A slow rollout of Covid-19 vaccines in the United States highlights the challenges of a decentralized distribution plan that depends on states and locations to deal with the complicated last-mile logistics of taking vaccines into people’s arms, supply chain experts say .
More than 22 million doses have been distributed to states and other jurisdictions as of Friday, according to the Centers for Disease Control and Prevention, while 6.7 million people have received their first injection so far. The numbers were below the U.S. target of 20 million vaccinations by the end of 2020, and communities and states were still reporting bottlenecks this month while administering their vaccination programs.
“If you told states that your priority is to vaccinate as many people as possible as quickly as possible, they would have campaigned differently,” said Julie Swann, professor and head of North Carolina’s systems and industrial engineering department. State University. “But that’s not what they said.”
Instead of trying to stop the spread of transmission in communities, said Dr. Swann, who advised the CDC during the H1N1 pandemic, the focus has been on reducing mortality, especially among high-risk populations.
Supply chain experts attribute the delays in part to the burdens faced by local and state health agencies, often underfunded, already stretched to their limits by the coronavirus pandemic, along with communication problems, including confusion over how many doses states should receive. .
But experts also point to the guidance of a federal vaccine advisory panel on who should be inoculated first, who recommended that limited initial dose provision be administered to health professionals and residents of long-term care facilities.
On Friday, President-elect Joe Biden’s transition team said it would try to release almost all available doses to speed up distribution.
New York Governor Andrew Cuomo and New York Mayor Bill de Blasio clashed with distribution, with the governor criticizing hospitals that take too long to administer doses and the mayor asking for more flexibility in state guidelines on who can be vaccinated.
The US distribution strategy for the Covid-19 vaccine is focused on supply, said Philip Palin, author and specialist in supply chain resilience who advises governments and companies in preparing for catastrophic events. Vaccines are being allocated to target groups, he said, in contrast to high-speed supply chains, which are more common and tend to be demand-driven.
The CDC reported that 6.7 million people in the United States received their first vaccine vaccine against Covid-19 on Friday.
Photograph:
Paul Sancya / Associated Press
He said the manufacture and distribution of the first two vaccines in the US – those produced by Pfizer Inc.
and BioNTech SE in a joint program and by Moderna Inc.
– effectively exceeded the ability of vaccine administrators to maintain current guidelines for setting vaccination priorities. “What hasn’t happened yet is enough ‘consumption’ of the distributed supply,” said Palin.
To speed up vaccinations, Palin said, officials could work with community organizations and local governments to identify potential vaccination sites and focus on areas where the need for the vaccine is greatest.
If dose distribution continues on the current path, coordinating vaccinations may become more challenging as authorities advance to the general population, said Pinar Keskinocak, professor at the Georgia Institute of Technology and director of the Center for Health and Humanitarian Systems from school.
“Ideally, we need some kind of online system where you sign up with your information and location and find out when it’s time to get the vaccine,” said Dr. Keskinocak. “We don’t seem to have a very concrete plan at the local level on how we are going to get this vaccine stored in people’s arms.”
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‘We don’t seem to have a very concrete plan at the local level on how we are going to get this vaccine stored in people’s arms.’
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Covid-19 vaccination programs in Europe are also experiencing delays amid a wave of infections in countries with varied approaches to the distribution of vaccines.
In the United States, state and local health departments typically have a lot of flexibility for these campaigns, said Dr. Swann. “This allows the distribution of North Dakota to be different from that of New York. This allows Arizona, with its Native American reserves and a different type of infrastructure, to distribute itself differently than California, ”she said.
Centralized vaccination efforts tend to be faster, but may face other challenges, said Dr. Swann. For example, sending military personnel to help vaccinate people would likely encounter resistance in some parts of the United States, she said.
Still, said Dr. Swann, “if the United States decided to pivot and say, ‘We have to reduce cases because our hospitals are overloaded’, then they could absolutely run mass vaccination clinics, and it would be much more efficient. “
Write to Jennifer Smith at [email protected]
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