US vaccinations hampered by complicated priority levels without federal aid

• The United States has one of the lowest COVID-19 vaccination rates per capita in the world. Israel has the best.
• Israel chose to prioritize its elderly. The United States, on the other hand, applied its doses using a complicated system of priority levels based, in part, on people’s employment.
• To fix the US vaccination campaign, the priority level system needs to be eliminated, say some experts.
• States also need more federal assistance during the implementation process.
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Authorities are struggling to accelerate COVID-19 vaccinations across the United States, but a complicated set of guidelines on who should be given priority has hampered states’ efforts to maximize the number of vaccines.

In fact, the implantation effectiveness of the USA is so poor that it is about 12% that of Israel, which is a way to become the first nation in the world to immunize its population against the coronavirus.

On January 15, Israel administered 24 doses per 100 people, the highest per capita rate for any country by a wide margin, according to Bloomberg. In comparison, the US administered 3.6 doses per 100 people.

The snail’s pace in the US can be explained by the states’ lack of guidance and federal aid – Operation Warp Speed ​​distributed vaccines in record time, but ultimately left it up to individual states to figure out how to distribute their vaccines.

Ethan Miller / Getty Images

Experts like Dr. Peter Hotez, a molecular virologist at Baylor College of Medicine in Texas, also argue that the CDC’s complicated guidelines, to which Americans should have priority access, and when, have ended US vaccination efforts.

“A massive vaccination campaign will not work with our current demanding and intricate criteria of who gets the injection and when,” Hotez wrote in an article for The Washington Post on Monday.

Israel’s history can prove Hotez’s point.

Israel chose to abandon the priority bands and focused on vaccinating its older residents first – in the month since its implementation began, almost 25% of Israel’s 9 million population has received a dose.

Why Israel’s vaccine launch surpassed that of the U.S.

Israel hopes to administer COVID-19 vaccines to all its citizens aged 16 and over by the end of March. For the time being, the country has limited vaccination to people 60 years of age or older, as well as to health professionals and people at high risk for serious illnesses. A person’s employment status does not take into account their eligibility.

Sebastian Scheiner / AP

The United States, on the other hand, spent the month after the vaccine was first approved, dividing its vaccines into priority groups based on where people work: health professionals and nursing home residents and employees should be first, followed by workers essentials and frontline people 75 years old. Americans 65 and older, and those with high-risk health conditions that exacerbated the risk of severe COVID-19, would come last before the vaccine floodgates were opened to the general public.

Although CDC guidelines stipulated that states could vaccinate multiple priority groups at the same time, initial implementation was hampered by members of the priority group who did not want a vaccine, doses that were wasted because hospitals were unable to find eligible weapons to place them on. . , and Americans harassing healthcare providers and pharmacies about their eligibility and whether they could show up at the nearest clinic and get lucky.

“There is no obvious way to vaccinate tens of thousands of people and, at the same time, ensure that the first in line qualify for essential occupation or underlying health condition,” wrote Hotez, adding, “confirming such criteria is complicated at best hypotheses, and probably not even feasible to try under coercive conditions. “

The resounding success of Israel’s vaccination may be due to the sheer simplicity of its priority system, San Francisco blogger Elad Gil wrote: “Having age-based levels makes it easier to know who should appear and who is eligible, and removes one great burden on inspection. “

Amir Cohen / AP

That said, Israel’s mass vaccination was also aided by the country’s small population and compact geographic footprint. Prime Minister Benjamin Netanyahu struck initial deals with vaccine makers BioNTech, AstraZeneca and Pfizer, and did not hesitate to pay dearly for more supplies.

Experts also pointed to the centralized public health system sponsored by the Israeli government as an asset in its efficient vaccination campaign.

Ronit Calderon-Margalit, a public health doctor at Hadassah-Hebrew University, told CNBC that each citizen has a unique health identity, so it’s “easy to call them, follow them” and make a centralized list of who was vaccinated and when.

States are struggling to vaccinate their citizens without federal aid

Moncef Slaoui, chief adviser to Operation Warp Speed, predicted last month that 50 million Americans would be vaccinated by the end of January. With only 16 days to go, only 11.9 million doses were administered and only 30 million doses were distributed, according to the CDC.

To speed up the launch, Health and Human Services (HHS) Secretary Alex Azar withdrew a page from Israel’s book.

He said on Tuesday that states should expand the range of people who have priority access. That pool should now include Americans aged 16 to 64 who have certain underlying health problems that increase their risk of developing serious COVID-19, he said.

Alex Wong / Getty Images

But expanding this set of priorities does little to solve a fundamental and fundamental problem of the US vaccination campaign: the scarcity of federal guidance (both now and before implementation) has placed the burden of scheduling consultations, identifying and configuring vaccination sites, and veto eligible residents for individual states.

The issue comes down to attitudes among White House and HHS officials, Ashish Jha, Dean of Brown University School of Public Health, told Insider. “They deeply believe that it is not the role of the federal government to help states in a health crisis, that it is up to states to resolve everything on their own,” he said.

The result was that it became easier for some Americans to be vaccinated – depending on where they live and what priority scheme their state officials decided to follow – and created 50 disparate schedules for when eligible people can expect vaccination.

Andrew West / The News-Press / USA Today via Reuters

According to Premier Inc., the leading healthcare performance improvement company in the United States, a decentralized deployment has resulted in widespread confusion, with providers unsure which state or federal agency is making decisions or where to turn to resolve problems. (Biden’s new vaccine plan seeks to solve problems like this.)

And centralization, according to Boaz Lev, a member of the Israeli Ministry of Health, was the key to Israel’s success, not priority levels.

“Create a good flow of vaccines, a good flow of people … with a good administrative background so you can register them and they know when to come for the next injection. So there are a variety of things that basically involve planning with advance and have it launched so that it flows, “he told CNBC on Wednesday.

The validity of Boaz’s comments is confirmed by data on which states in the U.S. are winning the vaccination race.

Dave Kolpack / AP Photo

States that opened vaccination to older residents before the rest of the United States, such as Florida and Texas, are not the leaders in vaccinating their residents.

West Virginia and the Dakotas, on the other hand, lead the country in vaccinations per capita, an achievement they have achieved by planning strong partnerships with local health systems and pharmacies to facilitate dose distribution before launch.

Andy Dunn, Aria Bendix and Hilary Brueck contributed to the account of this story.