Despite the clamor to speed up the U.S. vaccine against COVID-19 and bring the country back to normal, the first three months of the launch suggest that it is not necessarily better.
A surprising new analysis found that states such as South Carolina, Florida and Missouri, which advanced ahead of others in offering the vaccine to larger groups of people, have vaccinated smaller proportions of their population than those who they moved more slowly and methodically, as did Hawaii and Connecticut.
The explanation, as experts see it, is that the rapid expansion of eligibility caused too high an increase in demand for some states and caused a serious mess. Vaccine supply proved inadequate or unpredictable, websites crashed and phone lines got stuck, spreading confusion, frustration and resignation among many people.
“The infrastructure was simply not ready. He fell for it, ”said Dr. Rebecca Wurtz, an infectious disease physician and health data specialist at the University of Minnesota School of Public Health. She added: “In the rush to satisfy everyone, the governors satisfied few and frustrated many.”
The findings could contain an important lesson for the nation’s governors, many of whom have announced dramatic expansions in recent days after being challenged by President Joe Biden so that all adults could be vaccinated on May 1st.
“If you’re more focused and focused, you can do a better job,” said Sema Sgaier, executive director of Surgo Ventures, a nonprofit health data organization that conducted the analysis in collaboration with The Associated Press . “You can open it, if you’ve set up the infrastructure to vaccinate all these people quickly.”
Numerous factors impeded the performance of vaccination in the state. Conspiracy theories, poor communication, and unreliable shipments slowed efforts after the first precious vaccine vials arrived on December 14th.
But the size of the eligible population was always under the control of state officials, who made very different decisions about how many people they invited to line up when there was not enough vaccine to go around.
When the unit began, most states placed health workers and nursing home residents at the front of the line. In doing so, states complied with national expert recommendations that also suggested doing everything possible to reach everyone in these two groups before moving on to the following categories.
But in the face of political pressure and the outcry of the citizens, the governors hurried forward. Both the outgoing Trump administration and the incoming Biden team urged opening vaccines to older Americans.
By the end of January, more than half of the states had opened to older adults (about 75 or more, another 65 or more). That’s when the real problems began.
South Carolina extended eligibility to people in Steven Kite’s age group. On January 13th. Kite, 71, immediately booked a vaccine at a hospital. But the next day his appointment was canceled along with thousands of others due to the shortage of vaccine.
“It was frustrating at first,” Kite said. After a week of uncertainty, he rescheduled. Now he and his wife are vaccinated. “It simply came to our notice then. I know they have had other problems. Delivery of doses has been very unreliable. “
In Missouri, the scarcity of large cities sent vaccine seekers driving hundreds of miles to rural cities. Dr. Elizabeth Bergamini, a pediatrician in the suburban neighborhood of St. Louis, led about 30 people to vaccination events often out of the way the state opened requirements for those over 65 on Jan. 18 and then expanded further.
“We went from needing to vaccinate several hundred thousand people in the St. Louis area to half a million additional people, but we hadn’t vaccinated that first group yet, so it’s been that crazy,” Bergamini said. “It just turned out to be a hot mess.”
“It was a bit chaotic,” said Dr. Marcus Plescia, chief physician of the Association of State and Territorial Health Officials. “We created much more demand than there was supply. This underscored the system and this may have made the system less efficient. “
Plescia said the analysis suggests that “a more methodical, measured, prudent and priority-based approach – despite people’s perception – may actually be as efficient or more efficient than opening things up and making it available to more people “.
In retrospect, health workers and residents of the residences were the easiest groups to vaccinate. Doses could be delivered where they lived and worked.
“We knew where they were and we knew who they were,” Wurtz said. As soon as the states went beyond these populations, it was harder to find the right people. Residents of nursing homes live in nursing homes. People 65 and older live everywhere.
West Virginia overcame the trend with a high number of eligible residents and high vaccination rates in early March, but the state started slow and built its capacity before expanding eligibility.
Similarly, Alaska maintained a high vaccination rate with a smaller eligible population, and then opened fire on anyone 16 years of age or older. On March 9, this large increase in eligible adults near the end of the study period caused AP and Surgo Ventures to omit Alaska from the analysis.
The analysis found that, as of March 10, Hawaii had the lowest percentage of its adult population eligible for vaccination, around 26%. Still, Hawaii had administered 42,614 doses per 100,000 adults, the eighth highest rate in the country.
Thirty percent of Connecticut’s adult population was eligible on the same date and had administered doses at the fourth highest rate in the country.
In contrast, Missouri had the largest percentage of its eligible adult population at around 92%. However, Missouri had dispensed 35,341 doses per 100,000 adults, ranking 41st among the states.
Seven states, ranked in the top ten in terms of overall vaccination performance (Georgia, Tennessee, Texas, Florida, Mississippi, South Carolina, and Missouri) had quotas higher than the average of their residents eligible to receive shots.
Among high-performing states, five of the top ten high vaccination percentages (New Mexico, North Dakota, Connecticut, Wyoming, and Hawaii) were left with more restrictive eligibility. Two other high-yielding states in the top ten countries (South Dakota and Massachusetts) were approximately average in the number of residents eligible for the vaccine.
“This is a comprehensive analysis that shows a clear association between the breadth of eligibility and interstate vaccination rates,” said Dr. Mark McClellan, a former head of the Food and Drug Administration who did not participated in the new analysis, but reviewed it for AP.
Better-performing states could get results by paying more attention to the supply of vaccines, thoroughly vaccinating high-risk groups and opening up to additional categories more slowly as they wait for supplies to be built, McClellan said.
What happens next will depend on how many states can improve their vaccine delivery systems and whether Americans still want vaccination, even when the threat is favored by the protection of more people and reducing the number of cases.
“Have states used this time prudently and fruitfully to establish the infrastructure needed to open it up to more people?” Sgaier asked.
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Associated Press writer Heather Hollingsworth in Mission, Kansas, contributed to this report.