If the presentation of the COVID-19 vaccine seems chaotic and incomprehensible, with numbers that do not add up and assignments that do not make sense, you are not alone.
Even people who study this for life are at a loss.
“None of us know what’s going on,” said Dr. Amesh Adalja, a senior scientist at the Johns Hopkins Center for Health Safety.
He tried to figure out how the figures from the Centers for Disease Control and Prevention, the White House, and the state fit together, but they can’t.
“I don’t understand why there is no more transparency,” he said. “We could easily hold a webinar every day to go through the numbers – we sent so many boxes, so many boxes coming next week. The more they do not, the more discord is created between states and the federal government. “
Overall, the trends are positive, but the pace will need to increase significantly to meet the deadlines announced by the White House this week.
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As of January 25, the distribution of the COVID-19 vaccine by the federal government has increased by 57%. As of this week, up to 13.5 million doses are delivered weekly.
“We are on track to have a sufficient supply of vaccines for 300 million Americans by the end of July,” Jeff Zients, the White House’s COVID-19 response coordinator, told a working group briefing on Wednesday.
To get the projected two doses of approved vaccines for 300 million people, distribution from the federal government will have to increase by approximately one-third. At the current level, it should be by September.
Given how fast things are increasing, it seems sofeasible. However, the White House did not release actual data on future increases.
So, what happened? Why are there questions about delivery and deliveries?
If things seem to be going well, why is there so much chaos at the state level, with long queues, of people unable to schedule appointments and close clinics for lack of vaccines?
There are several reasons. One is the lack of federal transparency on the delivery and delivery of vaccines and the continuous fluctuation of vaccine deliveries, which confuses and confuses states.
Public health officials are frustrated by the constant ambiguity. It is impossible to know exactly how many vaccines are being shipped and where and to whom it has been given – information to plan for.
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The vaccine is delivered and calculated through several separate programs, including programs for states, nursing homes and long-term care facilities, Federal Qualified Health Homes, and private pharmacies. Some doses are controlled by the states themselves, and some by federal programs.
The National Association of Governors sent a public letter to President Joe Biden this week asking for greater clarity, including “the visibility of federal vaccination efforts at the plant level happening within our borders.”
The letter states “anxiety created by the demand and supply of the vaccine” and asks for better reporting to avoid confusion.
This didn’t help either: Some states chose to play by their own rules
States also bear some of the blame. Experts say they opened vaccinations too quickly for all wider groups, even though supplies were in short supply.
“We knew all along that there would be a limited number of doses in the beginning and that we would have to give priority,” said Dr. Marcus Plescia, Chief Medical Officer of the Association of State and Territorial Health Officers. “Somewhere out there, the vaccine was over-promised.”
This did not always happen.
CDCs Advisory Committee on Immunization Practices they spent months creating a carefully designed series of vaccine acceptability levels from the most endangered to the least.
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Some civil servants immediately ignored the recommendations and began opening up vaccinations to wider groups of people, Plescia said.
It is said in the ACIP guidelines from December First in line would be health care workers in the first place and residents of long-term care institutions, in what was known as Phase 1a. Next could come basic workers and people over the age of 75, in phase 1b. People over the age of 65 and people with high-risk medical conditions would be in a higher phase 1c.
Just a week after the first COVID-19 vaccine was distributed, Florida Gov. Ron DeSantis violated ACIP guidelines and unilaterally declared that his state favored people over the age of 65.
This resulted in long queues, seniors waiting for the vaccine overnight, the collapse of meeting websites and general chaos as more than 4 million seniors in Florida sought the vaccine.
What needs to happen now to fix this? Let’s start with honest messages.
Currently, in 35 states plus the District of Columbia, people over the age of 65 can seek a meeting, according to the White House. But other states have not gone further than vaccinating basic workers and those aged 75 and over.
Wisconsin law is debating this week whether to add teachers to phase 1a.
Early finger-pointing that states are going too slow may have triggered a rush for speed and circumvention of guidelines. In any case, he said, the vaccine was over-promised.
“We suddenly skipped the ACIP guidelines and told all these people they were right,” he said. “I don’t know if that was the most sensible thing I could do. It would probably be better if we held out.”
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Other states, such as Georgia, have resisted the widespread expansion of vaccine requirements, said Glen Nowak, director of the Center for Health and Risk Communication at the University of Georgia and former communications director for the CDC National Immunization Program.
The governor there has consistently said that there is not enough vaccine for the first priority groups yet, so he will not open it yet. “He says,‘ I hear you, I want to do it. But we don’t have enough vaccines at the moment, ”Nowak said.
In order for representation to seem out of control, states must manage expectations. “Expansion isn’t going to help, it’s going to make things worse,” he said.
Honest messages are needed that this process cannot happen overnight. While not everyone will get the vaccine right away, everyone will get it in the end, said Dr. Gregory Poland, director of the Mayo Clinical Clinic Research Group and editor-in-chief of the journal Vaccine.
“The cure is a tincture of time,” he said. Although he admitted, “Now it’s easy for me to say I got both doses.”
Where Operation Warp Speed fell short: ‘Huge communication failure’
Much of the problem, since before the first doses of the vaccine were delivered, was a lack of clear, consistent communication, experts say. It has made the job of explaining what is happening now with the supply of vaccines even more difficult.
Even the man who played a key role in enabling the COVID-19 vaccine, Moncef Slaoui says the messaging was a major failure operations Warp Speed otherwise stellar works.
“It was a huge communication failure, honestly,” Slaoui said of the presentation at a recent conference of academies of science in New York.
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There was no chance that everyone in America would be immunized immediately, he said, but that message didn’t come out. Millions of Americans have expressed anger and frustration over something Slaoui and his team thought they had clearly explained.
“Every time we say, ‘We will produce enough doses of vaccine to immunize the American population by the summer of 2021.’ It is understood from that statement that it will take six, seven months to get enough vaccine to immunize everyone, ‘” he said. “But, actually, I think we should have communicated a lot, a lot better that there won’t be enough vaccine for everyone right away.”
It will take time to overcome that deficit of trust and information, said Dr. Kelly Moore, deputy director of the nonprofit Immunization Coalition.
“We will never regain lost opportunities to build a solid foundation for the vaccination program before the vaccines start running,” she said, “but we are getting back on track and the signs are giving me hope.”
Contact Elizabeth Weise at [email protected]