How is West Virginia getting vaccines in arms so fast?


Q: How is West Virginia getting vaccines in arms so fast? They have vaccinated at a higher rate than any other state!

A: 3 things have driven West Virginia’s success:

1. A unique arrangement with local pharmacies (not national chains) to vaccinate long-term care staff and residents.

2. Advanced planning.

3. Leadership.

First, let’s do the numbers:

As of January 14, the US had delivered 36.6 million doses to state, tribal, local, and territorial jurisdictions, and 11.1 million of those doses — or 36% — had been administered “in arms”.

That overall number masks a lot of state-level variation: Alabama has only administered 21% of its available doses, while West Virginia has administered a whopping 74% of available doses, covering over 6% of their population. (Nerd alert: See link to Benjy Renton’s vaccine allocation and administration dashboard below – updated daily!).

How did they do it? In recent coverage from NPR and The Conversation (both inked below), 3 key factors were identified:

🏪 1. Partnering with independent vs. chain pharmacies: Through a federal partnership program, 49 states have contracted with CVS and Walgreens to deliver vaccines to long-term care facilities, including nurses homes.

West Virginia opted out. They recognized 2 important things:

1️⃣ CVS and Walgreens didn’t cover large parts of the predominantly rural state.

2️⃣ The state had a strong network of more than 200 small, independent pharmacies in place that already had excellent working relationships with long-term care facilities. Those pharmacies regularly deliver medications to long-term care facilities, and had been doing COVID testing at the facilities for months.

📋2. Advanced planning: Once the state decided to opt out of the federal partnership program, they made good use of the time window between when Pfizer and Moderna submitted their applications for Emergency Use Authorizations to the FDA, and when vaccines arrived in the state. Public health organized the pharmacy network and made detailed allocation and delivery plans. The pharmacies already had patient data for the long-term care facilities they partnered with, and could start scheduling vaccination appointment sbefore vaccine was even available. Those plans paid off: In the first week that doses were available, West Virginia was able to administer 90% of them, a rate no other state came close to matching.

👩‍💼 3. Leadership: If you’ve read our other “success story” posts, you know we often highlight the importance of leadership. In West Virginia’s case, Governor Jim Justice has been a strong voice in supporting a nimble, responsive vaccine roll-out, tailored to West Virginia’s unique circumstances. Krista Capehart, Director of Professional and Regulatory Affairs fort West Virginia’s Board of Pharmacy led the design and implementation of the plan that’s now getting national recognition.

So, will other states be able to close the gap in the near future? Both CVS and Walgreens claim to be on track with their long-term care contracts and plans. The transition to a new presidential administration next week may bring new urgency, resources, and leadership to federal efforts to support states. As this massive effort continues, matching supply and demand at the local level will continue to be a challenge. But West Virginia’s experience points to some key success strategies: Recognize when a local, tailored solution will work best. Use precious lead time wisely for planning. Elect and appoint strong leaders!


Vaccine allocation and delivery dashboard

Tinglong Dai’s piece in Conversation

NPR story

Link to original FB post