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© Denise Cathey / Associated Press
In south Texas, a man slept in his car for two nights in a row so as not to lose his place in a line of hundreds at a mass vaccination event. In western Kentucky, residents signed up for online immunization slots, only to find out when they arrived that their doses had been taken by walk-in people. In New Mexico, state officials have rushed to hire more people to staff a vaccination hotline after they were inundated with calls.
The biggest challenges of the U.S. Covid-19 vaccination effort turned out to be getting vaccines in the arms of the right people. As of Friday morning, some 31 million doses of the vaccine had been distributed nationwide, but only about 12 million had been administered, according to the Centers for Disease Control and Prevention.
The federal government has shipped these doses to states across the country, with states setting their own criteria for determining who should get vaccinated first. But the onus is on local health departments, hospitals and other providers to actually deal with the logistical tangled up, and many have not been able to do so effectively.
The result is an erratic and rambling process that sows frustration and confusion across the country.
Jeff Duchin, public health manager for Seattle and King County, Washington, said the federal government had been successful in helping fund and purchase vaccines that had been developed in record time, but said it was not doing enough to ensure that the -mile ‘distribution efforts would be successful.
“Operation Warp Speed gave us two Cadillac vaccines with empty gas tanks,” he said.
Dr Duchin said that while the county has set up four clinics, it has been difficult to link unaffiliated health workers in hospitals to health providers. Officials are currently planning two large-scale vaccination sites, he said, which are complicated to organize but are the most effective way to vaccinate teachers, public transport workers, police and the general public. . If everyone needs to schedule one-on-one appointments, “we’ll never get there,” said Dr Duchin.
The confusion is only growing as many states move from vaccinating health workers and nursing home residents to people over 65 or with pre-existing conditions. California, Texas and Arizona are among the states that are launching mass vaccination sites in places such as sports stadiums.
Suppliers across the country said they had so far received little guidance on how to implement eligibility criteria, no funding to manage staffing and planning, and no guidance the number of doses they would receive at any one time. Oscar Alleyne, director of programs for the National Association of County and City Health Officials, said the long lines and blocked phones show how much responsibility has been thrown on local officials without preparation .
“Most are struggling,” he says. “There is a lack of communication, a lack of understanding with the systems that have been developed, no visibility into how the state’s plans are going to be implemented on the local front.”
Health officials have said they hope $ 8 billion in a recent stimulus package passed by the federal government would help local ministries that have been underfunded for years. President-elect Joe Biden on Friday presented a plan that includes federally-backed community immunization centers, mobile clinics to reach underserved populations, funding for more public health workers, and reimbursement from states for the deployment of the National Guard to distribute doses.
Health officials at the Barren River District Health Department in Bowling Green, Ky., Were looking for new software systems to schedule appointments in mid-December when they discovered upcoming doses, forcing a quick choice, said Janarae Conway, director of disaster preparedness. “We really didn’t have time to test it,” she says.
Administrators allowed the system to continue accepting appointments online after printing a calendar, which allowed people to come in to see their time slots being distributed to walk-in people.
New Mexico Secretary-designate of Health Tracie Collins said her department was hiring more staff after people recently couldn’t go through phone lines when the state expanded eligibility to people over 75 years old.
Texas State Representative Vikki Goodwin said after the state granted eligibility to anyone over 65 on December 28, her constituents rushed to call grocery stores and pharmacies for appointments only to be told there weren’t enough doses for it yet.
“It’s crazy that people have to call to see which different vendors have the vaccine, rather than having a central place,” Ms. Goodwin said. “People think we’ve had months and months to prepare for this.”
Meanwhile, due to issues with Texas’ supplier approval system, some rural hospitals have not received vaccines for frontline healthcare workers, according to the Texas Rural and Community Hospitals Organization. .
In the Rio Grande Valley in south Texas, Rolando Zarate, a 54-year-old diabetic, stocked his van with blankets and food before rushing to beat others for a mass vaccination. He was shot after waiting 30 hours.
“I was, like most countries, worried [Covid-19] for nine months, ”Zarate said. “I said, I don’t care how long I have to wait.
The disorganization has led some ineligible people to get vaccinated by chance. When Seyward Darby saw a healthy friend from the early 1930s in Washington, DC post on Instagram that he had received one, she asked how. He said he picked up Hot Pockets to eat at Safeway when the store announced he had extra doses to use, she said.
With limited guidance from states beyond the rules on who is eligible and limited resources for outreach, vaccine suppliers in some cases fail to reach everyone in the surrounding community, raising concerns about the equity in health.
Ruben Becerra, the elected executive of Hays County, south of Austin, said some providers are focusing on their own patients, excluding people without a primary care physician.
“Some facilities have said, ‘Well you have to have a relationship with us and we have to do an assessment before we give you the vaccine,’ he said.
In Washington, DC, Dana Mueller, director of adult and family medicine at Mary’s Center, said the district had submitted lists of people who signed up for the 24-hour health center vaccination to the advance – not enough time for staff to set up an automated call-back system. This has led to confusion as to when people are supposed to show up and whether they have confirmed the slots, Dr Mueller said.
“It’s still very localized,” Dr. Mueller said. “It’s the small-scale effort that makes it look like you’re going to be vaccinating people for years to come.”
Write to Elizabeth Findell at [email protected], Jared S. Hopkins at [email protected] and Dan Frosch at [email protected]
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