Rapid vaccine rollout backfired in some states
Analysis shows fewer inoculated when more rushed at once for shots.
Despite the clamor to speed up the U.S. vaccination drive against COVID-19 and get the country back to normal, the first three months of the rollout suggest faster is not necessarily better.
A surprising new analysis found that states such as South Carolina, Florida and Missouri that raced ahead of others to offer the vaccine to ever-larger groups of people have vaccinated smaller shares of their population than those that moved more slowly and methodically, such as Hawaii and Connecticut.
The explanation, as experts see it, is that the rapid expansion of eligibility caused a surge in demand too big for some 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 people.
Rollout
“The infrastructure just wasn’t ready. It kind of backfired,” said Dr. Rebecca Wurtz, an infectious disease physician and health data specialist at the University of Minnesota’s School of Public Health. She added: “In the rush to satisfy everyone, governors satisfied few and frustrated many.”
The findings could contain an important 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 make all adults eligible for vaccination by May 1.
“If you’re more targeted and more focused, you can do a better job,” said Sema Sgaier, executive director of Surgo Ventures, a nonprofit health-data organization that conducted the analysis in collaboration with The Associated Press. “You can open it up — if you have set up 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 first vials of precious vaccine arrived Dec. 14.
But the size of the eligible population was always within the control of state officials, who made widely varying decisions about how many people they invited to get in line when there wasn’t enough vaccine to go around.
When the drive began, most states put health care workers and nursing home residents at the front of the line. In doing so, states were abiding by national recommendations from experts who also suggested doing everything possible to reach everyone in those two groups before moving on to the next categories.
But faced with political pressure and a clamor from the public, governors rushed ahead. Both the outgoing Trump administration and the incoming Biden team urged opening vaccinations to older Americans.
By late January, more than half the states had opened up to older adults — some 75 and above, others 65 and up. That’s when the real problems started.
South Carolina expanded eligibility to people in Steven Kite’s age group Jan. 13. Kite, 71, immediately booked a vaccination at a hospital. But the next day, his appointment was canceled along with thousands of others because of a shortage of vaccine.
“It was frustrating at first,” Kite said. After a week of uncertainty, he rescheduled. He and his wife are now vaccinated. “It ended up working out fine. I know they’ve had other problems. The delivery of the doses has been very unreliable.”
In Missouri, big-city shortages sent vaccine seekers driving hundreds of 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 and then expanded further.
“We went from needing to vaccinate several hundred thousand people in the St. Louis area to an additional half-million people, but we still hadn’t vaccinated that first group, so it has been this mad dash,” Bergamini said. “It has just been a whole hot mess.”
“It got a little chaotic,” said Dr. Marcus Plescia, chief medical officer of the Association of State and Territorial Health Officials. “We created far more demand than there was supply. That stressed the system and that may have left the system less efficient.”
Plescia said the analysis suggests that “a more method i cal, measured, judicious, priority-based approach — despite people’s perception — actually can be as efficient, or more efficient, than opening things up and making it available to more people.”
In retrospect, health workers and nursing home residents were the easy groups to vaccinate. Doses could be delivered to them where they lived and worked.
“We knew where they were and we knew who they were,” Wurtz said. As soon as states went beyond those populations, it got harder to find the right people. Nursing home residents live in nursing homes. People 65 and older live everywhere.
MISSION, KAN. — After a dreary year spent largely at home in front of the computer, many U.S. children could be looking at summer school — and that’s just what many parents want.
Although the last place most kids want to spend summer is in a classroom, experts say that after a year of interrupted study, it’s crucial to do at least some sort of learning over the break, even if it’s not in school and is incorporated into traditional camp offerings.
Several governors, including in California, Kansas and Virginia, are pushing for more summer learning. And some states are considering extending their 2021-22 academic year or starting the fall semester early. Many cities, meanwhile, are talking about beefing up their summer school programs, including Los Angeles, Hartford, Connecticut and Atlanta — the latter of which considered making summer school compulsory before settling for strongly recommending that kids who are struggling take part.
“People are exhausted right now, but they know that it is really important for our kids,” said Randi Weingarten, the head of American Federation of Teachers, who has been calling for what she described as a voluntary “second second semester” and for districts to start recruiting for it.
The new $ 1.9 tr i llion coronavirus relief package should help, as it allocates $122 billion in aid to K-12 public schools, including $30 billion specifically for summer school, after-school and other enrichment programs.
The influx of money and increase in summer offerings has come as a relief to parents of kids who struggled with remote learning during the coronavirus pandemic. Among them is Ashley Freeman, of St. Paul, Minnesota, who quit her nursing assistant job when the pandemic began so that she could help her kids learn from home and because a frightening past bout with the H1N1 flu that landed her on a ventilator.
Freeman, 32, is eager to get back to work after having to rely on food stamps and other benefits to get through the pandemic. She feels her kids have fallen behind academically and is hoping they’ll catch up over the break — her district recently extended its summer program by two weeks.
“I need something where they keep their education going because they have lacked this entire last year,” she said late last month about an hour after her 11-year-old daughter and 6-year-old son returned to in-person classes for the first time in nearly a year. “I feel like the kids have struggled tremendously.”
Keri Rodrigues, a co-founder of the education advocacy group the National Parents Union, said her kids have floundered with remote learning even though she transformed the family’s suburban Boston living room into a classroom and hired them a tutor. She said her family isn’t unique.
“We don’t have any time to waste here,” she said. “We need to access where our kids are, determine what they need, and then get to work right away and not just put it off for three months for no apparent reason while our families continue to deteriorate and our kids continue to suffer.”
Engaging poor children should be a priority, educators say. Summer has traditionally been one of the most inequitable times in education, with kids from upper and middle income households getting to attend camps or take part in other enrichment activities that often aren’t an option for poorer ones, said Aaron Dworkin, the CEO of the National Summer Learning Association, a nonprofit focused on increasing investment in summer learning.
“This has been an epic aha! moment for the country to understand what lower income families have to struggle with over the summer,” Dworkin said. “Everything we are all dealing with in COVID is what they deal with every summer: ‘I am working. My kids have nowhere to go. I need to figure out how to do it.’ Now other people are seeing it.”
Connecticut Sen. Chris Murphy, himself the father of a third- and sixth-grader, said in a tweet that it wasa “big win for kids” that the summerlearning money can be used for camps and recreational programs, too. He had argued in seeking the funding that “if we simply assume that kids will be able to ‘snap back’ when things return to normal, we are fooling ourselves.”
Dworkin envisions summer programs offered through the YMCA or municipal park districts using the federal funding to expand their typical offerings of swim lessons and crafts by blending in academics.
That’s what the Boys & Girls Clubs of Central Minnesota plans to do, said Geri Bechtold, the group’s vice president of operations. It will combine music, dance, theater and other fun activities meant to lure students from two low-income St. Cloud elementary schools with academic help the district will provide.
“We find that kids eat up all of that,” she said of the mixed approach.
There will be more scholarships this year to help lower income students attend camp, said Tom Rosenberg, president and CEO of the American Camp Association. He said more than two-thirds of camps already have science, technology, engineering and math components. But he said camp also provides nonacademic benefits that are particularly important after a year of social distancing.
Students typically lose ground academically during the summer, which requires teachers to spend the first few weeks of the fall semester reteaching old material. The fall 2020 test results showed that students lost more ground than usual following the hasty shift to virtual instruction last spring, said Megan Kuhfeld, a researcher with one of the nation’s major test-makers, NWEA.