Why is vaccine rollout so slow!?!


Q: Why can’t we get available vaccine doses administered more quickly?

A: Many factors: The holidays, lack of funding, staffing and logistical challenges, getting large-scale vaccine operations up and running, sticking to prioritization schemes, and lower take-up among high-priority groups. Things should be speeding up in the next few weeks.

It’s frustrating to see statistics from the CDC that only 5 million of 17 million available vaccine doses have actually been delivered “in arms”. That’s just 30%. And at this pace, it would take (checks calculator) 392 weeks (almost 6 years!) to get everyone in the US vaccinated with 2 doses.

🚧 Why so slow??

🎄 Holiday period: Vaccination in the US started on December 14, just as we headed into a 2-week holiday period. Health systems and public clinics that were vaccinating health care workers were not running round the clock and many closed or ran skeleton crews on weekends, Christmas Eve, Christmas Day, and New Year’s Day.

💰Funding: Unfortunately, state and local health departments tasked with vaccine delivery have received little to no federal funding to manage this extraordinary effort. (Hot tip: Contact your Congressional representatives and tell them to fund vaccine roll-out!)

👩‍⚕️ Staffing and logistics: Standing up vaccination clinics on top of managing the COVID-19 case surges many health systems are facing is hard. There wasn’t a lot of advance notice between Emergency Use Authorization of the first two vaccines and when they arrived in state. The vaccines require strict cold chain storage and handling once thawed. All of this takes time to get right.

📈 Scaling up: Over the past week, many public health experts have called for mass vaccination clinics (think stadiums, armories, indoor arenas) that can handle thousands of vaccinations a day. In most jurisdictions vaccination is happening primarily through occupational health departments of hospitals and health systems. As we work down the priority list, look for larger scale operations to come on line. The same goes for the pharmacy-run efforts to vaccinate at long-term care facilities.

📋 Sticking to the priority schemes: Every vaccine jurisdiction in the US (there are 64 jurisdictions — most are states, but some are cities, territories, etc.) makes its own distribution plan and priority scheme. These priority schemes mostly follow the ACIP recommendations (linked below) with some local tweaks. Adhering strictly to the priority schemes means offering vaccines to everyone in “Group 1A” or “Phase 1a” before moving to the next groups. In most jurisdictions, that means health care workers and staff and residents of long-term care facilities. For all the reasons mentioned above, it’s taking some time to get to all the people in Group 1A.

 (See link below for Florida’s approach – mass vaccination has started for seniors before health care workers phase is done.)

👍 Take-up in high priority groups: If you’ve been reading the news about vaccine roll-out, you may have seen that some people in high priority groups are declining to be vaccinated (some stories linked below). For example, a hospital may invite 1,000 staff members to make vaccination appointments, but only 700 do so. Reaching the 300 who declined to make an appointment takes more time and effort.

🚦Will things speed up soon? Very likely yes! No one is happy about the pace of vaccination, and staff at every level from hospital occupational health departments to the CDC are working hard to overcome all the challenges above (see link below to interview with CDC’s Dr. Nancy Messonnier).

⏱ How much faster do we need to go? If we wanted to reach 70% of the US population with 2 doses by the end of June, we would need to start administering about 18 million doses per week, or 2.5 million doses per day. That’s about 11 times faster than we’re going now. President-elect Biden has said he wants 100 million doses administered in his first 100 days in office. That’s about 5 times faster than we’re going now. You can track vaccine allocations and distribution at the links below.

💡 If you’ve seen some creative and effective strategies for efficient and large-scale vaccination in your area, tell us about it below!


ACIP vaccine allocation guidance

Vaccine distribution tracker

Florida mass vaccination efforts for seniors

Long-term care staff in Ohio declining vaccine

CDC’s Dr. Nancy Messonnier interview

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