eligibility criteria, mass vaccination clinics can focus on people over 65, whose age can be easily verified. – Thomas J. Bollyky, Jennifer B. Nuzzo and Prasith Baccam, New York Times
With virus spreading rapidly, limiting deaths should be top priority
“If the vaccine is rolled out slowly, which is currently the case, and if community transmission is high, which is also the case now, then it is best to prioritize adults over 60 to minimize mortality. . ” – Daniel Larremore, Public Health Data Specialist at NPR
Older people are most at risk and should be at the center of immunization efforts
“The coronavirus is not an equal opportunity killer. The vast majority of its victims were elderly. – Editorial, Las Vegas Review-Journal
Limiting eligibility will help avoid line breaks
“Generally speaking, having a high demand for COVID-19 vaccines is a good problem. … But until we reach a point where there is more supply than demand, the scarce doses should only go to those most in need of protection, not to the highest bidder. – Editorial, Los Angeles Times
Wide eligibility will worsen racial disparities in health
“The bottleneck is about to get worse, and we fear that communities of color are being left further behind.” – Editorial, Baltimore Sun
Without targeted vaccinations, the most vulnerable will be left behind
“A ‘first come, first served’ approach will leave out many of the most vulnerable, who may not be able to call a hotline as soon as it opens or will camp overnight for the shot. Those with connections will almost certainly find a way forward, and access rather than need will determine someone’s place in the line. – Leana S. Wen, Washington Post
Focus on speed
The goal should be to administer as many vaccines as possible per day
“The public health imperative is to distribute vaccines quickly, even if the sequence is imperfect. … Our collective imperative is to put it in as many arms as possible to strengthen our cumulative defense as the virus increases. – Editorial, (Newark) Star-Ledger
Expand eligibility to avoid waste, but step up efforts to vaccinate the most vulnerable
“We need to release all available doses of the Covid-19 vaccines – but we need to go further by expanding the categories of people who can get the vaccine to avoid wasting doses and simultaneously increasing funding and support to get the vaccine in. people’s arms in different ways. that explicitly address equity considerations and do not allow people to use their influence or resources to cut the line. – Megan Ranney, CNN
Too complex criteria can lead to wasted doses
“Unfortunately, a complex, multi-layered approach presents a barrier to vaccine delivery. Who will make sure that a person is a critical worker or suffers from a certain illness? Do you bring a pay stub or a note from your doctor to the clinic or pharmacy? What is considered an underlying condition? This adds delay and can lead to vaccine wastage if vaccinators do not have enough people available to receive vaccines before doses expire. – Linn Goldberg and Louis Speizer, Oregonian
Strict eligibility criteria slow efforts to end pandemic
“Americans have been warned… there will be a vaccine shortage. Health officials were instructed to adhere to a strict prioritization schedule, which created a “shortage mentality” that slowed the distribution of available vaccines. »- Arielle Kane, La Colline
Protecting vulnerable people must be an objective, not a strict mandate
“The part that needs to change is strict respect for the pecking order. This is only given as an indication, but is applied too strictly. … It is tragic that regulations hinder vaccinations. – Marc Siegel, Fox News
Broader criteria will help fight vaccine skepticism
“Ensuring that everyone who is already convinced of the vaccine’s effectiveness has access to inoculation should be our first priority. Transitioning to a first come, first served model is the most effective way to achieve this. This is the obvious first step in ensuring that an adequate amount of the American population is vaccinated, as it relieves the burden of convincing skeptics. – Anthony DiMauro and Leonard Robinson, Business Insider
If the rules are too complicated, vulnerable people will get lost in the shuffle
“The prioritization patterns in many states are complicated and vague. It may all seem like a way to ensure fairness, but in reality we know from similar programs that those with more connections, free time and know-how will be better able to navigate this maze. while the process slows it down for everyone – especially those who need it. – Zeynep Tufekc, New York Times
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Photo illustration: Yahoo News; photos: Getty Images
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