SUPPLY, RI – Public health officials have been sounding the alarm for months, complaining that they do not have enough support or money to get COVID-19 vaccines into their arms quickly. Now the start of the largest vaccination effort in US history is slower than expected.
While they are increasing the shots, U.S. state and local public health departments cite a variety of obstacles, most notably a lack of federal government leadership. Many officials are worried that they are wasting precious time at the height of the pandemic, and the delays could cost lives.
States deplore the lack of clarity on how many doses they will receive and when. They say more resources should be devoted to education campaigns to give people the impression that they are getting the chance. And while the federal government recently approved $ 8.7 billion for the vaccination effort, it will take time to reach places that could have used the money months ago to prepare to deliver shots more effectively.
Such complaints have become a common refrain in a country where public health officials are largely left on their own to solve complex problems.
“The recurring theme is the lack of a national strategy and the attempt to pass the money, ever lower, until the poor people on the receiving end have no one else to whom they can send the money,” said Gianfranco Pezzino. who was the public health officer in Shawnee County, Kansas, until he retired last month.
Operation Warp Speed, the federal vaccine program, promised to distribute enough doses in December to immunize 20 million people in the US. It missed the target, and as of Friday, about 6.6 million people got their first shot. About 22 million doses have been delivered to states.
According to the American Hospital Association, 1.8 million people must be vaccinated daily from January 1 to May 31 to achieve widespread immunity by summer. The current rate is more than 1 million people a day below that.
Elected President Joe Biden called the launch a ‘travesty’ on Friday, noting that there was no national plan to get doses in the arms and reiterating his commitment to 100 million shots in his first 100 days to apply. He did not share details and is expected to discuss the attempt this week. His office has announced a plan to release most doses immediately, rather than keeping the second doses in reserve, which is the Trump administration’s more conservative approach.
The Trump administration defined its primary role as the development of coronavirus vaccines and delivery to states, which would then take over and ensure that vaccine doses move ‘the last mile’ in the arms. Each state had to draw up its own plan, including issuing guidelines for who would be vaccinated first. Several health experts have complained about the approach, saying it leads to confusion and a patchwork reaction.
“Let’s just say I was disappointed with how they handled the test, and the deployment of the vaccine reminded me of how disappointed I was when they handled the test,” said Dr. Mysheika Roberts, health commissioner in Columbus, Ohio, said.
Several public health officials and experts believe that some of the early mistakes are getting smoother. Marcus Plescia, chief medical officer of the Association of Civil Servants and Territorial Health Officers, said the slow start should not be surprising, given the sheer size of the task.
“It would not be seamless,” he said.
Still, Plescia said the federal government could do more before it goes into effect – such as releasing billions of dollars earlier to help with personnel, technology and other operational needs.
An ongoing investigation by The Associated Press and Kaiser Health News sets out how state and local health departments have been underfunded for decades. Public health officials have warned since the spring that they do not need staff, money and tools to use a vaccine. The money was only approved at the end of December.
The distribution of vaccines involves a long, complex chain of events. Each dose should be followed. Suppliers need to know how many staff they need. Eligible persons must be notified to schedule their shots, given the handling requirements of the vaccine and the need to observe people for 15 minutes after the shot – even if social distance is taken.
It is difficult to plan too far in advance because the number of doses the state receives may vary. Hospitals cannot give shots to all their workers on the same day due to possible side effects and staffing problems, and therefore they need to be spread out.
Rhode Island health officials said it could take up to seven days to get doses to people once they were received. Officials in several states, including Rhode Island, Pennsylvania, Kentucky and New Jersey, said the lack of supply was one of the biggest obstacles to getting more people vaccinated.
Some communities have seen a large number of medical workers get the chance to shoot, even though they are first in line. Columbus, Ohio, has lower-than-expected demand among the top priority groups, including medical emergency workers.
A public education campaign could help address the hesitation among health workers that delayed the start of the first shots, said James Garrow, a spokesman for the Philadelphia Department of Health. Instead, officials talked for months about the rate at which they were developing the vaccines – which did not help alleviate concerns that it would not be safe.
“There just hasn’t been any good news about the security and purposefulness of the security protocols,” Garrow said.
The federal government has done little to provide information resources that local officials can adapt to their own communities, to address concerns of people such as pregnant women or black men living in rural areas, Drs. Michael Osterholm, an expert on infectious diseases at the University, said. of Minnesota, who is a member of Biden’s COVID-19 advisory board.
‘You do not need 50 different states to do this kind of work. What you want is an information board with information sources that address different populations that any state can use, ‘Osterholm said. “That’s what we do not have at present.”
Some states get creative. Oregon held a mass vaccination event on the state exchange with the help of the National Guard. The governor said it was aiming to vaccinate 250 people an hour. New Jersey has planned to open six “megacity” vaccinations where officials hope more than 2,000 people a day can finally get their chance.
But without a federal plan, such attempts could amount to ‘throwing spaghetti against a wall to see what is stuck,’ “said Chrissie Juliano of the Big Cities Health Coalition, which represents metropolitan health departments.
What is needed is a national effort to push out wartime to as many people as possible, several experts said. Medical emergencies can be covered 24 hours a day, seven days a week, says Pezzino, who is also a senior fellow at the Kansas Health Institute. Why not make vaccinations available according to the schedule?
“It’s possible. It’s achievable,” he said. “I don’t see the level of urgency, or the sense of urgency in anyone around here. And it’s really, honestly, it’s the only thing that makes a difference. can make. ”
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