Are we there yet?
January 14, 2021 7:47 AM Subscribe
What is causing the majority of Covid vaccine doses "distributed" to not be administered? Depending on what numbers I see 50-75% have not been given.
What is taking so long to administer the vaccine doses? The CDC is saying that 10.3 million first doses have been given out of 29.4 million "distributed" (35%). The Washington Post says only 36% of doses "administered" out of those "scheduled for delivery" (10.3 million out of 28.4 million as of this writing). All the sources seem to have similar numbers. The US gave about 160 million flu shots last year, over several months. What gives?
Is the problem primarily transportation, refrigeration, personnel, facilities, what? Is the large number of tiers and prioritization making it slow? I understand when the very first doses were getting delivered that it took some time to spin up, but it feels like we should be moving into a mass vaccination phase and that is, numerically at least, nowhere close to happening. LA County, the most populous in California, is saying that they won't even have health care workers vaccinated until the end of the month.
What is taking so long to administer the vaccine doses? The CDC is saying that 10.3 million first doses have been given out of 29.4 million "distributed" (35%). The Washington Post says only 36% of doses "administered" out of those "scheduled for delivery" (10.3 million out of 28.4 million as of this writing). All the sources seem to have similar numbers. The US gave about 160 million flu shots last year, over several months. What gives?
Is the problem primarily transportation, refrigeration, personnel, facilities, what? Is the large number of tiers and prioritization making it slow? I understand when the very first doses were getting delivered that it took some time to spin up, but it feels like we should be moving into a mass vaccination phase and that is, numerically at least, nowhere close to happening. LA County, the most populous in California, is saying that they won't even have health care workers vaccinated until the end of the month.
I think it's the organization of interfacing the personnel with the arms. I'm on 1b in my state, and I've signed up with a website but heard that won't actually be used for organizing appointments. There's two phone numbers to call, which are getting overwhelmed, and the info from the phone people is that they're going batch-by-batch for making appointments, so try again tomorrow. So in other words, every single arm is a lot of people-labor to coordinate.
This is, on a large scale, a clusterfuck.
posted by Dashy at 8:15 AM on January 14, 2021 [5 favorites]
This is, on a large scale, a clusterfuck.
posted by Dashy at 8:15 AM on January 14, 2021 [5 favorites]
One barrier I'm seeing (via Library Twitter) with elders targeted in early vaccination groups is that vaccine signup is solely online/mobile, and quite a few elders don't have the equipment or skills to make that work.
posted by humbug at 8:24 AM on January 14, 2021 [1 favorite]
posted by humbug at 8:24 AM on January 14, 2021 [1 favorite]
Additionally, like the CDC page says, there’s a significant amount of reporting latency.
Healthcare providers report doses administered to federal, state, territorial, and local agencies up to 72 hours after administration. There may be additional lag for data to be transmitted from the federal, state, territorial, or local agency to CDC. A large difference between the number of doses distributed and the number of people initiating vaccination is expected at this point in the COVID-19 vaccination program due to several factors, including the time between doses being shipped and received, the time it takes for administered doses to be reported to CDC, and management of available vaccine stocks by jurisdictions and federal pharmacy partners.posted by zamboni at 8:33 AM on January 14, 2021
There's a political/reputational element at work, too. For example, in St. Louis a hospital chain came under fire for broadly defining and administering doses to executive and administrative staff that was meant for frontline healthcare employees. The general feeling was that it was rich/privileged people jumping the line (as was predicted early on in the rollout). So in response to that, a number of places have imposed strict rules both to qualify and to establish identity at the appointment. An unintended consequence has been that the bureaucracy slowed everything down.
posted by AgentRocket at 9:08 AM on January 14, 2021
posted by AgentRocket at 9:08 AM on January 14, 2021
it feels like we should be moving into a mass vaccination phase and that is, numerically at least, nowhere close to happening.
Where I am (rural Vermont) there's been a small delay but not an awful one. The big deal is, as long as you keep the doses cold, they are stable for a while. So in the absolute absence of any national plan, system, or infrastructure, there has been a lot of delay in figuring out distribution which can happen via a few methods. So where I am, for example, health care workers have mostly gotten their second doses, older people (I think 75+ or 65+, not sure, all I know is "Not me") will be getting vaccinated at the hospital starting tomorrow, but the process is someone calls them, leaves a message if they're not there to schedule, and then the number they have to call back just rings and rings.
My local hospital is great in many ways but can't really handle this process (the vaccinating process and even the testing process are going great but the scheduling every old person for a shot, pretty difficult). Meanwhile older people who are in nursing homes and other managed care facilities are not getting vaccinated by the hospital, they're getting vaccinated by CVS/Walgreens (drug stores which are not necessarily nearby) and that's a completely different supply chain and planning mechanism.
