A slow deployment of Covid-19 vaccines across the United States highlights the challenges of a decentralized distribution plan that depends on states and localities to manage the complicated logistics of the last mile of firing into people’s arms. , according to supply chain experts.
According to the Centers for Disease Control and Prevention, more than 22 million doses had been distributed to states and other jurisdictions as of Friday, while at that point 6.7 million people had received the first shot. The figures were below the target of 20 million vaccinations in the United States by the end of 2020 and communities and states were still reporting bottlenecks this month while managing their inoculation programs.
“If you told them your priority is to vaccinate as many people as possible as quickly as possible, they would have run the campaign differently,” said Julie Swann, a professor and head of the state university’s department of industrial and systems engineering. of North Carolina. “But that’s not what they were told.”
Instead of trying to stop the spread of transmission to communities, said Dr. Swann, who advised the CDC during the H1N1 pandemic, the focus has been on reducing mortality, especially among populations of high risk.
Supply chain experts attribute the delays in part to the burdens faced by often underfunded state and local health agencies that were already stretching to their limits by the coronavirus pandemic, along with communication problems, including the confusion about the amount of doses the states were to receive.
But experts also point to guidelines from a federal vaccine advisory group on who should be inoculated first, who recommend administering the initial limited dose supply to health care workers and residents of health facilities. long-term care.
On Friday, President-elect Joe Biden’s transition team said it would try to release almost every dose available to speed up distribution.
New York Gov. Andrew Cuomo and New York City Mayor Bill de Blasio have clashed over the distribution, with the governor criticizing hospitals for administering late doses and the mayor calling for more flexibility in state guidelines on who can be vaccinated.
The U.S. Covid-19 vaccine distribution strategy focuses on supply, said Philip Palin, an author and supply chain resilience expert who advises governments and businesses to prepare for catastrophic events. He said vaccines are assigned to specific groups, unlike high-speed supply chains, which are more common and are usually demand-based.
The CDC reported that 6.7 million people in the U.S. had received their first vaccine against Covid-19 as of Friday.
Photo:
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 and Modern program Inc.
—It has effectively exceeded the capacity of vaccine administrators to keep up to date with current guidelines for setting vaccination priorities. “What hasn’t happened yet is a sufficient‘ consumption ’of distributed supply,” Palin said.
To speed up vaccinations, Palin said, authorities 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 the deployment of doses continues on the current path, coordination of vaccinations may be more difficult as authorities move to the wider population, said Pinar Keskinocak, a professor at the Georgia Institute of Technology and director of the School Health and Humanitarian Systems Center.
“Ideally we would need some sort of online system in which you register with your information and location and let us know when it’s time to get the vaccine,” Dr. Keskinocak said. “It looks like we don’t have a very specific plan at the local level on how we will get this vaccine to be stored in people’s arms.”
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“It looks like we don’t have a very specific plan at the local level as to how we will get this vaccine to be stored in people’s arms.”
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Covid-19 vaccination programs in Europe are also experiencing delays amid rising infections in different countries with different approaches to distributing vaccines.
In the United States, state and local health departments often have a lot of flexibility for these campaigns, Dr. Swann said. “This allows North Dakota to distribute differently in New York. It allows Arizona, with its Native American reserves and a different kind of infrastructure, to be distributed differently than California, ”he said.
Centralized vaccination efforts are usually faster, but they can face other challenges, Swann said. For example, deploying the military to help vaccinate people would likely have resistance in some parts of the U.S., he said.
Still, Dr. Swann said, “if the United States decided to pivot and say, ‘We have to drop cases because our hospitals are overflowing,’ then they could run mass vaccination clinics and it would be much more efficient.”
Write to Jennifer Smith to [email protected]
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