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Despite the clamor to speed up the U.S. vaccination campaign against COVID-19 and bring the country back to normal, the first three months of the deployment suggest that faster isn’t necessarily better.
A surprising new analysis has found that states such as South Carolina, Florida and Missouri that have raced ahead of others to bring the vaccine to growing groups of people have vaccinated a smaller proportion of their population than those who moved more slowly and methodically, like Hawaii. and Connecticut.
The explanation, as experts see, is that the rapid expansion in eligibility caused an increase in demand too great for some states to handle and led to severe disarray. Vaccine supplies were found to be insufficient or unpredictable, websites collapsed and phone lines were blocked, causing confusion, frustration and resignation to many.
“The infrastructure just wasn’t ready. It kind of backfired on him, ”said Dr. Rebecca Wurtz, infectious disease physician and health data specialist at the University of Minnesota School of Public Health. She added: “In a hurry to satisfy everyone, the governors satisfied few and frustrated many.”
The results could hold an important lesson for governors across the country, many of whom have announced dramatic expansions in their deployments over the past few days after being challenged by President Joe Biden to make all adults eligible for vaccination. here May 1.
“If you’re more focused and focused, you can do a better job,” said Sema Sgaier, executive director of Surgo Ventures, a nonprofit health data organization that conducted the analysis in collaboration with the ‘Associated Press. “You can open it – if you have the infrastructure in place to quickly vaccinate all of these people.”
Many factors have hampered the immunization performance of states. Conspiracy theories, miscommunication and unreliable shipments slowed efforts after the first vials of the precious vaccine arrived on December 14.
But the size of the eligible population was still under the control of state officials, who made widely varying decisions about how many people they invited to line up when there weren’t enough vaccines to circulate. .
When the campaign began, most states put healthcare workers and nursing home residents on the front lines. In doing so, the States complied with the national recommendations of the experts who also suggested doing everything possible to reach all members of these two groups before moving on to the following categories.
But in the face of political pressure and public outcry, the governors rushed in. The outgoing Trump administration and the incoming Biden team have urged opening up vaccinations to older Americans.
By the end of January, more than half of the states had opened to seniors – some 75 and over, others 65 and over. This is where the real problems started.
South Carolina expanded eligibility to people in Steven Kite’s age group on January 13. Kite, 71, immediately booked a vaccination at a hospital. But the next day, her appointment was canceled along with thousands more due to a vaccine shortage.
“It was frustrating at first,” Kite said. After a week of uncertainty, he postponed his schedule. He and his wife are now vaccinated. “It worked well. I know they had other problems. Dose administration was very unreliable. “
In Missouri, shortages in major cities have pushed vaccine seekers to travel hundreds of miles to rural towns. Dr Elizabeth Bergamini, a pediatrician in the suburbs of St. Louis, led about 30 people to often out of reach vaccination events after the state opened eligibility to people 65 and older on Jan. 18, then widened.
“We went from needing to vaccinate several hundred thousand people in the Saint-Louis area to half a million more people, but we still hadn’t vaccinated that first group, so it was this mad rush. ”Said Bergamini. “This has just been a hot mess.”
“It got a little chaotic,” said Dr Marcus Plescia, chief medical officer of the Association of State and Territory Health Officials. “We created a lot more demand than supply. It messed up the system and maybe it made the system less efficient. “
Plescia said the analysis suggested that “a more methodical, measured, judicious, and priority-based approach – despite people’s perceptions – may in fact be as effective, or more effective, than opening things up and make them available to more people.
In retrospect, health workers and nursing home residents were the easiest groups to immunize. The doses could be delivered to them where they lived and worked.
“We knew where they were and we knew who they were,” Wurtz said. As soon as states overtook these populations, it became more difficult to find the right people. Residents of nursing homes live in nursing homes. People 65 and over live everywhere.
West Virginia turned the tide with both a high number of eligible residents and high vaccination rates in early March, but the state started slowly and built capacity before expanding eligibility. .
Likewise, Alaska maintained a high vaccination rate with a smaller eligible population, and then launched vaccines every 16 and up on March 9. This sharp increase in eligible adults towards the end of the study period led the AP and Surgo Ventures to omit Alaska from the Analysis.
Analysis found that as of March 10, Hawaii had the lowest percentage of its adult population eligible for vaccination, at around 26%. Yet Hawaii had administered 42,614 doses per 100,000 adults, the eighth highest rate in the country.
Thirty percent of Connecticut’s adult population was eligible as of the same date and he had administered doses at the fourth highest rate in the country.
In contrast, Missouri had the largest percentage of its eligible adult population at around 92%. Still, Missouri had distributed 35,341 doses per 100,000 adults, ranking 41st among states.
Seven states in the bottom 10 for overall immunization performance – Georgia, Tennessee, Texas, Florida, Mississippi, South Carolina, and Missouri – had larger than average shares of their eligible residents. vaccines.
Among the top performing states, five in the top 10 for high vaccination rates – New Mexico, North Dakota, Connecticut, Wyoming and Hawaii – ended up with more restrictive eligibility. Two other top-10 high-performing states – South Dakota and Massachusetts – had roughly the average number of residents eligible for the vaccine.
“This is an in-depth analysis showing a clear association between the extent of eligibility and vaccination rates across states,” said Dr. Mark McClellan, a former chief of the Food and Drug Administration who was not involved in the reanalysis, but reviewed it for AP.
Best performing states could achieve results by paying more attention to vaccine supply, carefully vaccinating high-risk groups, and then opening up more slowly to additional categories while waiting for supplies to build, McClellan said.
What happens next will depend on how well states can improve their vaccine delivery systems and Americans’ willingness to be vaccinated, even as the threat abates with more people protected and the number of cases. falling.
“Have states used this period wisely and fruitfully to put in place the necessary infrastructure to open it up to more people?” Sgaier asked.
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Associate Press Editor Heather Hollingsworth in Mission, Kansas contributed to this report.
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