Despite the noise of accelerating the momentum of vaccination against the US against COVID-19 and bringing the country back to normal, the first three months of the launch suggest faster that it is not necessarily better.
A surprising new analysis found that states such as South Carolina and Florida, which ran ahead of others to provide the vaccine to larger groups of people, vaccinated smaller sections of their population than those who moved more. slowly and methodically, such as Hawaii and Connecticut. .
The explanation, as experts see it, is that the rapid expansion of eligibility has caused too much increase in demand for some states to cope with and has led to serious disorder. Vaccine supplies proved inadequate or unpredictable, websites collapsed and telephone lines were blocked, spreading confusion, frustration and resignation among many people.
“The infrastructure was simply not ready. It’s kind of gone, “said Dr. Rebecca Wurtz, an infectious disease physician and health care specialist at the University of Minnesota School of Public Health. She added: “In a hurry to satisfy everyone, the governors thanked the few and frustrated the many.”
The findings could contain an important lesson for the nation’s governors, many of whom have announced dramatic expansions in their launches in recent days after being challenged by President Joe Biden to make all adults eligible for vaccination by May 1st.
“If you’re more focused and focused, you can do a better job,” said Sema Sgaier, chief executive of Surgo Ventures, a nonprofit health organization that conducted the analysis in collaboration with The Associated Press. “You can open it – if you’ve created the infrastructure to vaccinate all those people quickly.”
Numerous factors have hampered the performance of state vaccination. Conspiracy theories, poor communication and independent transport have slowed efforts after the first bottles of the precious vaccine arrived on December 14th.
But the size of the eligible population has always been under the control of state officials, who have made very varied decisions about the number of people they have invited to line up when there is not enough vaccine to circulate.
When the vehicle started, most states put health workers and nursing home residents in front of the line. In doing so, the states followed the national recommendations of the experts who also suggested doing their best to reach everyone in these two groups before moving on to the following categories.
But faced with political pressure and a public outcry, the governors rushed forward. Both the Trump administration and the Biden team have called for vaccination for older Americans.
By the end of January, more than half of the states were open to older adults – about 75 and over, others 65 and over. That’s when the real problems started.
South Carolina has extended eligibility for people in Steven Kite’s age group. January 13th. The 71-year-old kite immediately booked a vaccination at a hospital. But the next day, his appointment was canceled along with thousands more due to lack of vaccine.
“It was frustrating at first,” Kite said. After a week of uncertainty, he rescheduled. He and his wife are now vaccinated. “It simply came to our notice then. I know they had other problems. Dose administration was very unreliable. ”
In Missouri, where more than half of adults were eligible for gunfire, the lack of big cities has sent vaccine seekers hundreds of miles to rural cities. Dr. Elizabeth Bergamini, pediatrician in the suburb of St. Louis, led about 30 people to vaccination events often out of the way after the state opened eligibility for those aged 65 and over Jan. 18 and then expanded further.
“We have gone from the need to vaccinate several hundred thousand people in the St. Louis to another half a million people, but I still hadn’t vaccinated that first group, so it was this crazy race “, said Bergamini. “It was just a hot mess.”
“It has become a bit chaotic,” said Dr. Marcus Plescia, chief physician of the Association of State and Territorial Health Officials. “We created much more demand than supply. This underscored the system and may have made the system less efficient. “
Plescia said the analysis suggests that “a more methodical, measured, judicious, priority-based approach – despite people’s perceptions – may actually be as effective or efficient as opening things up and making more people available.”
In retrospect, health care workers and nursing home residents were easily vaccinated groups. Doses could be delivered to them where they lived and worked.
“We knew where I was and we knew who I was,” Wurtz said. As soon as the states outnumbered these populations, it became harder to find the right people. Residents of nursing homes live in nursing homes. People over the age of 65 live everywhere.
West Virginia declined with both a large number of eligible residents and high vaccination rates in early March, but the state began slowly and strengthened its capacity before expanding eligibility.
Similarly, Alaska maintained a high vaccination rate with a smaller eligible population, then fired for everyone aged 16 and over March 9. This large increase in eligible adults near the end of the study period led AP and Surgo Ventures to omit Alaska from the analysis.
The analysis found that, as of March 10, Hawaii had the lowest percentage of its adult population eligible for vaccination, at about 26%. However, Hawaii administered 42,614 doses per 100,000 adults, the eighth highest rate in the country.
Thirty percent of Connecticut’s adult population was eligible from the same date and administered doses at the fourth highest rate in the country.
In contrast, Mississippi had the sixth percent of its eligible adult population at about 83%. However, Mississippi administered only 35,174 total doses per 100,000 adults, ranking 43th between states.
Missouri, with 61% of its eligible population, distributed 35,341 doses to 100,000 adults.
Seven states in the top 10 for overall vaccination performance – Georgia, Tennessee, Texas, Florida, Mississippi, South Carolina and Missouri – had higher than average rates for their vaccine-eligible residents.
Of the high-performing states, five of the top 10 for high vaccination rates – New Mexico, North Dakota, Connecticut, Wyoming and Hawaii – remained with more restrictive eligibility. Two other high-performing states in the top 10 – South Dakota and Massachusetts – were on average the number of residents eligible for the vaccine.
This is a detailed analysis that shows a clear association between eligibility width and vaccination rates in all states, said Dr. Mark McClellan, a former head of the Food and Drug Administration who was not involved in the new analysis, but reviewed it. o for AP.
Higher-performing states could get results by paying more attention to vaccine supply, thoroughly vaccinating high-risk groups and then opening up more slowly to additional categories while waiting for supply to build, McClellan said.
What happens next will depend on how many states can improve their vaccine delivery systems and whether Americans remain eager for vaccination, even if the threat relaxes with more people protected and the number of cases decreases.
“Have states used this time wisely and fruitfully to establish the infrastructure needed to open it to more people?” Sgaier asked.