© Denise Cathey / Associated Press
In South Texas, a man slept in his car for two nights in a row to avoid losing his place in a line of hundreds of people at a mass vaccination event. In western Kentucky, residents registered for online vaccination slots, only to find out when they arrived that their doses had been taken by walk-ins. In New Mexico, state officials struggled to hire more people to work on a vaccination hotline after it was full of calls.
The biggest challenges in America’s Covid-19 vaccination effort ended up being injecting into the arms of the right people. As of Friday morning, about 31 million doses of vaccines were distributed across the country, but only about 12 million were administered, according to the Centers for Disease Control and Prevention.
The federal government has dispatched these doses to states across the country, with states setting their own criteria for who should get the vaccine first. But it is up to local health departments, hospitals and other providers to manage the logistical tangle and many have not been able to do this effectively.
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The result is an erratic and disconnected process that is causing frustration and confusion across the country.
Jeff Duchin, public health officer for Seattle and King County, Wash., Said the federal government had succeeded in helping to finance and buy vaccines that were developed in record time, but said it had not done enough to ensure that the “last -mile ”distribution efforts would be successful.
“Operation Warp Speed gave us two Cadillac vaccines with empty gas tanks,” he said.
Dr. Duchin said that while the county has established four clinics, it has been difficult to link health professionals not affiliated with hospitals to providers that administer vaccines. Authorities are currently planning two large-scale vaccination sites, he said, which are complicated to organize but are the most effective way to vaccinate teachers, traffic workers, the police and the general public. If everyone needs to schedule individual appointments, “we’ll never get there,” said Duchin.
The confusion only increases as many states move from immunizing health professionals and nursing home residents to people over 65 or with pre-existing illnesses. California, Texas and Arizona are among the states that are starting mass vaccination sites in places like sports stadiums.
Providers across the country said they have so far received little guidance on how to implement the eligibility criteria, no funding to manage staff and planning, and no indication of how many doses they will receive at any given time. Oscar Alleyne, program director for the National Association of Municipal and Municipal Health Officials, said that long lines and congested phones show how responsibility was assigned to local authorities without preparation.
“Most are struggling,” he said. “There is a lack of communication, a lack of understanding with the systems that were developed, zero visibility of how state plans are going to be implemented on the local front.”
Health officials said they expected $ 8 billion in a recent federal government-approved stimulus package to help local departments that haven’t had resources for years. President-elect Joe Biden outlined a plan on Friday that includes federally supported community vaccination centers, mobile clinics to reach underserved populations, funding for more public health workers and reimbursements to states to deploy the National Guard to distribute doses.
Health officials from the Barren River District Health Department in Bowling Green, Ky., Were looking for new software systems to schedule appointments in mid-December when they found that doses were coming, forcing a quick choice, said Janarae Conway, director disaster preparedness. “We really didn’t have time to test it,” she said.
Administrators allowed the system to continue accepting online appointments after they printed a schedule, resulting in people showing up to see that their slots were given to visitors.
New Mexico’s designated health secretary, Tracie Collins, said her department was hiring more staff after people recently failed to speak on the phone lines when the state expanded eligibility for people over 75.
Texas State Representative Vikki Goodwin said that after the state granted eligibility to anyone over 65 on December 28, its constituents rushed to call grocery stores and pharmacies for consultations and were told that there was still no enough doses for that.
“It’s crazy that people need to call to see which different providers have the vaccine, instead of having a central location,” said Goodwin. “People are thinking that we had months and months to prepare for this.”
In the meantime, due to problems with the Texas provider approval system, some rural hospitals have not received vaccines for frontline health workers, according to the Texas Rural and Community Hospitals Organization.
In the Rio Grande Valley, in southern Texas, Rolando Zarate, a 54-year-old diabetic, stocked his truck with blankets and food before racing to beat the others for a mass vaccination event. He was shot after waiting 30 hours.
“I have been, like most of the country, concerned with [Covid-19] for nine months, ”said Zarate. “I said, I don’t care how long I have to wait.”
The disorganization has resulted in some people being ineligible for luckily getting vaccines. When Seyward Darby saw a healthy 30-year-old friend in Washington, DC, post on Instagram that he had received one, she asked how. He said he was taking Hot Pockets to eat at Safeway when the store announced it had extra doses to use, she said.
With limited guidance from states in addition to rules on who is eligible and limited resources for dissemination, vaccine providers, in some cases, do not reach everyone in the surrounding community, raising concerns about health equity.
Ruben Becerra, the elected executive of Hays County, south of Austin, said that some providers are focused on their own patients, excluding people without primary care doctors.
“Some facilities said, ‘Well, you need to have a relationship with us and we need to do an evaluation before we give you the vaccine,'” he said.
In Washington, DC, Dana Mueller, director of adult and family medicine at Mary’s Center, said the district has been sending out lists of people who signed up for vaccinations at the health center 24 hours in advance – insufficient time for staff to move. prepare an automated reminder call system. This created confusion about when people should attend and whether seats were confirmed, said Mueller.
“It is still very localized,” said Mueller. “It’s the small-scale effort that makes it look like you’re going to vaccinate people for years.”
Write to Elizabeth Findell at [email protected], Jared S. Hopkins at [email protected] and Dan Frosch at [email protected]
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