Health officials worry U.S. is not ready for COVID-19 vaccine

Sept. 3, 2020

United States public health departments, which have struggled for months to test and trace everyone exposed to COVID-19, are now being told to prepare to distribute COVID-19 vaccines as early as November 1, wroteLiz Szaboin a Kaiser Health News report. 

In a four-page memo this summer, the Centers for Disease Control and Prevention (CDC) told health departments across the country to draft vaccination plans by October 1 “to coincide with the earliest possible release of COVID-19 vaccine.” 

The CDC’s director, Dr. Robert Redfield, also wrote to governors last week about the urgent need to have vaccine distribution sites up and running by November 1, McClatchy first reported. Redfield asked governors to expedite the process for setting up these facilities. 

But health departments that have been underfunded for decades say they currently lack the staff, money and tools to educate people about vaccines and then to distribute, administer and track doses to some 330 million people. Nor do they know when, or if, they’ll get federal aid to do that. 

“There is a tremendous amount of work to be done to be prepared for this vaccination program and it will not be complete by Nov. 1,” said Dr. Kelly Moore, associate director of immunization education at the Immunization Action Coalition, a national vaccine education and advocacy organization based in St. Paul, Minnesota. “States will need more financial resources than they have now.” 

Dozens of doctors, nurses and health officials interviewed by KHN and The Associated Press expressed concern about the country’s readiness to conduct mass vaccinations, as well as frustration with months of inconsistent information from the federal government. 

The gaps include figuring out how officials will keep track of who has gotten which doses and how they’ll keep the workers who give the shots safe, with enough protective gear and syringes to do their jobs.

With only about half of Americans saying they would get vaccinated, according to a poll from AP-NORC Center for Public Affairs Research, it also will be crucial to educate people about the benefits of vaccination, said Molly Howell, who manages the North Dakota Department of Health’s immunization program. 

The U.S. has committed more than $10 billion to develop new coronavirus vaccines but hasn’t allocated money specifically for distributing and administering vaccines. And while states, territories and 154 large cities and counties received billions in congressional emergency funding, that money can be used for a variety of purposes, including testing and overtime pay. 

An ongoing investigation by KHN and the AP has detailed how state and local public health departments across the U.S. have been starved for decades, leaving them underfunded and without adequate resources to confront the coronavirus pandemic. The investigation further found that federal coronavirus funds have been slow to reach public health departments, forcing some communities to cancel non-coronavirus vaccine clinics and other essential services. 

States are allowed to use some of the federal money they’ve already received to prepare for immunizations. But KHN and the AP found that many health departments are so overwhelmed with the current costs of the pandemic — such as testing and contact tracing — that they can’t reserve money for the vaccine work to come. Health departments will need to hire people to administer the vaccines and systems to track them, and pay for supplies such as protective medical masks, gowns and gloves, as well as warehouses and refrigerator space. 

Then there’s the basic question of scale. The federally funded Vaccines for Children program immunizes 40 million children each year. In 2009 and 2010, the CDC scaled up to vaccinate 81 million people against pandemic H1N1 influenza. And last winter, the country distributed 175 million vaccines for seasonal influenza vaccine, according to the CDC. 

But for the U.S. to reach herd immunity against the coronavirus, most experts say, the nation would likely need to vaccinate roughly 70 percent of Americans, which translates to 200 million people and — because the first vaccines will require two doses to be effective — 400 million shots. 

Although the CDC has overseen immunization campaigns in the past, the Trump administration created a new program, Operation Warp Speed, to facilitate vaccine development and distribution. In August, the administration announced that McKesson Corp., which distributed H1N1 vaccines during that pandemic, will also distribute COVID-19 vaccines to doctors’ offices and clinics. 

“With few exceptions, our commercial distribution partners will be responsible for handling all the vaccines,” Operation Warp Speed’s Paul Mango said in an email. “We’re not going to have 300 million doses all at once,” said Mango, deputy chief of staff for policy at the Health and Human Services Department, despite earlier government pledges to have that many doses ready by the new year. “We believe we are maximizing our probability of success of having tens of millions of doses of vaccines by January 2021, which is our goal.” 

Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security, said it will take time for the vaccines to be widespread enough for life to return to what’s considered normal. “We have to be prepared to deal with this virus in the absence of significant vaccine-induced immunity for a period of maybe a year or longer,” Adalja said in August. 

In preliminary guidance for state vaccine managers, the CDC said doses will be distributed free of charge from a central location. Health departments’ local vaccination plans may be reviewed by both the CDC and Operation Warp Speed. 

Kaiser Health News has the report

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