For months, states warned that additional funding would be needed to distribute a coronavirus vaccine. Last week, they finally got their wish.
The Department of Health and Human Services said it would push out $3 billion to states for vaccine distribution, and another $19 billion for testing before January 19. Both were sorely needed.
While the current administration has kept half of all vaccine doses in reserve to be used for people’s second doses, President-elect Joe Biden said he plans to send most of them out to be used immediately. The bet is that pharmaceutical companies will be able to manufacture enough doses in time for people to receive their booster shot.
So far, the vaccine rollout has been a bumpy one. As of Friday, 22 million doses had been distributed, but only 6.7 million had been administered, according to data from the Centers for Disease Control and Prevention (CDC). This falls far short of Operation Warp Speed’s goal of vaccinating 20 million people by the end of the year.
On top of that, state health departments have largely been left to draft up plans, despite facing slashed budgets and limited staff — who are also trying to manage other facets of the pandemic.
“It just becomes more and more complex. It’s falling to an agency that has limited staff to execute this well,” Tamyra Porter, a partner with Guidehouse, said in an interview.
Different approaches by state
Most states have opted to vaccinate healthcare workers and nursing home residents first, which should be the easiest part of the process.
Volunteers are help step up the vaccine rollout. For instance, the state of California is calling for help from dentists and retired healthcare workers. Meanwhile, Walgreens and CVS have been staffing up to administer the vaccine in nursing homes.
The process, however, is a bit more complicated than giving people their annual flu jab.
“You can’t just go down the line like a flu shot. It’s a lot more time intensive. You need to survey people in advance of the vaccine, and monitor them for 15 minutes after administering it,” said Martha Roherty, executive director of ADvancing States, a nonprofit representing state aging and disability agencies.
And while giving several vaccines to a big system, such as Kaiser Permanente, might be relatively easy, several practitioners not affiliated with hospitals are still waiting for their first dose.
In other states, such as Florida and Texas, people ages 65 and older are being prioritized for the first doses, bucking CDC recommendations. But this process takes much more careful planning. In Florida, people waited in long lines outside to receive their first doses of the vaccine at first-come first-serve sites.
“You don’t want a bunch of people milling around because that can be a transmission event. You need to have appointments scheduled out so you can see people every 2 or 3 minutes,” said George Rutherford, an epidemiology professor at the University of California San Francisco.
Even with the best set plans, all states need one critical component: people who are willing to take it. A Gallup poll last month found that 63% of Americans would be willing to take the vaccine, up slightly from September.
Testing still a big piece
As the vaccine rollout begins, testing will remain a big part of the Covid-19 response for several months ahead, as indicated by the $19 billion HHS said it plans to allocate for this purpose.
After seeing a surge in cases in advance of the holidays, many states — including California — are at a tipping point. They could see an additional surge after New Year’s, or cases could finally start to decrease again.
The detection of a new, more transmissible strain of the virus in several cities makes testing and preventive measures all the more important. Called B.1.1.7, the variant was first detected in the U.K., but multiple cases were recently found in California, Colorado, New York and Florida.
“Vaccines still work, the drugs still work, monoclonal antibodies still work, masks still work, the tests still work. Everything still works, it’s just a little bit more transmissible,” Rutherford said.
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