Despite the scramble to speed up US vaccination against COVID-19 and bring the country back to normal, the first three months of implementation suggest that faster is not necessarily better.
A surprising new analysis found that states like South Carolina and Florida that rushed ahead of others to offer the vaccine to larger groups of people vaccinated smaller sections of their population than those who moved more slowly and methodically, such as Hawaii and Connecticut. .
The explanation, as experts see it, is that the rapid expansion of suitability has caused an increase in demand for some states to deal with and has led to serious disorder. Vaccination stocks were inadequate or unpredictable, websites crashed and phone lines crashed, spreading confusion, frustration and resignation among many people.
“The infrastructure was just not ready. It hit back a bit, ‘said dr. Rebecca Wurtz, an infectious disease physician and health data specialist at the University of Minnesota’s School of Public Health, said. She added: “In a hurry to please everyone, governors have frustrated little and much.”
The findings could contain an important lesson for the country’s governors, many of whom have announced dramatic expansions in their implementation over the past few days after being challenged by President Joe Biden to be eligible for adult by May 1st.
“If you’re more purposeful and focused, you can do a better job,” said Sema Sgaier, executive director of Surgo Ventures, a nonprofit healthcare organization that conducted the analysis in collaboration with The Associated Press. “You can open it – if you have the infrastructure to vaccinate all the people quickly.”
Several factors hampered the performance of the state’s vaccination. Conspiracy theories, poor communication and independent shipments delayed efforts after the first vials of precious vaccine arrived on 14 December.
But the size of the suitable population was always under the control of government officials, who made very different decisions about how many people invited them to line up if there was not enough vaccine to go around.
When the ride began, most states put health care workers and nursing home residents at the front of the queue. In doing so, states complied with national recommendations from experts who also suggested doing everything possible to reach everyone in the two groups before moving on to the next categories.
But confronted with political pressure and a scramble by the public, governors rushed forward. Both the outgoing Trump administration and the incoming Biden team have insisted on vaccinating older Americans.
By the end of January, more than half of the states were open to older adults – some 75 and older, others 65 and older. It was then that the real problems began.
South Carolina has allowed people in the Steven Kite age group to qualify January 13th. Kite, 71, immediately discussed a vaccination in a hospital. But the next day, his appointment with thousands of others was canceled due to a vaccine shortage.
“It was frustrating at first,” Kite said. After a week of uncertainty, he reschedules. He and his wife have now been vaccinated. “In the end, it works well. I know they had other problems. The delivery of the doses was very unreliable. ”
In Missouri, where more than half of the adults were eligible for shots, shortages in the big city sent vaccines that drove hundreds of miles to rural towns. Dr. Elizabeth Bergamini, a pediatrician in the suburban St. Louis, drove about 30 people to the vaccination events that were often out of the way after the state enrolled 65-year-olds and older on Jan. 18 and then expanded further.
“We had the need to vaccinate a few hundred thousand people in the St. Louis area to an additional half a million people, but we still did not vaccinate the first group, so it was a crazy streak,” said Bergamini. “It was just a lot of mess.”
“It got a little chaotic,” said Dr. Marcus Plescia, medical chief of the Association of State and Territorial Health Officials, said. “We created a lot more demand than there was. This stressed the system and it may have left the system less efficient. ”
Plescia said the analysis suggests that ” a more methodical, measured, judicious, priority-based approach – despite the perception of people – can actually be just as effective or efficient as opening things up and making them available to more people. ‘
In retrospect, health workers and nursing home residents were the easy groups to vaccinate. Doses could be given to them where they lived and worked.
“We knew where they were and we knew who they were,” Wurtz said. Once states went beyond the populations, it became more difficult to find the right people. Nursing home residents live in nursing homes. People 65 and older live everywhere.
West Virginia showed the trend in early March with a large number of eligible residents and a high vaccination rate, but the state started slowly and built up its capacity before being eligible.
Similarly, Alaska maintained a high vaccination rate with a smaller population eligible, and then threw a shot at everyone 16 and older on March 9th. This large increase in eligible adults by the end of the study period led the AP and Surgo Ventures to omit Alaska from analysis.
The analysis found that as of March 10, Hawaii has the lowest percentage of its eligible adult population, about 26%. Yet Hawaii administered 42,614 doses per 100,000 adults, the eighth highest percentage in the country.
Thirty percent of Connecticut’s adult population was eligible on the same date and administered doses at the fourth highest rate in the country.
In contrast, Mississippi is eligible for the sixth largest percentage of its adult population at 83%. Yet Mississippi administered only 35,174 total doses per 100,000 adults, ranking 43rd among the states.
Missouri, with 61% of the eligible population, distributed 35,341 doses per 100,000 adults.
Seven states among the top 10 for overall vaccination performance – Georgia, Tennessee, Texas, Florida, Mississippi, South Carolina and Missouri – have higher than average shots of their residents eligible for shots.
Among the top performing countries, five of the top 10 high vaccination rates – New Mexico, North Dakota, Connecticut, Wyoming and Hawaii – were more restrictive. Two other states of the top 10, which perform very well – South Dakota and Massachusetts – were about average in how many residents are eligible for vaccination.
“This is a thorough analysis that shows a clear link between the breadth of suitability and the vaccination rates in countries,” said Dr. Mark McClellan, a former head of the Food and Drug Administration, said he was not involved in the new analysis but reviewed it for AP.
The countries that perform best can achieve results by paying closer attention to the vaccine supply, vaccinating high-risk groups thoroughly and then starting more slowly to additional categories while waiting for the stock, McClellan said.
What happens next will depend on how many states can improve their vaccine delivery systems and whether Americans remain eager for vaccination, even if the threat is mitigated with the protection of more people and the decline in the number of cases.
“Did states use this time wisely and fruitfully to lay down the infrastructure to open it up to more people?” Asked Sgaier.
___
This story has been corrected to determine the percentage of people eligible for COVID-19 vaccines as of March 10 in Missouri. It was 61%, not 92%.
___
Associated Press Writer Heather Hollingsworth in Mission, Kansas, contributed to this report.
___
The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Scientific Education. The AP is solely responsible for all content.