U.S. Covid-19 vaccination plan limits speed of deployment, supply chain experts say


Slow deployment of Covid-19 vaccines across the United States highlights challenges of a decentralized distribution plan that relies on states and localities to handle complicated last mile logistics of sending injections to the arms people, according to supply chain experts.

More than 22 million doses had been distributed to states and other jurisdictions as of Friday, according to the Centers for Disease Control and Prevention, while 6.7 million people had received their first vaccine by that time. The numbers were below the U.S. goal of 20 million vaccinations by the end of 2020, and communities and states were still reporting bottlenecks this month as they managed their immunization programs.

“If you had told states that your priority was to vaccinate as many people as possible as quickly as possible, they would have run the campaign differently,” said Julie Swann, professor and head of the industrial and systems engineering department at the 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 has been on reducing mortality, especially among populations at high risk.

Supply chain experts partly attribute the delays to the burdens facing often underfunded state and local health agencies, already pushed to their limits by the coronavirus pandemic, as well as communication challenges, including confusion over the number of doses states should receive.

But experts also rely on advice from a federal vaccine advisory committee on who to vaccinate first, which recommends that the initial limited-dose supply be given to health workers and residents of long-term care facilities. .

President-elect Joe Biden’s transition team said on Friday they would seek to release nearly any available dose to speed up distribution.

New York Gov. Andrew Cuomo and New York Mayor Bill de Blasio clashed over distribution, with the governor criticizing hospitals’ slowness in administering doses and the mayor calling for more flexibility over distribution. state guidelines on who can be vaccinated.

The strategy for the distribution of the Covid-19 vaccine in the United States is focused on supply, said Philip Palin, author and expert in supply chain resilience who advises governments and businesses on preparing for catastrophic events. Vaccines are allocated to target groups, he said, unlike faster supply chains, which are more common and tend to be demand driven.

The CDC reported that 6.7 million people in the United States received their first vaccine against Covid-19 on Friday.

Paul Sancya / Associated Press

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

and BioNTech SE in a joint program and by Moderna Inc.

—Effectively exceeded the ability of those administering vaccines to follow current guidelines for setting immunization priorities. “What has not yet happened is sufficient ‘consumption’ of the distributed supply,” said Palin.

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

If the dose rollout continues on the current track, coordinating vaccinations may become more difficult as authorities move to the general population, said Pinar Keskinocak, professor at the Georgia Institute of Technology and director of the Center for Health. and Humanitarian Systems of the school.

“Ideally, we need some sort of online system where you sign up with your information and location, and get notified when it’s time for you to get your vaccine,” Dr Keskinocak said. “We don’t seem to have a very concrete plan locally as to how we’re going to get this vaccine out of storage into people’s arms.”

“We don’t seem to have a very concrete plan locally as to how we’re going to get this vaccine out of storage into people’s arms.

– Pinar Keskinocak, professor at the Georgia Institute of Technology

Vaccination programs against Covid-19 in Europe are also experiencing delays due to an outbreak of infections in countries with varied approaches to vaccine distribution.

In the United States, state and local health departments have generally had a lot of flexibility for such campaigns, Dr Swann said. “It allows North Dakota to distribute differently from New York. This allows Arizona, with its Native American reservations and another type of infrastructure, to distribute itself differently from 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 immunize people would likely meet resistance in parts of the United States, she said.

Yet, said Dr Swann, “if the United States decided to pivot and say, ‘We have to reduce cases because our hospitals are overwhelmed,’ then they could absolutely run mass vaccination clinics, and that would be. much more efficient. . ”

Write to Jennifer Smith à [email protected]

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