Micromanagement is impeding rollout of COVID-19 vaccines
For too many people, it’s a knee-jerk reaction: Blame the slow U. S. rollout of COVID-19 vaccines on too little central planning by the administration of President Donald Trump. Demand tighter control from the incoming administration of President- elect Joe Biden. Limit the number of vaccination sites! Bring in the military! Put somebody in charge!
But the problem with the rollout of COVID-19 vaccines isn’t that no one is in charge. Far from the answer, tighter federal control would probably be a disaster. It would only amplify the problem.
By guaranteeing large purchases, the federal government gave manufacturers strong incentives to produce the vaccines. It was a smart move and it worked. But now we’re experiencing the downside. Buying up the supplies and bestowing a vaccine monopoly on state governments blocked the normal distribution channels connecting producers with vaccinators.
When the federal gover nment tur ned state agencies into the country’s vaccine distributors, it bypassed the usual supply chains. Doctors and hospitals couldn’t get COVID-19 vaccines the way they order other inoculations.
Distribution also became politicized in ways that slow down vaccination. Every shot comes with a ton of paperwork and the rationing rules are hard to understand.
Who exactly qualifies as a health care worker or an essential employee? Is it OK for hospitals to give shots to janitors or billing clerks?
As he threatens fines for hospitals that don’t use all their vaccines, New York Gov. Andrew Cuomo also signed an executive order requiring providers to certify that every recipient qualifies under the current rationing protocol. Letting someone jump the queue now risks a $1 million fine and the loss of a state license.
“If you wanted to make sure that rapidly expiring vaccines distributed in 10- dose vials end up in the trash, this is how you’d do it,” observed commentator Mason Hartman on Twitter.
Micromanagement is impeding the rollout.
Distribution is hard enough without these roadblocks. Start with the numbers. At Kaiser Permanente facilities, a single vaccinator can give about 10 shots an hour, with much of the time spent filling out forms. To get to herd immunity, the U.S. needs to inject two doses several weeks apart to something like 240 million people. At 10 injections an hour, that’s 48 million hours of vaccinators’ time, 4.8 million hours a week over 10 weeks to get to early March. We’d need 120,000 vaccinators working 40hour weeks. In a big country, that sounds doable.
After all, the U.S. has nearly a million practicing physicians, about 4 million registered nurses ,920,000 licensed practical orvo cational nurses, more than 670,000 medical assistants, plus pharmacists, paramedics and medical, dental, nursing and pharmacy students. The problem is that most of those people already have jobs or full- time coursework. Most aren’t available to spend all day giving COVID-19 shots.
The last thing we need in these circumstances are special restrictions on who can administer vaccines — restrictions that send the perverse message that vaccines against this disease are somehow more questionable than those against the flu or measles.
Before we lose more time, it’s worth asking what a program to get vaccines to people as quickly and effectively as possible might look like. Economist John Cochrane has made the case for selling vaccines to the highest bidder. That’s not going to happen, but we could do better by abandoning the urge to control every aspect of the process.
Keep it simple. Use rationing rules people can easily understand. Worry less about queue jumping and more about getting vaccines into arms as quickly as possible. Trust medical professionals to do their jobs.
C OV I D - 1 9 v a c c i ne s are a magnificent scientific and technological achievement. The challenges now are social and political. Meeting them requires flexibility, experimentation and trust.