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What The U.S. Can Do To Speed Up COVID-19 Vaccine Distribution47:20
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Three nearly empty bottles of the Moderna COVID-19 vaccine which can not be mixed to provide an addition dose for a vaccination shot. (Jesse Costa/WBUR)
Three nearly empty bottles of the Moderna COVID-19 vaccine which can not be mixed to provide an addition dose for a vaccination shot. (Jesse Costa/WBUR)

President Joe Biden's new bar for the COVID vaccine rollout: 200 million doses by summer. But what about people who hope to get the vaccine now? What can the government really do to speed up distribution?

Guests

Dr. Julie Morita, executive vice president of the Robert Wood Johnson Foundation. Member of President Biden’s COVID-19 advisory panel. (@DrJulieMorita)

Dr. Ashish Jha, dean of Brown University's School of Public Health. (@ashishkjha)

Also Featured

Lennore Vega, retired teacher from Naples, Florida.

Erin Ourada, administrator for Custer Health, a public health department in Mandan, North Dakota.

Interview Highlights

What’s the chief problem in the uneven rollout we've seen of COVID-19 vaccines across the country?

Dr. Julie Morita: “One thing to think about as we look at what's happened so far is to recognize that this is the largest, most expansive immunization effort that's happened in a very compressed period of time. So this is a complicated system. But when I look back on successful public health responses in the past, based on my time in Chicago, what I saw play out there, whether it was Zika or whether it was H1N1 influenza or whether it was Ebola, was clear federal leadership, guidance and coordination and oversight of things like the vaccine distribution.

“And so those kinds of things are just beginning to happen at this point. When President Biden was inaugurated, the next day, there was a federal response plan for the COVID response. Which outlined a broad, expansive plan that included things about comprehensive vaccination campaign, expanding masking, testing, data, treatments. Also protecting equity, really focusing on equity across racial and ethnic and urban lines. So these kinds of things are really, really critical for a comprehensive, smooth response. And those kinds of things will make a difference. It's not going to happen immediately, but it will definitely get better, and vaccine supply will get better as well.”

On the federal, state and local response to vaccinations 

Dr. Julie Morita: “In the past, the state and local health departments did not get a lot of resources. So they didn't get money to support hiring more people to do the vaccinations. They hadn't received resources to actually build up their immunization registry systems. So all those kinds of things weren't able to be done.

“Now the funds are beginning to flow. And so those things are actually beginning to happen. The other thing to keep in mind is that the vaccine was approved by FDA, recommended by the CDC, and the vaccine arrived within days. That didn't give the state and local health departments much time to really ramp up their systems. So when you look now at the administration rates that are happening in the states and locals, you can see that's actually improving.

"More people are being administered more quickly. So there's definite improvement. The other thing is it was really, really difficult for state and local health departments to plan. How many mass vaccination sites should they have? How many vaccines should they give to doctor offices?

“Because they only had a couple of days’ notice about how much vaccine they were receiving. So they'd get two days’ notice and then they receive another allocation of vaccine. What the Biden administration has done is really committed to having an improved line of sight on the vaccine supply. And I've talked to a number of states and local health agencies already, and they're reporting that they're getting better projections for longer periods of time so they can do this kind of planning. But it's not just because these changes have happened. It won't happen overnight. And so it's going to take some time to smooth things out.”

On the possibility of vaccinating two million people a day

Dr. Ashish Jha: “So first of all, I mean, there's a question, is that even doable? And there are obviously constraints. Like the biggest one is can we make that many vaccines? But if you look at what both Pfizer and Moderna are saying, so we're not even talking about the new Johnson & Johnson vaccine or anything else, sticking with the ones we have, there is a sense that we should be able to produce about 200 million doses of these vaccines by the end of March.

"You know, there is about 60, 70 days left. … I'd like to get to a point where we are administering two million shots a day. It's going to take a lot of work. It's going to take the full power of the federal government working very, very closely with states. We're at a little over a million right now. And I want to see that number continue to tick up until we really do get to that two million a day, ideally, you know, by mid-February, if not earlier."

On inefficiencies in vaccine distribution

Dr. Ashish Jha: “I do believe that by the late spring, certainly by summertime, there'll be plenty of vaccines for every amount. And the question is, what do we do in the next couple of months? But there is no doubt in my mind that the lack of planning on how these vaccines we're going to get distributed, it's been incredibly frustrating and has created a lot of confusion and at times has led to even inefficiencies and waste of vaccine doses, which we've heard about.

