An editorial today in the New York times appropriately questioned why we have so little data about the COVID-19 vaccination program in the United States. They point out that it’s very difficult to improve a program when you don’t even understand what’s currently happening.
For once, this failing was not solely attributed to the prior administration and did address the long-term deterioration of the public health infrastructure in the United States. Importantly, it also pointed to the states which have not been consistent or transparent in their actions to distribute these important vaccines.
There are some near term problems with the U.S. vaccine distribution program that need to be immediately addressed. Part of the problem seems to be a wildly ineffective vaccine management system. As the journal M.I.T. Technology Review has reported, the federal government gave the company Deloitte a $44 million no-bid contract to develop software that all states could use to manage their vaccine rollouts. The resulting product is so unreliable that many health departments have abandoned it.
Another problem, noted by ProPublica, is that states have not required reporting of vaccine waste, despite being asked to do so by the C.D.C. The anecdotal reports on this make it sound like a huge problem, but without some defined reporting system we have no idea how much vaccine we’re actually wasting.
In addition, rigid contracts with CVS and Walgreens to vaccinate the elderly in nursing facilities appear to have issues with overstock of vaccines as well as wastage. This issue needs to be clarified immediately, and it may be time to end both these contracts, especially since the nursing home immunization program is reportedly nearing completion.
It is particularly disconcerting that the methods for distributing vaccines appear to be ill defined and currently result in significant (?) wastage. As the U.S. gets additional stocks of vaccine, 10 to 100 times the amounts that we currently have, these problems will be magnified if not resolved now. We need to immunize the mass of the population, and the government needs to have the infrastructure to do that efficiently.
Another problem that the editorial addresses is the lack of monitoring in the United States for alterations in the virus. Part of the reason we’ve known about variants of SARS-CoV-2 is that we have been informed by countries such as the United Kingdom and South Africa that are sequencing most of their viral isolates. The U.S. must do a better job of monitoring the virus throughout the United States, so we have advanced notice if there is a variant that becomes vaccine resistant.
I have discussed all of these problems previously in posts, but the NYT editorial makes a concise argument for better information to assure that our vaccine campaign is successful in ending the pandemic.