COVID vaccine rollout: Epidemiologist on problems, lessons, need for national coordination

The coronavirus has killed more than 380,000 Americans. In LA, more than 300 people died on Tuesday — one person every eight minutes. There’s a need to quickly vaccinate as many people as possible, but the process has been slower than officials hoped.

Now the federal government is changing its guidance on who should be vaccinated. Health and Human Services Secretary Alex Azar announced on Tuesday, “We are telling states they should open vaccinations to all people age 65 and over, and all people under age 65 with a comorbidity with some form of medical documentation as defined by governors.”

California said today it would follow suit, and counties across the state can now vaccinate anyone 65 or older.

Tuesday’s call was a radical departure from the approach so far, says Jennifer Nuzzo, epidemiologist at the Bloomberg School of Public Health at Johns Hopkins University.

She points out where things went wrong: “There was perhaps too much fidelity to the priority groups, whereby if there was extra vaccine at the end of the day, a health clinic was faced [with] either … throwing the vaccine away, which in my view was the worst thing they could do, or offering it to someone else who may not have qualified according to that category, or … trying to scramble around and find somebody who did.”

Some places seem to be further along. “I was actually quite surprised to hear that people in the District of Columbia that were 65-plus were already getting appointments to be vaccinated. I think that's encouraging. I heard today about a mass vaccination clinic being conducted in Arizona. That I think is also promising.”

However, Nuzzo emphasizes that it’s difficult to truly tell how states are doing with the data that’s publicly available right now.

Nuzzo points out a lesson: It’s important to build flexibility into policies around allocating scarce resources. “So that if you do have a health center that finds itself with extra vaccines, that there is a procedure and policy for deviating from the vaccine allocation.”

Also, not everyone wants to be vaccinated, and health care workers are also subject to disinformation campaigns, she says.

With President-elect Joe Biden set to be inaugurated next week, should he change the federal government’s handling of the vaccine rollout? Nuzzo says there should be a coordinated national approach.

“Your ability to be vaccinated, to be protected against this virus shouldn't depend on where you live. In a pandemic that affects every single state at once, you absolutely need a national strategy. And we as a nation are not going to be safe until all states are safe.”