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What The U.S. Can Do About Vaccine Rollout Issues


And so you heard about the hiccups there in Florida, but there haven't just been problems in Florida. Health workers in Tennessee, for example, turned away elderly residents, then gave the vaccine to friends and family. Officials say it was the result of miscalculating the number of doses and not wanting the extra doses to go to waste. But here in D.C., some doses were left to expire instead of administering them to people who were not in a high-priority group. We're joined now by Dr. Elisabeth Rosenthal. She is the editor-in-chief of Kaiser Health News. She has called the rollout so far a nightmare. Hello.

ELISABETH ROSENTHAL: Hi, Lulu. Thanks for having me.

GARCIA-NAVARRO: It is good to have you. Thoughts on what you heard there from Broward County in Florida?

ROSENTHAL: Well, I think it's more than a nightmare. It's a very disorganized kind of slow walk. And it really depends where you live and, in some places, who you know. And that is not how a national vaccine campaign should be carried out.

GARCIA-NAVARRO: Yeah. I mean, I guess everything we've seen during this pandemic here in the United States would lead one to the obvious conclusion that it was going to be a mess. And yet, as with so much, surely, this could have been avoided. What has been going wrong?

ROSENTHAL: Well, you know, the Trump administration put General Perna in charge of the distribution, which is great because the Army is good at logistics. But in the Army, General Perna controls the supply chain. Here, basically, what's happened is the feds have, you know, basically distributed the vaccine to the states, told them how many doses they were going to get but, of course, not exactly when. And then the states distribute them to hospitals, to counties, to cities. And so it's like every place is different - who gets it, what the process is. Do you need to know someone? I mean, we've heard terrible things. Like, at one hospital the so-called process was the comms department got it - the PR people - but the interns who were by the bedside of COVID patients didn't. So, you know, some places are doing a really good and equitable job and have a process. But even those places - you know, imagine if you're running a vaccination program, and you don't know when you're getting vaccine. And these are all vaccines that need, you know, cold storage - some ultra-cold storage - and suddenly someone calls and says, hey, you know, we just got 10,000 doses. OK, great. You know, you need to store them. You need to set up a vaccination clinic. You need to figure out who on the list to notify to come get it. I mean, I find...

GARCIA-NAVARRO: That there needs to be a list.


GARCIA-NAVARRO: There even needs to be a list. I mean, in some places there isn't even a list.

ROSENTHAL: There isn't a list. And I find this business of, you know, calling to try and get an appointment the way you try and get tickets to the playoff game - is completely nuts, you know?

GARCIA-NAVARRO: And we should say in other countries that have a national health service, for example, they have been calling their patients because they know who they are, something that doesn't happen here. And this is something that you have talked about a lot - our troubled health care system in America. And this vaccination sort of campaign is being left up to underfunded, neglected and now battered local public health departments and for-profit pharmacies.

ROSENTHAL: Yeah. Yeah. I think, you know, you do need a national health system. As you mentioned, in Israel, you know, 10% of the population has been vaccinated. In Britain and in Belgium, people will get a notice saying, we will send you the time and date of your appointment, and you will go there. And it will be in the order in which - you know, according to your risk of getting COVID and/or getting really sick with COVID. So there's a national plan. Here, you know, we have this kind of crazy nonsystem where there is no central direction. It's not like you need a national health system to have central direction, but we've so hollowed out our public health infrastructure in the last 20 years that they could maybe have done it if it was a robust system, but it's not. So, you know, they don't have the people. They don't have the authority. Look what - no one gave the CDC the authority. All the CDC could do was recommend a priority order. Well, we've seen how that's gone with their recommendations on masking, right?

GARCIA-NAVARRO: Right. Let me ask you this. You know, other countries, though, are struggling with vaccinating their populations. Part of the issue is that the two vaccines are tricky. Storage is hard. They come in vials with multiple doses. People need to get vaccinated twice at specific times. Some have also suggested the holidays have slowed things down. I mean, this is a complicated thing to do.

ROSENTHAL: Yes, no doubt about it. I mean, you know, one thing you have to say is Operation Warp Speed produced vaccines at an incredible pace, which is great, although - PS, a lot of that was work done by government scientists before COVID arrived. So we've got to celebrate them, too. But then the next step of - you have to get them out there and in an equitable national way into people's arms, and that's been a mess. And part of the problem is, yes, it's the holidays, and, yes, you know, Israel is a small country. But part of it is the dumb logistics of doing this kind of massive campaign. We've heard, for example, that one of the limitations of how much vaccine could be produced is there's a shortage of little glass vials to be bought. Now, what about invoking the Defense Production Act and saying, OK, you guys, don't make little glass vials for hair conditioner - make it for a vaccine this year? But that hasn't happened in our country.

GARCIA-NAVARRO: That is Dr. Elizabeth Rosenthal. She is the editor-in-chief of Kaiser Health News. Thank you very much.

ROSENTHAL: Thanks for having me.