A rapid COVID-19 vaccine rollout backfired in some US states

A surprising new analysis found that states like South Carolina, Florida and Missouri that raced before others to supply the vaccine to ever-larger groups of individuals have vaccinated smaller shares of their population than people who moved more slowly and methodically, like Hawaii and Connecticut.

A rapid COVID-19 vaccine rollout backfired in some US states
A rapid COVID-19 vaccine rollout backfired in some US states

Despite the clamor to hurry up the U.S. vaccination drive against COVID-19 and obtain the country back to normal, the primary three months of the rollout suggest faster isn't necessarily better.A surprising new analysis found that states like South Carolina, Florida and Missouri that raced before others to supply the vaccine to ever-larger groups of individuals have vaccinated smaller shares of their population than people who moved more slowly and methodically, like Hawaii and Connecticut.

The explanation, as experts see it, is that the rapid expansion of eligibility caused a surge in demand too big for a few states to handle and led to serious disarray. Vaccine supplies proved insufficient or unpredictable, websites crashed and phone lines became jammed, spreading confusion, frustration and resignation among many of us .“The infrastructure just wasn’t ready. It quite backfired,” said Dr. Rebecca Wurtz, an communicable disease physician and health data specialist at the University of Minnesota’s School of Public Health. She added: “In the push to satisfy everyone, governors satisfied few and frustrated many.”

The findings could contain a crucial go-slow lesson for the nation’s governors, many of whom have announced dramatic expansions in their rollouts over the past few days after being challenged by President Joe Biden to form all adults eligible for vaccination by May Day .“If you’re more targeted and more focused, you'll do a far better job,” said Sema Sgaier, executive of Surgo Ventures, a nonprofit health-data organization that conducted the analysis together with The Associated Press. “You can open it up — if you've got found out the infrastructure to vaccinate all those people fast.”

Numerous factors stymied state vaccination performance. Conspiracy theories, poor communication and undependable shipments slowed efforts after the primary vials of precious vaccine arrived Dec. 14.But the dimensions of the eligible population was always within the control of state officials, who made widely varying decisions about what percentage people they invited to urge in line when there wasn’t enough vaccine to travel around.

When the drive began, most states put health care workers and home residents at the front of the road . In doing so, states were abiding by national recommendations from experts who also suggested doing everything possible to succeed in everyone in those two groups before moving on to subsequent categories.But faced with political pressure and a clamor from the general public , governors rushed ahead. Both the outgoing Trump administration and therefore the incoming Biden team urged opening vaccinations to older Americans.

By late January, quite half the states had opened to older adults — some 75 and above, others 65 and up. That’s when the important problems started.South Carolina expanded eligibility to people in Steven Kite’s age bracket Jan. 13. Kite, 71, immediately booked a vaccination at a hospital. But subsequent day, his appointment was canceled along side thousands of others due to a shortage of vaccine.

“It was frustrating initially ,” Kite said. After every week of uncertainty, he rescheduled. He and his wife are now vaccinated. “It ended up understanding fine. i do know they’ve had other problems. The delivery of the doses has been very unreliable.”In Missouri, big-city shortages sent vaccine seekers driving many miles to rural towns. Dr. Elizabeth Bergamini, a pediatrician in suburban St. Louis, drove about 30 people to often out-of-the way vaccination events after the state opened eligibility to those 65 and older Jan. 18 then expanded further.

“We went from wanting to vaccinate several hundred thousand people within the St. Louis area to a further half-million people, but we still hadn’t vaccinated that first group, so it's been this mad dash,” Bergamini said. “It has just been an entire hot mess.”“It got a touch chaotic,” said Dr. Marcus Plescia, chief medic of the Association of State and Territorial Health Officials. “We created much more demand than there was supply. That stressed the system which may have left the system less efficient.”

Plescia said the analysis suggests that “a more methodical, measured, judicious, priority-based approach — despite people’s perception actually are often as efficient, or more efficient, than opening things up and making it available to more people.”In retrospect, doctors and home residents were the straightforward groups to vaccinate. Doses might be delivered to them where they lived and worked.

“We knew where they were and that we knew who they were,” Wurtz said. As soon as states went beyond those populations, it got harder to seek out the proper people. home residents sleep in nursing homes. People 65 and older live everywhere.West Virginia bucked the trend with both high numbers of eligible residents and high vaccination rates in early March, but the state started slow and built its capacity before expanding eligibility.

Similarly, Alaska maintained a high vaccination rate with a smaller eligible population, then threw shots hospitable everyone 16 and older March 9. This big increase in eligible adults near the top of the amount studied led the AP and Surgo Ventures to omit Alaska from the analysis.The analysis found that as of March 10, Hawaii had rock bottom percentage of its adult population eligible for vaccination, at about 26%. Yet Hawaii had administered 42,614 doses per 100,000 adults, the eighth-highest rate within the country.

Thirty percent of Connecticut’s adult population was eligible as of an equivalent date, and it had administered doses at the fourth-highest rate within the country.In contrast, Missouri had the most important percentage of its adult population eligible at about 92%. Yet Missouri had dispensed 35,341 doses per 100,000 adults, ranking 41st among the states.“This may be a thorough analysis showing a transparent association between breadth of eligibility and vaccination rates across states,” said Dr. Mark McClellan, a former head of the Food and Drug Administration who wasn't involved within the new analysis but reviewed it for AP.

Seven states within the bottom 10 for overall vaccination performance  Georgia, Tennessee, Texas, Florida, Mississippi, South Carolina and Missouri  had larger-than-average shares of their residents eligible for shots.Among high-performing states, five within the top 10 for top vaccination rates New Mexico North Dakota , Connecticut, Wyoming and Hawaii  cursed with more restrictive eligibility. Another two high-performing states from the highest 10 South Dakota and Massachusetts — were about average in what percentage residents were eligible for vaccine.

What happens next will depend upon what proportion states can improve their vaccine delivery systems and whether Americans remain looking forward to vaccination, whilst the threat eases with more people protected and case numbers dropping.“Have states used this point wisely and fruitfully to get down the infrastructure needed to open it up to more people?” Sgaier asked.

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