For some mysterious reason, people are shocked – shocked! – the distribution of COVID-19 vaccines in the USA has been hampered.
And it’s messy. On Monday, about 11.4 million doses of the Pfizer and Moderna vaccines were distributed, according to the Centers for Disease Control and Prevention. But only 2.1 million people have been vaccinated.
By the standards of the government itself, this is a major failure. On December 10, Health and Human Services Secretary Alex Azar promised that 20 million Americans would be vaccinated “in the coming weeks”.
It is up to the States to distribute the vaccines once they have been taken to areas designated by the Federal Government.
President Trump
Considering that it has been three weeks since then this weekend, obviously this is not going to happen. Thus, the White House changed the beams, promising that 20 million doses would be distributed by the end of the year. It then revised its promise for 20 million doses in the first week of January. Anyway, the prospect of finding this self-imposed brand is vague.
Designing the pace of actual vaccinations in the future produces a bleak conclusion.
Based on the judgment that 80% of Americans, or 264 million people, would need to be inoculated for the nation to achieve collective immunity – that is, enough immunity so that the virus could not spread significantly, even among the unvaccinated – specialist. in public health Leana Wen, of George Washington University, estimated that “at the current rate, the United States would take approximately 10 years to reach this level of inoculation”.
President-elect Joe Biden spoke about the slow effort. In a statement on Tuesday, he said the country would have to increase its vaccination rate five or six times to meet its own goal of fully vaccinating 50 million Americans (that is, with the two doses of the Pfizer and Moderna vaccines) the first 100 days in office.
At the current rate, he said, “It will take years, not months, to vaccinate the American people.”
It is appropriate to recognize that large public health projects, such as mass vaccinations, are difficult and prone to errors and disappointments in their early stages.
The launch, for example, of the government website for enrollment in Affordable Care Act health plans, as of October 1, 2013, was a milestone in sloppy technology. But the Obama administration controlled the matter, and within a few weeks, the site was up and running perfectly.
The Trump administration had seven years to absorb the lessons from the Obamacare disaster, but it doesn’t seem to have done so. He surprised several states in mid-December by informing them that their allocations for the Pfizer vaccine, the first to be approved for widespread use, would be up to 40% below initial expectations.
Government officials attributed the confusion to misunderstandings of the original promises, but for many governors this explanation was not valid.
General Gustave Perna, chief operating officer of the government’s Operation Warp Speed financing program for vaccines and other anti-pandemic products, later acknowledged that the confusion resulted from “a planning error, and I am responsible.”
At a news conference on Wednesday, Moncef Slaoui, Operation Warp Speed’s top scientific advisor, acknowledged that the vaccination rate as a proportion of available doses is “less than we expected”.
But Perna, at the same briefing, tried to put a happy glow on the record. “Everyone should be very proud together,” he said. “It has been an approach for the whole of America.”
Even so, many of the factors that slow the rate of vaccinations are obvious. They include inadequate planning and the government’s refusal to take on the task at hand. The latter reflects Trump’s approach to the pandemic from the beginning. Summarized in its essence, this approach has been: “It is not our problem”.
As of Tuesday, Trump was blaming state governments for any problems. “It is up to the States to distribute the vaccines, once they are taken to the areas designated by the Federal Government”. he tweeted. “We not only developed vaccines, including money to move the process forward quickly, but we also took them to the states. Biden failed with the swine flu! “
But experts say leaving the vaccine administration to states alone is not an answer. What was needed – and does not come – is federal coordination.
There was “no real planning on what will happen when the vaccines arrive in the state,” Ashish Jha, dean of Brown University School of Public Health, tweeted this week. “Without a plan, without money, I just hope that the states will find that out.”
The state’s health departments that are likely to inherit the vaccine management task are already hopelessly overwhelmed, Jha noted. Throughout the year, they struggled with the need to “manage all tests, data analysis and reporting, advise companies, schools, run public campaigns, etc.”. Now they will have the vaccine loaded on their plates.
Mass vaccination programs like the one needed for COVID-19 are not without precedent. The model often cited is a smallpox vaccination campaign conducted in New York City after an outbreak was detected in 1947.
