Vaccine Rollout Confirms Public Health officials’ Warnings

Public health officials sounded the alarm for months, complaining that they did not have enough support or money to get COVID-19 vaccines quickly into arms. Now the slower-than-expected start to the largest vaccination effort in U.S. history is proving them right.

As they work to ramp up the shots, state and local public health departments across the U.S. cite a variety of obstacles, most notably a lack of leadership from the federal government. Many officials worry that they are losing precious time at the height of the pandemic, and the delays could cost lives.

States lament a lack of clarity on how many doses they will receive and when. They say more resources should have been devoted to education campaigns to ease concerns among people leery of getting the shots. And although the federal government recently approved $8.7 billion for the vaccine effort, it will take time to reach places that could have used the money months ago to prepare to deliver shots more efficiently.

Such complaints have become a common refrain in a nation where public health officials have been left largely on their own to solve complex problems.

Operation Warp Speed, the federal vaccine program, had promised to distribute enough doses to immunize 20 million people in the U.S. in December. It missed that target, and as of Friday, about 6.6 million people had received their first shot, according to a tracker from the Centers for Disease Control and Prevention. About 22 million doses have been delivered to states.

The American Hospital Association has estimated that 1.8 million people need to be vaccinated daily from Jan. 1 to May 31 to reach widespread immunity by the summer. The current pace is more than 1 million people per day below that.

An ongoing investigation by The Associated Press and Kaiser Health News detailed how state and local health departments have been underfunded for decades. Public health officials have warned since the spring that they lacked the staff, money and tools they needed to deploy a vaccine. The money was not approved until the end of December.

Vaccine distribution involves a long, complex chain of events. Every dose must be tracked. Providers need to know how much staffing they will need. Eligible people must be notified to schedule their shots, given the vaccine’s handling requirements and the need to observe people for 15 minutes after the shot — all while social distancing is observed.

It’s difficult to plan too far ahead because the number of doses the state receives can fluctuate. Hospitals cannot give all their workers shots on the same day because of possible side effects and staffing issues, so they must be spaced out.

Rhode Island health officials said it can take up to seven days to get doses out to people once they are received. Officials in several states, including Rhode Island, Pennsylvania, Kentucky and New Jersey, said the lack of supply is one of the biggest obstacles to getting more people vaccinated.

Some states are getting creative. Oregon held a mass vaccination event at the state fairgrounds with the help of the National Guard. The governor said it aimed to vaccinate 250 people per hour. New Jersey planned to open six vaccine “megasites” where officials hope more than 2,000 people per day can eventually get their shots.

But without a federal plan, such efforts can amount to “throwing spaghetti at a wall to see what sticks,” said Chrissie Juliano of the Big Cities Health Coalition, which represents metropolitan health departments.

What’s needed is a national, wartime-type effort to get vaccines out to as many people as possible, multiple experts said. Medical emergencies can be covered 24 hours a day, seven days a week, said Pezzino, who is also a senior fellow at the Kansas Health Institute. Why not make vaccinations available on that schedule?

“It is possible. It is feasible,” he said. “I don’t see the level of urgency, the feeling of urgency in anybody around here. And that’s really, honestly, that’s the only thing that could make a difference.”