How some states are delivering Covid-19 vaccines twice as fast as others

In comparison, Alabama and Georgia administered only 23% of their doses and five other states administered 30% or less.

When it comes to effective vaccination against Covid-19, “there is no silver bullet,” Claire Hannan, executive director of the Association of Immunization Managers, told CNN.

In faster moving states, strategic planning and communication, the use of strong local partnerships, and state ownership of the process have each played a role.

In South Dakota, conversations about vaccine planning started as early as August and continued daily, Daniel Bucheli, communications director for the state’s health department, told CNN.

“Preparation and not panic was the key,” he said. “There is daily communication, with the ability for partners to share their feedback on what is working and what is not. Open lines of communication are underway.”

Efforts to build a unified system also began over the summer in Colorado, bringing together hospital systems, emergency management, technology leaders and more for a “whole-of-state approach,” Scott said Bookman, Covid-19 Incident Commander for the state health department, to CNN. .

According to Bookman, all vaccine suppliers in the state must administer the doses they received within 72 hours. If not, the state will step in and move the unused doses elsewhere.

“You’ll hear 72 hours in Colorado all the time,” he says. “We have moved the vaccine from one place to another. And now we’re at a point where suppliers understand our expectations and how seriously we take them.

Setting expectations early and often among everyone involved has been essential, he said.

“We’ve made it a top priority. We’ve set expectations that we’re going to get there, that we’re going to save lives and bring Colorado back to normal.”

In Colorado, nearly all long-term care facilities – including nursing homes and assisted living facilities – have opted for a federal program in partnership with CVS and Walgreens to deliver vaccine doses to the priority group.

But nationally, the federal program has had mixed reactions, with some nursing home directors and other health care providers blaming poor logistics and bureaucracy for the slow rollout.

While Bookman says the program hasn’t grown as quickly as expected or hoped for in Colorado long-term care facilities, Walgreens and CVS have been great partners and the state stepped in where needed. to provide additional support staff and technology support.

West Virginia, meanwhile, has taken full ownership of vaccine administration. Hannan of the Association of Immunization Managers attributes part of West Virginia’s success to his decision to opt out of the federal long-term care facility program.

“The biggest thing we’ve done is move away from the standardized (federal) agenda,” West Virginia Governor Jim Justice told CNN.

More than 40% of West Virginia pharmacies are not affiliated with a chain and the state wanted to prioritize existing relationships, the governor said at a press briefing on Dec. 16.

“Instead, we’ve partnered with all the pharmacies in West Virginia. We felt that, from a state perspective, this would limit our ability to quickly distribute and administer the vaccine to the population in need if we had opted for the federal program ”. he said.

Acting independently, West Virginia began vaccinating in long-term care facilities about a week before the other states began.

The state has also broken with federal guidelines on priority groups to receive the vaccine first, emphasizing speed rather than details.

“There’s a real sleeping giant that’s a problem, and that’s one thing only: we, like other states, are going to take an inventory beyond belief because everyone is trying to design a program on it. how to administer the vaccines, “Justice told CNN. .

Federal leaders on Tuesday called on states to put people 65 and older and those with high-risk health conditions on the front line. However, West Virginia had previously announced an elderly resident vaccination program – Operation SOW: Save Our Wisdom – about a week earlier.

Notably, many of the states that most effectively administer their vaccine distributions are among the more rural states in the country.

Fewer health systems responsible for larger parts of the population may play a role in success, some say.

Hannan notes that in North Dakota, the state works closely with suppliers to distribute necessary supply and redistribute it as needed. The same is true in South Dakota, where a few large healthcare systems cover a large portion of the population.

“They have strong supplier relationships that cannot be replicated in large states,” she said.

In anticipation of the emergency use authorization for the Covid-19 vaccine, Monument Health in South Dakota has started creating databases of individuals in its care who would be eligible to receive the vaccine and contacting them. proactively, Dr Shankar Kurra, vice president of medical affairs, told CNN.

As one of the state’s top three healthcare providers, Monument Health covers nearly half of the state’s population and their spreadsheets and outreach activities reflect that.

“There are many reasons for success,” Kurra said. “The Department of Health and the way they communicated well when the vaccine becomes available, three health systems in the state make it a lot logistically simple, and the third factor is critical: Even with only three systems, we have taken the initiative to make it a mission to administer the doses within a week of receiving them. “