While the 20 million target may have been too high to start, the holidays may have caused delays, some health experts said, and there may be a lag in vaccination notification.
Fauci warned against jumping to conclusions about the pace of vaccine implantation in such a short period of time, saying that “we just started”.
Still, while a lot of money and effort has been invested in vaccine development and distribution to states, less seems to have been invested in how to actually administer them, public health experts said.
“There seems to have been an idea in Washington that, damn it, you have all these public health people out there. All you have to do is send the vaccine,” said William Schaffner, professor of infectious diseases at Vanderbilt University.
“I’m having flashbacks of what happened to the tests,” said Dr. Leana Wen, a visiting professor of health policy and management at the Milken School of Public Health at George Washington University and a medical analyst at CNN.
“It is the same thing, that initially there were promises made based on optimistic projections. Everyone assumed that there was a national strategy when, apparently, there was not.”
State and local health departments are already overwhelmed and “did not have the resources they need to plan and implement the most ambitious vaccination program that our country has ever undertaken,” said Wen.
These departments “have performed all other aspects of pandemic operations, such as testing, contact tracking, public education, data tracking, and now you are adding that huge responsibility to that responsibility, which is why they have been saying for months that they need Additional support. “
In addition, there is the fact that “public health infrastructure in the United States has been shrinking for about 15-20 years,” said Schaffner.
How to increase vaccination
The federal government can do a number of things to speed up the vaccination process, Wen said, including instilling a sense of urgency and “(making it clear) that this is a wartime mobilization. This requires a national effort 24 hours a day, seven days a week, with no excuses. “
Schaffner agreed.
“You can vaccinate on Saturdays, you can vaccinate on Sundays, you can start at 6 am,” said Schaffner. “You can go until 8 or 9 pm. So the more you vaccinate, the better.”
Second, Wen said, the government could set targets, determine which state and local officials need to meet the targets and help them get what they need.
And the government could help streamline the process by equipping vaccination centers and creating mass vaccination sites.
“They should do everything that can be done by the federal government, specifically recruiting staff,” said Wen. “Why should 50 states be trying to figure out how to recruit vaccinators?”
Mass immunization clinics – in parking lots, for example – would be a way to eventually speed up inoculation for everyone, said LJ Tan, the strategy director at the Immunization Action Coalition, which works to increase immunization rates.
With the flu, “we know that if you run a really well-done mass immunization clinic, you can easily clean 20,000 vaccines a day,” said Tan. The rate for the coronavirus vaccine would not be as high because of the waiting time required after applying the vaccine to ensure that there is no allergic reaction, he said.
Hesitation among health professionals
But the real key to solving the problem, said Schaffner, is communication.
‘There has been an underestimation of how much communication work will be needed to bring people who are hesitant into the herd and vaccinate them, “said Schaffner.” Even my good friends and dear friends at the CDC deeply underestimated the degree of vaccination hesitation among people who work in the healthcare environment. “
Sensing this would be a problem, Vanderbilt University Medical Center started an educational program four to six weeks before the vaccine was delivered, Schaffner said, including videos, social media and question and answer sessions.
“We can see the proverbial movement of the needle in the direction of acceptance,” said Schaffner.
In Kentucky, “more than 30% of qualified people refuse to receive the vaccine when offered” in some cases, the state health commissioner said on Thursday.
In nursing homes, there are reports that nursing assistants – not residents – hesitate to be vaccinated, Tan said.
“We need to find ways to get in and help them and help educate nursing assistants,” said Tan. “This is a safe and effective vaccine.”
Part of the reason why implantation has been slow has to do with the population recommended to be the first to receive the vaccine: elderly people in long-term care facilities and health professionals, said Tan.
In places like California, for example, where virus cases are skyrocketing and hospitalization rates are overwhelming, facilities are judicious when administering vaccines to healthcare professionals who can then develop fever – one of the possible side effects of the vaccine, but also a symptom of Covid-19 – which would prevent them from working, even for a short time, when hospitals need all possible help.
“You can imagine that healthcare systems, with the increase in patients and needing the full availability of their staff, will be much more careful in the way they vaccinate their staff,” said Tan. “You are not going to vaccinate everyone at the same time”, or even half of them at the same time.
‘I just need to start,’ says the general surgeon
“Take these vaccines where they will be taken,” Adams told NBC’s “Today” program on Tuesday. “We don’t have to recreate the wheel, we just need to make it spin.”
Some states have started to move even faster to expand the group of people eligible for a vaccine, but this has created its own problems. In Florida, after those 65 and older were allowed to shoot, people lined up for hours and supplies ran out quickly.
President-elect Joe Biden set an aggressive goal of 100 million kicks in his first 100 days in office. This would vaccinate 50 million people, because immunization requires two separate doses for each person.
This is a departure from the Trump administration’s strategy to retain half of vaccine production in the United States to ensure that second doses are available.
Although it is a risky strategy, given that both vaccines now approved in the United States require two doses, administered at specific intervals, a transition official said that Biden’s team believes that vaccine manufacturers will be able to produce sufficient second doses in time. ; Biden’s team plans to use the Defense Production Act to produce vaccines and other materials.
Biden said he would establish vaccination centers administered and supported by the federal government across the country with the help of the Federal Emergency Management Administration, the CDC, the military and the National Guard.
CNN’s Jacqueline Howard, Jen Christensen and Sara Murray contributed to this report.