What to do when there is a Covid-19 Glut vaccine

After the early challenges, the delivery of the vaccine keeps pace with the supply. But by the end of March, the monthly supply of the vaccine could reach 100 million doses. To keep up, the vaccination rate should double and then some. This will require a comprehensive approach to vaccine administration, substantial capacity building in pharmacies, primary care practices and other reliable healthcare providers.

Especially with improved delivery, at some point, maybe in April, supply will start to exceed demand. The challenge will not be how to rationalize a limited resource, but how to reach patients who are not allowed to be vaccinated. Based on the latest follow-up polls by the Kaiser Family Foundation, more than half of Americans say they don’t want to get vaccinated. Some may simply want to wait; others may oppose obtaining it.

One reason for the hesitation may be that it was necessary to rationize rare doses at first, leading many Americans to internalize the idea that some people may have more benefits or more merits than others. It is essential to emphasize in public health messaging that every adult can benefit and deserve the protections they can offer and that there will be no reason to give it up once the problem of the deficit is resolved.

The government at every level should work with as many partners as possible to expand access. More Americans will get the vaccine if they can get it in a comfortable location. Not everyone will be willing or able to line up at Dodger Stadium. Insurers, pharmacies and large employers can help public health systems reach people in every community.

Medicare shares Medicare Advantage policyholders’ immunization plans with health plans to help plans focus on people and communities who haven’t been vaccinated. Medicare should also share data with primary care providers. Utah shares vaccination data and works with health care systems such as Intermountain, with a focus on providing low-income, hard-to-reach benefits. The federal government should provide financial support and technical assistance to enable more states to quickly establish such partnerships.

Washington can also support state and local efforts to improve programming, to help plan the calendar as far as possible. States could, for example, send a vaccine ticket to those who are not eligible to be inoculated under current rationing rules for later redemption. No one should be removed: those looking for a dose should receive something to connect them to a future slot.

America also needs an effective public education campaign to alleviate fears and uncertainty about the safety and benefits of the vaccine. The Covid Collaborative, which works with the Advertising Board and community organizations, tests educational approaches that can address the concerns of those in doubt, for example, it works with influencers who can talk to certain groups that may be more reluctant or satisfying, such as young Americans. People in their 20s and 30s, who will need to be vaccinated when doses are available, may not show up if they are not employed – especially as the prevalence decreases and, with it, a sense of urgency.

There are significant gaps in vaccination rates between race, income and location. Polls suggest that confidence is also breaking down politically, with many Republicans skeptical about vaccination. Even groups that are now eligible, such as health workers, are giving up the vaccine at high rates.

The focus is now on expanding distribution and increasing supply. Problems will soon shift to the demand side of the equation. It is time to address the next set of challenges.

Dr. Gottlieb is a fellow resident at the American Enterprise Institute and was commissioner of the Food and Drug Administration, 2017-19. Dr. McClellan is director of the Duke-Margolis Center for Health Policy at Duke University and was FDA commissioner, 2002-04. Dr. Gottlieb serves on the boards of Pfizer and Illumina, and Dr. McClellan on the boards of Johnson, Johnson and Cigna; each company is involved in aspects of Covid’s response.