© Denise Cathey / Associated Press
In South Texas, a man slept in his car for two nights in a row so that he would not lose his place in a row of hundreds of people during a mass vaccination event. In Western Kentucky, residents registered online for vaccination slots, only to find out on arrival that their doses had been taken per walk-in. In New Mexico, government officials scrambled to hire more people to man a vaccination phone after it was overrun by callers.
The biggest challenges in America’s Covid-19 vaccination effort seem to be getting shots into the arms of the right people. According to the Centers for Disease Control & Prevention, about 31 million doses of vaccines were distributed nationwide on Friday morning, but only about 12 million were administered.
The federal government has sent the doses to countries in the country, with states setting their own criteria for who should get the vaccine first. But it is the local health departments, hospitals and other providers who have to manage the tangle of logistics, and many are unable to do so effectively.
The result is a volatile and uninterrupted process that causes frustration and confusion across the country.
Jeff Duchin, a public health official from Seattle and King County, Wash., Said the federal government was able to fund and buy vaccines developed in record time, but said it had not done nearly enough to to ensure that the “last-mile” distribution efforts would be successful.
“Operation Warp Speed gave us two empty gas tanks with Cadillac vaccines,” he said.
Dr. Duchin said that although the province had set up four clinics, it was difficult to connect non-hospital healthcare workers to providers. Officials are currently planning two large vaccination sites, which he says are complicated, but the most effective way is to vaccinate teachers, transport workers, police and the general public. If everyone has to plan separate appointments, “we’ll never get there,” said Dr. Duchin said.
Confusion only increases as many states transition from immunizing health workers and residents of nursing homes to people older than 65 years or with pre-existing conditions. California, Texas and Arizona are among the states starting mass vaccination sites in places like sports stadiums.
Suppliers across the country said they have so far received little guidance on implementing admission requirements, no funding for staff management and planning and no indication of how many doses they will receive at any one time. Oscar Alleyne, chief program officer of the National Association of County and City Health Officials, said long queues and pinned phones show how responsibility has been thrown at local officials without preparation.
“Most struggle,” he said. “There is a lack of communication, a lack of understanding with the systems that have been developed, and no visibility of how the state plans will be implemented on the local front.”
Health officials said they hoped $ 8 billion in a recent stimulus package adopted by the federal government would help local departments that have been underfunded for years. Elected President Joe Biden on Friday unveiled a plan that includes community vaccination centers, mobile clinics to reach underprivileged populations, funding for more public health workers and the compensation of states for the distribution of doses.
Health officials at the Barren River District Health Department in Bowling Green, Ky., Looked at new software systems in mid-December to schedule appointments when they found out doses were coming, which would force a quick choice, said Janarae Conway, director for disaster preparedness, said. “We really did not have time to test it,” she said.
Administrators allowed the system to accept online appointments after drawing up a schedule, which resulted in people showing up to see their slots sent away for boarding.
Tracie Collins, secretary of health indicator in New Mexico, said her department was hiring more staff after people were unable to get through on phone lines recently when the state expanded the facility for people over the age of 75.
Rep. Vikki Goodwin, State of Texas, said that after her state was eligible for anyone over the age of 65 on Dec. 28, her voters quickly called grocery stores and pharmacies for appointments to hear that there were not enough doses for it.
“It’s crazy that people have to call around to see which providers have the vaccine, rather than having a central location,” she said. Goodwin said. “People think we’ve had months and months to prepare for this.”
Meanwhile, some rural hospitals have not received vaccines for front-line health care workers due to problems with the provider approval system in Texas, according to the Texas Organization of Rural & Community Hospitals.
In the Rio Grande Valley in South Texas, Rolando Zarate, a 54-year-old diabetic, equipped his pickup truck with blankets and food before rushing to beat others after a mass vaccination. He received a shot after waiting 30 hours.
‘I was, like most of the country, worried about [Covid-19] for nine months, ”said Mr. Zarate said. “I said, I do not care how long I have to wait.”
The disorganization has resulted in some ineligible people getting vaccinated by luck. When Seyward Darby saw a healthy, early 30-year-old friend in Washington, DC post on Instagram that he had received one, she asked how. He said he picked up Hot Pockets to eat in Safeway when the store announced it had extra doses he needed to use, she said.
With limited guidance from states outside the eligibility rules and limited outreach resources, in some cases, vaccine providers do not reach everyone in the surrounding community, raising health equity concerns.
Ruben Becerra, the elected executive of Hays County, south of Austin, said some providers are focused on their own patients, excluding people without doctors in primary care.
“Some facilities said ‘Well, you need to have a relationship with us and we need to do an investigation 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 24 hours in advance of people enrolled to get vaccinations at the health center – not enough time to set up staff. an automatic reminder call system. This has led to confusion about when people are supposed to show up and whether they have confirmed slots, Dr. Mueller said.
“It’s still very localized,” said Dr. Mueller said. “It’s the small-scale effort that makes you feel like you’re going to vaccinate people for years.”
Write to Elizabeth Findell at [email protected], Jared S. Hopkins at [email protected] and Dan Frosch at [email protected]
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