US Covid-19 vaccination plan limits launch speed, supply chain experts say

“If you told states that your priority is to vaccinate as many people as possible as soon as they can, they would have run the campaign differently,” said Julie Swann, professor and head of the industrial and systems engineering department at North Carolina State University. “But that’s not what they were told.”

Instead of seeking to stop the spread of transmission in communities, said Dr. Swann, who advised the CDC during the H1N1 pandemic, the focus was on reducing mortality, especially among high-risk populations.

Supply chain experts attribute the delays, in part, to the burdens faced by state and often underfunded health agencies, already extended to their limits by the coronavirus pandemic, along with communication problems, including confusion over the number of doses they states must receive them.

But experts also point to guidance from a federal vaccine advisory group on who should be inoculated first, who recommended that the initial limited dose intake be given to health workers and residents of long-term care facilities. .

On Friday, President Joe Biden’s transition team said it would try to release almost all available doses to speed up distribution.

New York Governor Andrew Cuomo and New York City Mayor Bill de Blasio faced the distribution, with the governor criticizing hospitals for slow dosing, and the mayor called for more flexibility in state guidelines on who can be vaccinated.

The US Covid-19 vaccine distribution strategy is supply-oriented, said Philip Palin, author and supply chain resilience expert, who advises governments and companies on preparing for catastrophic events. Vaccines are allocated to the target groups, he said, as opposed to higher-speed supply chains, which are more common and tend to be demand-driven.

He said that the manufacture and distribution of the first two vaccines in the US – those produced by Pfizer Inc.

and BioNTech SE in a joint and Modern program Inc.

– has effectively exceeded the ability of vaccine administrators to keep up with current guidelines for setting vaccination priorities. “What has not happened yet is a sufficient ‘consumption’ of distributed supply,” Mr Palin said.

To speed up vaccinations, Mr Palin said, authorities could work with community organizations and local governments to identify potential vaccination sites and focus on areas where vaccine needs are greatest.

If dosing continues on the current path, vaccination coordination may become more difficult as authorities move to a wider population, said Pinar Keskinocak, a professor at the Georgia Institute of Technology and director of the school’s Center for Sanitary and Humanitarian Systems.

“Ideally, we need some kind of online system where you sign up with your information and location and be informed when it’s time to get vaccinated,” said Dr. Keskinocak. “It seems we don’t have a very concrete plan at the local level on how we will get this vaccine out of storage in people’s arms.”

Covid-19 vaccination programs in Europe are also facing delays amid a wave of infections in countries with varying approaches to vaccine distribution.

In the US, state and local health departments usually had a lot of flexibility for such campaigns, said Dr. Swann. “This allows North Dakota to distribute differently from New York. It allows Arizona, with its Native American reservations and a different kind of infrastructure, to distribute differently than California, ”she said.

Centralized vaccination efforts tend to be faster, but may face other challenges, Dr. Swann said. For example, deploying the military to help vaccinate people would likely have resistance in some parts of the United States, she said.

However, Dr. Swann said, “If the United States decides to pivot and say, ‘We need to eliminate cases because our hospitals are overwhelmed,’ then it could absolutely run mass vaccination clinics and be much more effective.” . “

Write to Jennifer Smith at [email protected]