- North Dakota and South Dakota are two of the states that do the best job of distributing coronavirus vaccines.
- Despite an uneven deployment across the country, they stood out due to centralized storage and vaccination sites.
- Flexibility and collaboration between health systems has been the key to placing approximately 80% of vaccines distributed in the arms.
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North Dakota and South Dakota are among the US states that do the best job in developing coronavirus vaccines, and their experience can provide valuable lessons as the rest of the country struggles to recover.
North Dakota administered 87% of the vaccines it received, and South Dakota used 77%, according to vaccination data from the United States Center for Disease Control and Prevention. The weak US vaccination campaign means that nationally just over half of the vaccine doses distributed have actually been used.
From the beginning, vaccine implantation in the United States has been affected by lack of preparation, little federal guidance or assistance, and supply chain and logistics problems. President Joe Biden had committed to reviewing the vaccine launch by creating more vaccination sites administered by the federal government and increasing vaccine supplies by invoking the Defense Production Act.
In the United States, two major bottlenecks persisted in the early days of the vaccine’s launch, according to Dr. William Schaffner, an infectious disease specialist at Vanderbilt University School of Medicine. Vaccine supply was limited and unpredictable and there was little advance planning at vaccination sites, he said.
“They assumed it would be like a flu vaccination campaign, but it ended up being much more complicated due to the vaccine handling and record keeping,” said Schaffner.
According to Jesse Breidenbach, executive director of pharmacy at Sanford Health, Dakotas’ largest health system, the region stood out for two main reasons: flexibility and collaboration between public health departments and major health providers.
And like West Virginia, which chose not to join a federal partnership with CVS Health and Walgreens to vaccinate nursing home residents, the Dakotas largely abandoned distribution through national firms, opting to work with pharmacies and local partners .
It is important to note that North Dakota and South Dakota have small populations and are served by a handful of health systems, facilitating collaboration. Sanford Health, based in Sioux Falls, South Dakota, for example, managed to dispatch a fleet of 180 vans to bring the Pfizer vaccine to rural health professionals in December, as Shelby Livingston of Insider reported.
Mail vans from Sanford Health, based in Sioux Falls, SD, will take COVID-19 vaccines to remote hospitals in the rural midwest.
Sanford Health
US patchwork efforts have led to uneven vaccination across states
State and local officials across the country initially wondered how to prioritize high-risk groups and essential workers, and were concerned about people skipping the line to be vaccinated. Despite the planning, setbacks abounded, leading to cases of vaccine wastage in California, widely unfounded fears of skipping the line in New York and Eventbrite-based vaccinations in Florida excluding technology illiterates.
In the past few weeks, more populous states like Florida and New York have begun to reject tighter adherence to the CDC’s phased approach to implementations.
Read more: Here’s what you need to know about Joe Biden’s plan to get 100 million vaccines in 100 days
Collaboration and communication between public and private health officials helped the Dakotas to “move forward”
Collaboration was easier in South Dakota’s initial vaccination process, because the state has only three major health systems, said Breidenbach of Sanford Health.
As one of the top three health systems in the state, along with Avera and Monument, Sanford has worked with the South Dakota state health department continuously.
“It is because of partnerships at the municipal level and, at the state level, we are able to cut red tape, I think much more effectively than many states. We just sort it out,” Dr. David Basel of Avera Health told Dakota News Now.
In the early days of the vaccination effort, when South Dakota was prioritizing health workers, Breidenbach said that teams from each system were able to reach the state and inform authorities who had not been vaccinated.
Centralized provider and patient information systems alleviated implementation problems in both states
Although Sanford’s deployment efforts were different in North Dakota, South Dakota and Minnesota, where the health care system also operates, Breidenbach said the North Dakota state health department was particularly clear in providing Sanford with the information and permission to “keep moving forward” in vaccinations as soon as frontline health workers receive their vaccines
According to a North Dakota Department of Health spokesman, the state maintains an e-mail list for all COVID vaccine suppliers, keeping them informed of vaccine shipments received. Vaccine providers receive weekly update emails.
Very different from patchwork distribution centers in larger states, North Dakota also has a single state depot for storing and handling COVID vaccines. North Dakota was also able to distribute vaccines to primary care providers and other smaller health facilities, not just hospitals and healthcare systems, said communications director Nicole Peske.
Breidenbach, of Sanford Health, also believes his electronic medical record has been useful, because having patient information on hand has helped Sanford identify and contact his high-risk patients to get a COVID-19 injection.
Where can the larger states learn from the Dakotas?
Breidenbach said he does not want to give advice to other health systems, because he does not know what challenges they are facing. At a higher level, however, it is clear to him that collaboration between major health systems has been useful, as well as the fact that health systems like Sanford, for example, have patient information at hand.
“The more granular you get, it paralyzes things,” he added, probably referring to failed attempts in other states to implement federal guidelines. “We don’t want people outside half the day.”