"And, you know, I think about my parents experience. So they're both in New Jersey, my mom’s in her late 70s, dad’s in his early 80s. And they spend an enormous number of hours every single day trying to figure out how they can get a vaccine. And look, there is a mismatch right now between supply and demand, but the way you deal with that is a well streamlined system. They should have been able to sign up somewhere and get on the list.

"They should be able to figure out where they are on the list and not have to wake up at 5:55 in the morning, as you know, as we heard earlier, and instead just have a well streamlined system that gets them in when it's their turn. They're happy to wait. It's the kind of free-for-all, disorganized. And I'm not blaming the local public health folks, because they have been doing unbelievable work for 10, 11 months.

"What I am saying is they needed more federal support. They needed more resources. I agree that that is starting to now come, thank goodness. But we're going to continue to work on supporting the local public health people because they can't keep going like this and we can't expect them to pick up every single crisis and manage it effectively."

Why aren't we seeing efforts being built on top of H1N1 vaccination plans?

Dr. Julie Morita: “The first thing is that it's resources. As Dr. Jha mentioned, the state and local health departments really did not get adequate resources in the initial phases to actually do the appropriate planning to build out and build up on those H1N1 plans. There are existing plans throughout the nation, but it's a very different response. COVID is a very different response then the H1N1 response. These vaccines that are available now are two dose vaccines. They require ultra-cold storage or freezing.

"They’re very difficult vaccines to get out. At the same time as ... these state agencies were supposed to be planning, they were also being held responsible for doing the testing, the treatment, managing outbreaks throughout their jurisdictions. And there weren't additional resources made available for them to hire more people or to enhance their planning.”

Looking towards the future of vaccine distribution

Dr. Julie Morita: “I'm seeing a lot of positive movement in terms of getting more vaccine out and improving distribution and administration efforts. What I am concerned about and what I really want to make sure is happening simultaneous to those efforts is reaching into the communities that have vaccine hesitancy or who aren't trusting the vaccine, because when the vaccine supply improves and we're able to broadly vaccinate, we really want demand to be there for the vaccine.

"And so right now is a critical point in time to be reaching out to those communities that actually have questions and concerns about the safety or the efficacy of vaccine, understand what it is their concerns are. Who do they want to hear from and what do they want to hear about to actually help them feel more confident in getting the vaccines? So that would be on the top of my wish list.”

Dr. Ashish Jha: “I'm going to go a little bit of a different direction and say the other thing is, if we want to see about the long term protection of the American people, we also have to have a strategy right now to start helping the world get vaccinated. We're seeing the rise of these variants that put our own vaccine's efficacy at some risk, largely because there are such large outbreaks happening in many places. And part of a domestic strategy has got to include a global strategy so that the whole world gets vaccinated along with the United States.”

From The Reading List

ABC News: "Crushing the coronavirus: What's Biden's 'clear, unified approach' on testing?" — "As much of the nation waits on vaccines and variants swirl the globe, experts said President Joe Biden's plan to tackle the pandemic this year will hinge on his ability to bulk up the nation's ability to test for the coronavirus — a massive undertaking that will require cash and industry cooperation."

Wall Street Journal: "Covid-19 Vaccine Sites Call In Volunteers, Retirees to Staff Rollout" — "Bill Renda expected to spend this time of year traveling and visiting family, were it not for the pandemic. Instead, the retired orthopedic surgeon from Louisville, Ky., and his wife, Sally, spent much of January in a cold parking lot, directing drivers to a place for observation by medical staff after receiving doses of Covid-19 vaccine."

Brookings: "COVID-19 vaccinations: Why are some states and localities so much more successful?" — "As frustration spreads over the slow pace of vaccination for Covid-19, it is instructive to compare two states. One has the highest median household income of any state in the country—the other, the second lowest. One has the second lowest poverty rate, 8.2%, while the other’s is one of the highest at 17.6%. In one, about 40% of the adult population has a BA degree or more; in the other, about 20%."

Associated Press: "Oregon puts debate over race in vaccine rollout to test" — "The role that race should play in deciding who gets priority for the COVID-19 vaccine in the next phase of the rollout is being put to the test in Oregon as tensions around equity and access to the shots emerge nationwide."

KNWA: "COVID-19 VACCINATION PLAN: Arkansas compared to other states" — "Each state gets to make its own vaccination plan. According to Arkansas, it’s following CDC guidelines closely with a few changes — prioritizing those 70 and older and school staff."

This program aired on January 29, 2021.

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