The city set up vaccination posts in police stations, municipal buildings, community centers and “virtually all hospitals in the city,” reported Israel Weinstein, the city’s health commissioner, a few months later. The shots were made free of charge.
Mayor William O’Dwyer requested universal vaccination and received one, as did President Harry Truman, who traveled to the city for that purpose. The program enjoyed a level of cooperation between the authorities and the public, government support and popular faith in science that were undermined today.
“In less than a month, more than 6,350,000 people were vaccinated,” wrote Weinstein, “more than 5,000,000 of them within two weeks of the mayor’s call for universal vaccination.”
On the other hand, the launch of the vaccine is being given to pharmacies, whether they are local or parts of large chains like Walgreens and CVS. But these retailers do not have the ability to coordinate local or regional vaccination programs, which involves ensuring that everyone in a vaccination group, whether designated by age, health condition or job description, can be found and asked to come forward. vaccination when it’s yours or your turn.
In addition, the Trump White House has not exploited all the resources it has for the manufacture and distribution of COVID-19 vaccines.
For example, despite the vaccine supply restrictions caused by limited manufacturing capacity, the government has left Moderna and Pfizer the exclusive right to enter into contracts with manufacturers – although federal law gives the government the right to “march” and making your own manufacturing deals exactly in this situation.
The CDC’s obscure advice on which cohorts should be given priority for vaccination during a restricted supply period left states to devise their own policies. Even under ideal circumstances, not all states can adhere to the CDC’s recommendations, but the situation is not helped by the systematic destruction of the CDC’s reputation by the Trump administration, which was once the gold standard for public health agencies.
Florida and Texas, for example, began giving injections to residents over the age of 65, moving “essential” workers – those who need to make frequent contact with the public to do their jobs – further back in line.
“The problem is that 73-74 year-olds would be behind the line for a 21-year-old young worker who is considered ‘essential’,” said Florida Governor Ron DeSantis. “It doesn’t make sense, I think.”
According one account, elderly people living in southwest Florida were asked to go to the vaccination centers in person, where they waited for hours in a maskless crowd.
No system to impose priority rules for vaccines appears to exist, leading to the likelihood of line leaks by people with low priority, but with excessive pull. Moderna announced on Tuesday that it would make its vaccine available to its “workers, contractors and board members” and adult members of their families “to reduce the risk of absenteeism and interruption due to a COVID-19 infection”.
This is a good case to be made for workers. As for the board members, this privileged group of nine includes, in addition to Moderna’s CEO, Stephane Bancel, three executives (two retired), an MIT professor and four venture capitalists.
Other initial recipients include White House officials, Vice President Mike Pence and members of Congress and designated officials. Under normal circumstances, this would make sense in the interest of the government’s continued crisis.
But it is a difficult pill to swallow, so to speak, when so many of the newly vaccinated will be legislators and other political leaders who have spent much of last year dismissing the seriousness of the pandemic, refusing to set an example of responsible masking. social wear and tear, and voting against assistance for ordinary Americans facing death, illness and economic hardship.
Pence, for example, was blaming “the media” in June for raising the alarm about a second wave of COVID-19 infections, as the daily average of new cases dropped to 20,000 from 30,000 in April and 25,000 in May. The average rate of new cases is currently at 194,500 a day. This happened under his supervision as head of the White House coronavirus task force, a job for which he was majestically ill-prepared.
President-elect Biden and vice-president-elect Kamala Harris have also received injections in public, but this is consistent with their approach to the pandemic and their support for public health initiatives in the crisis.
It is possible, even likely, that the vaccine program is only experiencing labor pains. That is the opinion of Kevin Drum, of Mother Jones, who writes that “this problem will probably be solved in the coming weeks and people will soon forget that it happened”.
He may be right. But if so, it will probably be because the program will be taken over by a new government from January 20, which has already started to assemble a pandemic task force of experts in epidemiology and public health, without the sycophants and incompetents that prevailed in the Trump administration.
Biden at least knows that he is facing an elementary challenge, and he has not shown any inclination so far to avoid the responsibility of facing it.