PROVIDENCE, RI (AP) – Public health officials raised the alarm for months, complaining that they did not have enough support or money to get COVID-19 vaccines into arms quickly. Now the slower-than-expected start of the largest vaccination effort in US history proves them right.
As they work to ramp up the shots, state and local public health departments in the US cite a variety of obstacles, most notably a lack of federal government leadership. Many officials fear that at the height of the pandemic they will lose valuable time and that the delays could cost lives.
States regret the lack of clarity on how many doses they will receive and when. They say more resources should have been spent on awareness campaigns to allay the concerns of those who are suspicious of taking the photo. And though 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 shoot more efficiently.
Such complaints have become a common refrain in a country where public health officials are largely left to their own devices to solve complex problems.
“The recurring theme is the lack of a national strategy and the attempt to get the money down, lower and lower, until the poor people on the receiving end have no one else to send the money to,” 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, had promised to distribute enough doses to immunize 20 million people in the US by December. It missed that goal, and as of Friday, about 6.6 million people had received their first recording, according to a tracker of the Centers for Disease Control and Prevention. About 22 million doses have been delivered to states.
The American Hospital Association estimates that between January 1 and May 31, 1.8 million people will need to be vaccinated daily to achieve widespread immunity by the summer. The current rate is slower by more than 1 million people per day.
President-elect Joe Biden called the rollout a “travesty” Friday, noting that there was no national plan to get doses in the guns and reiterating his commitment to deliver 100 million shots in its first 100 days. He hasn’t shared any details and should discuss the effort this week. His office announced a plan to release most doses right away, instead of holding second doses in reserve, the Trump administration’s more conservative approach.
The Trump administration defined its primary role as developing coronavirus vaccines and delivering them to states, who would then take over and ensure the vaccine doses traveled “the last mile” in the arms. Each state had to develop its own plan, including issuing guidelines for who should be vaccinated first. Several health experts complained about that approach, saying it led to confusion and a patchwork quilt.
“Let’s just say I was disappointed with the way they handled testing, and the vaccination reminded me how disappointed I was when they handled testing,” said Dr. Mysheika Roberts, health commissioner in Columbus, Ohio.
Several public health officials and experts say they think some of the early problems are disappearing. Marcus Plescia, chief medical officer of the Association of State and Territorial Health Officials, said the slow start shouldn’t be surprising given the immense size of the task.
“It wasn’t going to be seamless,” he said.
Still, Plescia said the federal government could have done more ahead of the rollout – 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 detailed how state and local health departments have been underfunded for decades. Public health officials have warned since the spring that they were lacking staff, money and tools they had to use a vaccine. The money was not approved until the end of December.
Vaccine distribution involves a long, complex series of events. Each dose should be monitored. Providers need to know how many staff they need. Eligible people should be notified to schedule their injections, given the vaccine handling requirements and the need to observe people for 15 minutes after the injection – all while observing social distance.
It’s difficult to plan too far ahead because the number of doses the state receives can fluctuate. Hospitals cannot provide all of their employees with a photo on the same day due to potential side effects and staffing issues, so they should be kept at bay.
Rhode Island health officials said it can take up to seven days for people to receive doses 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 communities have seen a large number of medical workers delay admission, even though they are first in line. Columbus, Ohio, has had lower-than-expected demand among top-priority groups, including medical workers.
An awareness campaign could have helped address the hesitation among health workers that has delayed the rollout of the initial shots, said James Garrow, a spokesman for the Philadelphia health department. Instead, officials spent months talking about the speed at which they were developing the vaccines – which didn’t allay concerns that it might not be safe.
“There is simply not good reporting on the safety and targeting of the safety protocols,” said Garrow.
The federal government has done little to provide information resources that local officials can tailor to their own communities to address the concerns of people such as pregnant women or black men living in rural areas, said Dr. Michael Osterholm, an expert at the field of infectious diseases at the university. from Minnesota, who is a member of Biden’s COVID-19 advisory board.
‘You don’t need 50 different states to do this kind of work. What you want is a smorgasbord of information resources for different population groups that any state can use, ”said Osterholm. “That’s what we don’t have now.”
Some states are getting creative. Oregon held a massive vaccination event at the fairground with the help of the National Guard. The governor said it was intended to vaccinate 250 people per hour. New Jersey planned to open six vaccine “megasites.” where officials hope that more than 2,000 people a day can eventually get their photo.
But without a federal plan, such efforts could amount to “throwing spaghetti against a wall to see what sticks,” said Chrissie Juliano of the Big Cities Health Coalition, which represents the metropolitan health departments.
What is needed is a national wartime effort to get vaccines to as many people as possible, multiple experts said. Medical emergencies can be treated 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’s possible. It’s achievable,” he said. “I see the urgency, the sense of urgency with no one around. And that’s really, frankly, that’s the only thing that can make a difference.”
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Choi reported from New York. Associated Press Writer Ricardo Alonso-Zaldivar in Washington also contributed to this report.
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