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Washington DC – During the last 10 months of despair and hardship brought on by the COVID-19 pandemic in the United States, the prospect of an effective vaccine was always seen as the light at the end of the tunnel.
That hope seemed to materialize last month when US health authorities approved two vaccines for emergency use across the country.
But weeks after the U.S. Food and Drug Administration (FDA) approved the Pfizer-BioNTech and Moderna vaccines, public health experts say immunization efforts have been glacially slow and random.
“The launch of the vaccine has been slower than expected, but it has also been downright chaotic,” said Kevin Schulman, a professor at Stanford University School of Medicine in California.
Schulman, who serves as director of industry and education associations for the Stanford Center for Clinical Excellence Research, recently published an article describing the need for an effective public awareness campaign to promote the vaccine.
A man works at a ‘super vaccination station’, built to vaccinate 5,000 people a day against COVID-19, in San Diego, California, in January [Mike Blake/Reuters]
So far, there has been no national push to counter misinformation and respond to concerns about immunization. A recent Gallup poll showed that only 65 percent of Americans are willing to receive the vaccine, and acceptance drops to 62 percent in the non-white population.
But that’s just one of a long list of challenges inoculation efforts face.
In the absence of central planning, clear federal guidelines, databases of people who should be vaccinated first, and the infrastructure needed for mass immunization, the United States is falling far behind the goals it had set for the first few weeks of vaccination. .
Target lost
Government officials had said they expected to inoculate 20 million people by the end of 2020. But as of January 15, just over 12.2 million people had received their first dose of the two-shot vaccine, according to the Centers for Disease Control and Prevention. Disease Control and Prevention (CENTERS FOR DISEASE CONTROL AND PREVENTION).
The CDC did not respond to Al Jazeera’s request for comment on the vaccine launch.
In an interview with NBC News on Friday, US Secretary of Health and Human Services (HSS) Alex Azar, who resigned a day later over President Donald Trump’s handling of the Capitol unrest, appeared to blame states for the slow delivery of the vaccine.
“We have had great success with these incredibly effective vaccines: 38 million doses of vaccines available, 31 million already shipped and distributed; we have more than 12 million shots fired at weapons, “said Azar.
“We have had some governors who have been too prescriptive and restrictive in the groups of people that they are trying to get vaccines to.”
The now-former HSS secretary said the federal government’s “call” to governors has been to administer the vaccine to everyone over 65 and anyone with pre-existing medical conditions to “protect the vulnerable.”
However, in the same interview, Azar acknowledged reports that there were no reserve stocks of second doses of the vaccine, contradicting earlier statements that second injections are in reserve.
However, he said he was confident that “ongoing production” will be able to “provide the second dose for people.” The HHS Department did not respond to Al Jazeera’s request for comment over the weekend.
But Schulman denounced a lack of planning in the months leading up to FDA approval.
“This is all something that should have been figured out months ago: how are we going to develop rosters, how are we going to prioritize people for the vaccine and then how are we going to physically establish immunization clinics,” he told Al Jazeera.
“Those talks are continuing now, but they could have been going on for months.”
Theresa Ogunjimi, a registered nurse, rests for a moment inside a COVID-19 unit at the United Memorial Medical Center in Houston, Texas, on December 12. [File: Callaghan O’Hare/Reuters]Biden’s plan
US President-elect Joe Biden, who will take office on January 20, has called the vaccine launch a “regrettable failure so far,” and vowed to establish a fast-moving immunization campaign that would administer 100 million injections in the administration. first 100 days in office.
“Our plan is as clear as it is bold: get more people vaccinated for free, create more places for them to get vaccinated, mobilize more medical teams to get vaccines in people’s arms, increase supply and get it out the door. as soon as possible, ”Biden said in a speech Friday.
Mouhanad Hammami, chief health strategist in Wayne County Michigan, home to the city of Detroit, said he is “very optimistic” about Biden’s plan and, in particular, the promise to make vaccines more available.
“There are plans to increase the supply to the states and eventually to us and other health systems and not delay those vaccines, which will help enormously,” Hammami told Al Jazeera.
“I hope that funding to increase capacity will also be considered. With more vaccines, you will need more people to vaccinate; it will need a system that can adapt to that increase in supply. “
President-elect Joe Biden receives his second dose of the coronavirus vaccine at ChristianaCare Christiana Hospital in Newark, Delaware, on Monday, January 11, 2021 [File: Susan Walsh/AP Photo]
Hammami said he hopes the authorization of other vaccines, including the Oxford-AstraZeneca vaccine that the UK approved in late December, will help address the supply problem.
