Wisconsin is almost at the bottom of the nation; Republican-launched launch
Vaccination rates by state monitored by the Centers for Disease Control and Prevention consistently ranked Wisconsin close to the last place for gun shots per 100,000 inhabitants. On Sunday, Wisconsin registered as the 7th place at the base, with about 5.3% of every hundred thousand inhabitants, with a shot on Friday (5).
State officials and health experts warn that the CDC data tracker is not the most accurate measure for states, however. Health professionals have 72 hours to report doses administered to federal, state and local agencies; other discrepancies can occur between state and federal reports based on what time of day each update – and other factors. For example, the tracker lists Wisconsin as having administered 308,290 shots on Sunday; data on the DHS website – last updated on January 21 – reports about 2,000 more than the CDC.
Republicans, who blocked COVID-19 legislation in the legislature for most of 2020, have heightened criticism of the government’s implementation in recent weeks. At a news conference on Thursday, Governor Tony Evers defended the state’s response, saying the state was not receiving the required number of doses from the federal government.
“I think we are doing the best we can, considering the ramifications of the vaccines and the number of vaccines,” said Evers, when asked if anything would change about the state’s process. “We are going in the right direction, but the end result is that we need to have a vaccine to vaccinate.”
The federal government controls the state supply
States do not buy vaccines themselves. When New York Governor Andrew Cuomo sent a letter to Pfizer this week asking for just that, the Biden government disagreed.
DHS estimated that the state would need to receive three times its current dose quota to reach 80% of the state’s vaccinated residents by June this year. Of the more than 1,200 vaccinators enrolled in Wisconsin, about half did receive the vaccine.
But at a news conference last Thursday, Deputy Secretary Julie Willems Van Dijk said that negotiations with the federal government indicated that the state cannot expect to increase its nearly 70,000 weekly doses by at least three to four weeks. Across the country, states are begging the federal government for more supply.
“The biggest thing they want and need is doses,” said Claire Hannan, executive director of the Association of Immunization Managers. The nonprofit group includes public health agency managers across the country, providing a forum for sharing challenges, best practices and lessons learned.
“Part of that has been really not knowing, week after week, how many doses you are getting,” said Hannan. “And not seeing an increase when you expand.”
Major states have small populations and location-dependent deployment programs
West Virginia has consistently found itself in national headlines and at the top or near the top of the CDC vaccination tracker, after being the only state to refuse the federal pharmacy program to vaccinate its long-term care population. They completed vaccinating their long-term care population at the beginning of implementation, after partnering with local pharmacies across the state to schedule and administer vaccines.
More recently, Alaska has also topped the national charts for its deployment, which the state’s chief medical officer attributes in part to its largest military, veteran and indigenous populations. States obtain additional funds for the Department of Defense, Department of Veterans Affairs and the Indian Health Service – and are monitored as separate entities from the states themselves. In addition, the state has implemented a complete process to bring vaccines to its rural populations that are difficult to access.
Alaska, West Virginia, North Dakota, Connecticut and South Dakota were the top five states on the national charts on Friday. All but Connecticut are among the top ten states by population, across the country.
But experts warn that the implementation models used in other states are highly personalized and depend on local relationships and programs that are not necessarily replicable in other states.
“They are rural,” said Hannan. “They have a smaller number of providers.” With small populations and closer relationships with their existing health care providers, many of the best performing states have relied on existing local partnerships to accelerate their implementation.
“West Virginia is a good case study, but I don’t know if it is necessarily transferable to other states,” explained Prof. Ajay Sethi, director of the Master’s program in Public Health at UW-Madison. “It is very difficult to say that what is working in one state will certainly work in another if we use the same strategy.”
‘It’s a marathon, not a race’
Some states initially advanced vaccination rates because of the opening of large age groups, while other states like Wisconsin maintained the CDC’s initial guidance by recommending prioritizing health workers and long-term care populations before moving on to next phase.
While broader categorizations meant more gun injections, they also caused vaccine delays for healthcare professionals and long lines in states like Florida, where older people lined up at night to get vaccines.
Prof. Sethi says the vaccine’s launch should not be judged by its pioneers in the first month.
“We are almost at the first corner, if this were a horse race,” he explained. “Some horses come out of the gate a little too quickly; this does not guarantee that they will be crowned winners. “
Other states announced their candidates for the next phase earlier than others. Illinois announced on January 6 that the state would vaccinate people aged 65 and over in its next phase, while Wisconsin waited until much later in January to do the same. But announcing the next phase without the resources to start vaccinating this group has caused bottlenecks and confusion, with people trying to schedule appointments for vaccines that are not yet available.
“There is that initial euphoria that you signed up for the vaccine, pre-registered,” he explained. “But the devil is in the details. When are you really going to get the vaccine? “
To some extent, this has also been a factor in Wisconsin in the past few days, since they announced eligibility for people aged 65 and over. Health care providers have experienced a deluge of calls to request consultations; patients are now often asked to wait for their provider to reach them as soon as the supply expands. Only about half of Wisconsin’s vaccinators did not even receive doses, according to DHS last week.
“It will take time,” said Willems Van Dijk. “I know that asking for more patience is, frankly, asking a lot. So, today I’m going to order something a little different; today we are asking for perseverance. “
Authorities target next vaccine candidates for expanded offer
Health officials are cautiously hopeful about Johnson & Johnson’s next COVID-19 vaccine candidate, which hopes to be ready for consideration by the U.S. Food and Drug Administration within weeks.
According to CNN, the vaccine could result in millions more doses of vaccine as early as March, potentially increasing the national supply available.
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