Like many older Americans, my dad wanted to get his COVID-19 vaccine, but the process of signing up for an appointment was frustratingly complicated. In his home state of Oklahoma, there were several sites. However, it was not clear whether each site offered the same appointments or different offers. And refreshing the page at the right time to capture a coveted spot was impossible. “I have my annual examination tomorrow,” he told me. “Can’t I just get the vaccine from my doctor?”
Unfortunately, the answer was no. Americans are used to thinking of their doctor’s offices as the place to go for vaccinations, but the spread of the COVID-19 vaccine has largely bypassed primary care physicians. This is what doctors have been frustrated about recently. In a survey among doctors in primary care, 32 percent said they were not involved in any state or regional planning and that they had no idea if they would get vaccines for their patients. Years of surveys, however, suggest that physicians in primary care are the most reliable source of information on vaccines and vaccine safety. In a 2015 survey of Oklahoma residents, for example, it was found that 81 percent trust their healthcare providers for health information – this is compared to 24 percent who said the Internet is a reliable source. (Presumably their daughters writing on the internet is higher than that.)
The exclusion of primary care physicians is just one of the many ways in which a pandemic vaccination differs from the normal, everyday process of getting people vaccinated. We have a process that we know works – experts I spoke to described the normal vaccination system of the United States as one of the best in the world. So why not use it in a pandemic?
Because everything – from the logistics of the vaccines to the patients themselves – is different.
There are a number of reasons why people like my father can not just go to their primary care doctor for a COVID-19 vaccine, said Julie Swann, a professor and head of the department of industrial and systems engineering in Northern Carolina, said. The storage and distribution needs of the different vaccines, especially the requirements for ultra-cold storage, are a big part of this. Initially, the Food and Drug Administration said the Pfizer vaccine should be stored between -112 degrees Fahrenheit and -76 degrees Fahrenheit – something most doctors cannot do. They also do not have the ability to vaccinate as many people per day as public health experts deem necessary to combat the virus effectively.
“What is the maximum number of doses that the doctor’s office will give in one day?” says Swann. ‘Even if you have more of these individual doctors, if you have 10 mass vaccination sites and each do 5,000 shots a day, how many doctors will you need if the doctors only give 100? [vaccinations] per day? ”
There are also time constraints on how quickly each bottle of vaccine should be used once it is opened, said Julie Murphy, a senior administrator of the nonprofit Coalition for Immunization Actions. “We’re used to disposable bottles or pre – filled syringes in the fridge,” she said. Even when other vaccines are in multi-dose vials, they are stabilized with preservatives that work well in a primary care environment, where you are likely to go through five doses over a few days, but not necessarily in the six days. hour extract requiring the preservative-free COVID vaccines.
The absence of doctors in primary care is not the only way in which the distribution of COVID vaccine differs from normal. Vaccinations, for example, are usually not free to the public or are granted to states by the federal government. There are also usually no reporting requirements that someone who distributes vaccines must regularly submit information about the stock that is in their stock. The distribution process has changed in several ways – even from state to state or country to country. And while there are many ways to make the distribution of vaccines wrong, experts have said that there is also no single way to do it right.
In fact, it is important to remember that the distribution of vaccines is different from anything we have ever done before, said dr. Yvonne Maldonado, professor of infectious diseases in children at Stanford University, said. No one has ever tried to eradicate a pandemic in real time. According to her, the closest analogy is probably the elimination of smallpox, and it did not have such a short time limit. It is therefore no wonder that what we do now does not always look like what we did in the past.
But that does not mean that experts ignore the lessons of vaccinations in the past. In fact, during the H1N1 pandemic, Swann was part of a team modeling pandemic supply chains for the Centers for Disease Control and Prevention. One of the things she did was analyze which types of vaccine distribution sites were most effective. “States that sent more vaccine to places where people had easier access gave higher doses to high-risk adults.” When she says places that are more easily accessible, she means pharmacies.
Pharmacies are open after working hours and on weekends and without the need for a prior relationship with the patient, very effective in getting faster vaccinations in more people. Prior to the H1N1 pandemic, however, pharmacists only allowed vaccination in some countries. The lessons learned in the pandemic eventually changed laws nationwide, and now pharmacies are not only a normal place to get flu vaccine, but also a big part of the COVID-19 vaccine response.
However, mass vaccination sites can leave a confidence gap in who is vaccinated. They are good at vaccinating many people quickly – not necessarily good at vaccinating everyone. When the Kaiser Family Foundation surveyed Americans about the COVID-19 vaccines in December, they found that 39 percent followed a “wait and see” approach – they did not want to be one of the first and fastest to get the vaccine. However, the same group showed a lot of confidence in their doctors to tell them which vaccine is safe and when it is safe to get it – 87 percent of the waiters and nurses trust their own healthcare providers. Primary care physicians are likely to become an important part of COVID vaccination later, Murphy said that when more people are vaccinated, it means ‘the reluctant people are vaccinated’.
In the meantime, however, primary care offices could help with another vaccination problem with pandemic – catching up with Americans with the everyday vaccines they have missed over the past year. “We followed the decline in immunization rates in all age groups for all the other diseases,” Murphy said. “This is a serious concern.”
It’s a pandemic, but your health is important only in the way you become COVID. For older adults, it is quite important to go to a physical dose annually, even if no valued dose of vaccination awaits. So this is what my father did. And then, despite his annoyance with the system, he made a separate appointment to get his COVID-19 vaccine.