The federal government had initially given the impression that it had millions of vaccine doses in reserve. But Azar’s acknowledgment on Friday that stocks are out of stock confirms that supply is becoming a problem.
The United States ordered a total of 400 million doses of the Pfizer-BioNTech and Moderna vaccines by the end of 2020, enough to vaccinate 200 million out of a population of 328 million. But the timeline for administering the doses is unclear.
In May 2020, the US government also pre-ordered 300 million doses of the Oxford-AstraZeneca vaccine, which is still in the approval process.
$ 20 billion for vaccine distribution
On Friday, Biden said it would allocate $ 20 billion of its $ 1.9 trillion COVID-19 relief package to the vaccine distribution plan.
The funds would help establish federally supported vaccination centers and mobile clinics and help state and local health systems deliver the vaccine, logistical support that would be needed to administer one million vaccines a day.
People line up to receive a dose of the COVID-19 vaccine at a 24-hour vaccination center at the Brooklyn Army Terminal in Brooklyn, New York, on January 11. [File: Brendan McDermid/Reuters]
“Knowing that not all states and jurisdictions have the resources to scale vaccines at the rate demanded by this crisis, the Biden-Harris administration will leverage federal resources and emergency contracting authorities to launch new vaccination sites and expand state efforts and locations across the country, ”Biden’s transition team said in a statement Friday.
The Infectious Diseases Society of America (IDSA), a Washington-based advocacy group of health experts that specializes in infectious diseases, expressed support for Biden’s call to increase funding for the vaccination effort.
“The incoming Administration’s proposal comes at a crucial time, and we recommend more comprehensive measures to achieve its objectives,” the group said in a statement. “To ensure access to vaccines for those most at risk, expansion must be implemented quickly with adequate resources and capabilities.”
Congressman Frank Pallone, chairman of the House of Representatives Committee on Energy and Commerce, which oversees public health, also praised Biden’s plan to push to provide “additional resources and assistance” to combat the virus, “including for distribution. life-saving vaccines. “
“These investments will protect the health of the American people and help us squash this virus so that we can rebuild our economy,” Pallone said in a statement.
Priority stages
Michigan’s Wayne County has been one of the hardest hit areas in the country, with the virus killing nearly 4,000 people out of a population of 1.7 million.
Hammami said the unprecedented scale of the vaccination campaign has forced health experts and authorities to address challenges on the fly. “It’s like building the plane while trying to fly it,” he said.
The two main local challenges, Hammami said, are vaccine availability and figuring out how to move from one priority group to another to vaccinate as many people as possible.
The county had administered more than 40,000 doses by mid-January and Michigan Governor Gretchen Whitmer is seeking permission from federal officials to purchase 100,000 doses of the Pfizer vaccine directly from the manufacturer to fix a “two-week delay” in the supply.
The CDC has recommended vaccinating people in stages based on their job, age, and medical condition. In the first phase, vaccines have been targeted at healthcare workers, who are easy to identify, locate and access through the healthcare facilities for which they work.
But as many states and counties are moving into phase two – seniors 65 and essential front-line workers – they struggle to create databases of people who should get vaccinated now.
Hammami added that reluctance to receive the vaccine complicates planning efforts, as it is not always clear how many people within a particular vaccine priority group are actually willing to get vaccinated.
Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, who is advising Biden’s transition, has called for flexibility in adherence to priority groups to ensure vaccines are administered and do not remain in storage.
“If you have a fix, give it to him and don’t be so rigid about those first few appointments,” Fauci told NBC’s Today show on Friday.
Fauci added in a separate interview Sunday that Biden’s promise to administer 100 million doses of vaccines in his first 100 days in office is “absolutely doable.”
Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases, gestures after receiving his first dose of the COVID-19 vaccine on December 22, 2020 [File: Patrick Semansky/AP Photo]Greater awareness
Stanford’s Schulman said another problem is that the public and private health systems “aren’t necessarily in sync at all,” but said it’s too late to try to build a public infrastructure to deliver the vaccine.
Instead, he asked to strengthen existing networks with greater financing and logistical support.
Ultimately, if the United States wants to control the pandemic, vaccine supplies must be available and public health authorities must develop public awareness campaigns to encourage people to get vaccinated.
“The two tragedies would be for people to come because we believe we will have the vaccine available and we don’t have it available because we don’t receive our shipments,” Schulman said.
“And the worst tragedy would be to discover that we have the vaccine available to administer, but we don’t have enough people to vaccinate.”
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