Slow rollout of Covid-19 vaccines in the US highlights the challenges of a decentralized distribution plan that relies on states and places to handle the complicated last-mile logistics of getting people into arms, supply chain experts say .
More than 22 million doses had been distributed across states and other jurisdictions as of Friday, according to the Centers for Disease Control and Prevention, while 6.7 million people had received their first injection at the time. The numbers fell short of the U.S. target of 20 million vaccinations by the end of 2020, and communities and states continued to report bottlenecks in managing their vaccination programs this month.
“If you say your priority is to vaccinate as many people as possible as soon as possible, they would have conducted the campaign differently,” said Julie Swann, a professor and chief of the industrial and systems engineering department at North Carolina State University . . “But that’s not what they were told.”
Rather than trying to halt the spread of transmission in communities, said Dr. Swann, who advised the CDC during the H1N1 pandemic, the focus was on reducing mortality, especially among high-risk populations.
Supply chain experts attribute the delays in part to the burdens faced by the often underfunded state and local health agencies already stretched to their limits by the coronavirus pandemic, along with communication issues, including confusion over the number of doses states would receive .
But experts also point to guidelines from a federal vaccine advisory panel on who should be vaccinated first, which recommends administering the limited initial dose doses to health professionals and residents of long-term care facilities.
On Friday, President-elect Joe Biden’s transition team said it would try to release nearly all available doses to speed up distribution.
New York Governor Andrew Cuomo and New York Mayor Bill de Blasio have argued over distribution, with the governor criticizing hospitals for slow dosing and calling on the mayor for more flexibility in state guidelines on who can be vaccinated .
The distribution strategy of the U.S. Covid-19 vaccine is focused on delivery, said Philip Palin, an author and supply chain resilience expert who advises governments and businesses in preparing for catastrophic events. Vaccines are assigned to target audiences, he said, in contrast to more rapid supply chains, which are more common and tend to be demand-driven.
The CDC reported that 6.7 million people in the US had received their first vaccination against Covid-19 since Friday.
Photo:
Paul Sancya / Associated Press
He said the production and distribution of the first two vaccines in the US – those produced by Pfizer Inc.
and BioNTech SE in a joint program and by Moderna Inc.
—In fact, has exceeded the ability of those administering the vaccines to keep up with current guidelines for setting vaccination priorities. “What hasn’t happened yet is sufficient ‘consumption’ of the distributed supply,” said Mr Palin.
To speed up vaccinations, Mr. Palin, authorities could work with community organizations and local governments to identify potential sites of vaccination and focus on areas where the need for the vaccine is greatest.
If the dose rollout continues on the current path, coordinating vaccinations could become more challenging as authorities transition to the wider population, said Pinar Keskinocak, a professor at the Georgia Institute of Technology and director of the Center for Health and Safety. School Humanitarian Systems.
“Ideally, we need some sort of online system where you sign up with your information and location, and let you know when it’s time to get your vaccine,” said Dr. Keskinocak. “At the local level, we don’t seem to have a very concrete plan on how to get this vaccine from storage into people’s arms.”
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‘At a local level, we don’t seem to have a very concrete plan on how to get this vaccine from storage into people’s arms.’
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The vaccination programs for Covid-19 in Europe are also being delayed due to a wave of infections in countries with different approaches to distributing the injections.
In the US, state and local health departments typically have a lot of flexibility for such campaigns, said Dr. Swann. “This allows North Dakota to distribute differently than New York. It allows Arizona, with its Native American reservations and a different kind of infrastructure, to distribute itself differently from California, ”she said.
Centralized vaccination efforts are usually faster, but may face other challenges, Dr. Swann said. For example, if the military is deployed to help vaccinate people, some parts of the US are likely to meet resistance, she said.
Yet, said Dr. Swann, “if the US decided to turn around and say, ‘We need to clean up cases because our hospitals are overwhelmed,’ they could absolutely run massive vaccination clinics, and it would be much more efficient.” “
Write to Jennifer Smith at [email protected]
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