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This time last year, the world turned to a pandemic that would destroy everything and cost 1.9 million lives – and counting down. The promise of the new year is that vaccines are finally here and offer a way out.
But the vaccination campaign began slowly in the United States. Instead of the 20 million people vaccinated by the end of 2020 – a frequent promise of the Trump administration – only about 6 million people have received their first dose so far. Explanations for this include the holidays, snowstorms and the need to train healthcare professionals to take pictures.
But the number of cases and deaths is rising, making widespread vaccination more urgent than ever. So how can the American Leap start the COVID-19 vaccination campaign?
NPR spoke with more than a dozen public health experts to find out what they thought. Here are their restaurants.
1. Make the money flow
As early as September, CDC Director Robert Redfield testified in Congress that “now is the time” to receive billions of dollars for the distribution of the coronavirus vaccine in the United States.
But that didn’t happen, and public health officials say the delay in federal funding is partly to blame for the slow start of the vaccination campaign. This week, the federal government announced that part of the nearly $ 9 billion included in the COVID-19 relief package in December is on its way to the states.
“We look forward to receiving this money, which will be crucial to several aspects of our response,” Dr. Rachel Levine, Pennsylvania’s health secretary and president of the Association of State and Territorial Health Professionals, told NPR in a briefing. the press. She says the money will be used to contract with companies to manage vaccination clinics in the community and to run a campaign to inform the public about vaccines.
Dr Lee Norman, Kansas’s health minister, said the money would allow his state to “buy some mobile vaccination vehicles, attract more staff” and make contact with colorful communities.
Officials expect it will take at least three weeks for that money to reach the CDC in the states, and then more time to get to the forefront of vaccination efforts. When it arrives, experts expect the campaign to accelerate rapidly.
2. Get more vaccines
The two vaccines currently approved in the United States – manufactured by Pfizer and Moderna – are complex to operate. Both are frozen – one requires storage in ultra-cold temperatures and dilution in the field – they require patients to be monitored for at least 15 minutes after their shot, and patients must return a few weeks later for a second dose.
Complexity has slowed things down, and new, simpler vaccine candidates on the horizon may help.
The providers indicate that clinical guidelines on how to properly administer the two available vaccines came out at the same time as the doses arrived.
“It’s not that the vaccines are coming from the trucks and we’re able to get them right away,” said Dr. Jinlene Chan, deputy secretary of public health at the Maryland Department of Health. “Training is important to make sure we deliver the right amount of vaccines to each individual and do it safely and as efficiently as possible without waste.”
Even when healthcare professionals start handling these Pfizer and Moderna vaccines, employees are expecting other promising vaccine applicants that would increase the supply available.
“We have heard that both Johnson & Johnson and AstraZeneca are planning to present their proposals for [Emergency Use Authorization] by the end of this month or in February, “says Levin of ASTHO.” We’ll see how science is and what the FDA and CDC decide – but potentially the spread of more vaccines, especially single-dose Johnson and Johnson [vaccine], would increase things significantly. “
None of these vaccines have the ultra-cold storage requirements that Pfizer does – they can be stored in the refrigerator or freezer for longer, giving planners much more flexibility.
Jason Schwartz, a professor of health policy at Yale University, agrees that there is a lot of enthusiasm for the Johnson & Johnson vaccine. “The single-dose vaccine would change the game for the vaccination program here in the United States in the coming months,” he said.
As many vaccine applicants are already in production and can be ready for use after the federal health agencies give the green light, the availability of an available vaccine can increase very quickly.
And since there are more doses of vaccines that we can get around, “we can distribute more generously to doctors’ offices, federally qualified health centers, rural health centers, chain pharmacies, retail pharmacies, community pharmacies – we can’t give away in all of these places if we don’t have enough, “said Kentucky Public Health Commissioner Dr. Stephen Steck.
3. Open “mega-sites”
Until now, vaccines have been delivered mainly to hospitals to reach first-line health workers and long-term care facilities for residents and staff.
But several states, including New Jersey and Texas, are launching “mega-sites,” vaccination clinics designed to vaccinate hundreds or thousands of people each day. Most of these places are likely to appear across the country, as federal funding allows health workers to hire temporary staff and pay for space and supplies, and as soon as vaccine supplies are stable enough to keep these clinics full.
“There should be mass vaccination clinics in high schools, convention centers, and parking lots in all of America’s cities,” Schwartz said. This type of site will be essential as the range of people eligible for vaccination expands.
The key to achieving this work on the necessary scale is federal funding and logistical support, Schwartz said, because hospitals are already overcrowded and caring for patients with COVID-19, and local and state governments do not have the money to do it alone.
4. Make delivery more predictable
If vaccine providers have ready-made doses of vaccines, but no one is planning to get them, that is a problem. It is also a problem if there are planned patients – but no vaccine.
“[Once], our shipment Moderna just didn’t show up; “We have no idea where it went,” said Dr. Grace Lee, a medical officer at Stanford Children’s Hospital who serves as a vaccine advisor for the CDC and California. We planned around these doses, so we had to delay for a while. “
The match between supply and demand is key to the success of the vaccination campaign. In the beginning, there was a serious hiccup at the federal level: General Gus Perna, head of operations for Operation Warp Speed, had to apologize for telling states that there would be more vaccine than was actually ready for use. State and local officials say predictability has improved, but there are still inconsistencies.
A more stable supply of vaccine doses would help vaccine providers plan so that there are patients willing to take any dose that comes in.
5. Deploy public information campaigns
There is another key to the rapid introduction of the vaccine: a society that is ready and willing to be vaccinated. Health officials in Kentucky, Ohio and other states say hesitation has delayed their vaccination campaigns.
Combating misinformation and reassuring the public that vaccines are safe and effective, comprehensive public information campaigns will be crucial. This includes a national effort by the incoming Biden administration and a $ 50 million advertising campaign planned by the Advertising Council, along with efforts by the state and local authorities to spread the word.
“States need to have vaccine confidence teams that have the full resources to go out into the community and educate the public about the importance of these vaccines,” said Dr. Kelly Moore, deputy director of the Nonprofit Advocacy Group. Objective “Immunization Action” Coalition. These teams will have to “answer their questions, dispel myths, encourage them to decide to be vaccinated and communicate with them about how they get the vaccine in their own country.”
Efforts need to be state-specific, as each state has a slightly different allocation plan, says Adriane Casalotti, head of state and public affairs at NACCHO, the National Association of County and City Health Officials. Otherwise, “people are watching the nightly news and really trying to understand” why these people have access, but these people [in another state] no? “
In Michigan, Washton County Health Department has a team dedicated to responding to emails and calls about vaccine distribution. “For weeks we have been bombarded with questions with the question” When and where can I get the vaccine? “” Said spokesman Susan Ringler-Ink. “It was a challenge because people want and expect us to be able to tell them this date and this time, and we’re just not there yet.”
As long-awaited federal funding arrives and health departments can increase vaccine administration and activate their communication plans, they hope to receive these responses to the public soon.
Rob Stein and Alison Aubrey contributed to this report.