Locally we don't have much of a problem with uptake--that is people aren't refusing their doses which makes planning smoother--but this is a huge deal in some places which can also toss a wrench into things. Everything is left up to the states in the US and some have good infrastructure for it and some do not. Flu shots, in contrast, are in ample supply and a lot of people got them either at a regular medical appointment or because they were in a drug store and could get the entire thing done right then and for free or cheap. It's really the necessity of rationing that is making this all get so fussy. And it's SO high profile that people are trying, with a charitable view, to do it right.
posted by jessamyn at 9:23 AM on January 14, 2021
Where I am (rural Vermont) there's been a small delay but not an awful one. The big deal is, as long as you keep the doses cold, they are stable for a while. So in the absolute absence of any national plan, system, or infrastructure, there has been a lot of delay in figuring out distribution which can happen via a few methods. So where I am, for example, health care workers have mostly gotten their second doses, older people (I think 75+ or 65+, not sure, all I know is "Not me") will be getting vaccinated at the hospital starting tomorrow, but the process is someone calls them, leaves a message if they're not there to schedule, and then the number they have to call back just rings and rings.
My local hospital is great in many ways but can't really handle this process (the vaccinating process and even the testing process are going great but the scheduling every old person for a shot, pretty difficult). Meanwhile older people who are in nursing homes and other managed care facilities are not getting vaccinated by the hospital, they're getting vaccinated by CVS/Walgreens (drug stores which are not necessarily nearby) and that's a completely different supply chain and planning mechanism.
Locally we don't have much of a problem with uptake--that is people aren't refusing their doses which makes planning smoother--but this is a huge deal in some places which can also toss a wrench into things. Everything is left up to the states in the US and some have good infrastructure for it and some do not. Flu shots, in contrast, are in ample supply and a lot of people got them either at a regular medical appointment or because they were in a drug store and could get the entire thing done right then and for free or cheap. It's really the necessity of rationing that is making this all get so fussy. And it's SO high profile that people are trying, with a charitable view, to do it right.
posted by jessamyn at 9:23 AM on January 14, 2021
At the moment the vaccine is a two-part thing - the second dose is given 21 or 28 days later depending on the manufacturer. The data really isn't in yet about what happens if you take that second dose too late after the first but the current CDC advice is that you have a 4-day window.
The plan was to hold the second part of a person's vaccine in inventory so that the second injection could be made at the correct time. That stance was reversed on Tuesday and everyone is going to just hope that the supply chain can keep up.
posted by JoeZydeco at 9:37 AM on January 14, 2021 [3 favorites]
The plan was to hold the second part of a person's vaccine in inventory so that the second injection could be made at the correct time. That stance was reversed on Tuesday and everyone is going to just hope that the supply chain can keep up.
posted by JoeZydeco at 9:37 AM on January 14, 2021 [3 favorites]
Logistics are hard. Think about the last time you or someone you know had to wrangle 12-15 coworkers for a company lunch.
Since you mentioned Los Angeles Country:
Hospitals with COVID ICUs got their vaccines the week of the FDA approving them, so Dec 15th. My buddy, Director of Intake/Transportation at a hospital in The Valley that received 325 doses, got his first shot around Dec 20, and then got his second on Jan 12, which is the recommended interval.
However, his place is kinda small. Kaiser at Sunset/Vermont probably 15 buildings the size of my buddy's entire hospital, with thousands of employees. You can't just scale up the "putting shots in arm" portion, since it takes 15 mins to just walk from the big structure on the west side of the compound to the new Urgent Care right on Vermont, for just one concrete example.
Also, I some people who got shots because they happened to be doing something like getting their cancer meds checked out as a patient, when some roaming nurse was finding literally anyone in the building over 16 years old (that's the age limit for the Pfizer one I guess) because they had done all the officially eligible people, but they had left over doses because they were shipped ~30 too many. Some other hostiapl
For a non Covid example of why logistics are hard: I used to run 6-12 organized running races a year, and I can't count on 4 hands the amount of times I've run by a water stop that was just either pallets of water/cups and no people, or a group of people and no water/cups, or maybe just gallon water jugs and no cups, or there cups/water/people and no tables, and every other possible combination thereof.
posted by sideshow at 10:02 AM on January 14, 2021 [2 favorites]
Since you mentioned Los Angeles Country:
Hospitals with COVID ICUs got their vaccines the week of the FDA approving them, so Dec 15th. My buddy, Director of Intake/Transportation at a hospital in The Valley that received 325 doses, got his first shot around Dec 20, and then got his second on Jan 12, which is the recommended interval.
However, his place is kinda small. Kaiser at Sunset/Vermont probably 15 buildings the size of my buddy's entire hospital, with thousands of employees. You can't just scale up the "putting shots in arm" portion, since it takes 15 mins to just walk from the big structure on the west side of the compound to the new Urgent Care right on Vermont, for just one concrete example.
Also, I some people who got shots because they happened to be doing something like getting their cancer meds checked out as a patient, when some roaming nurse was finding literally anyone in the building over 16 years old (that's the age limit for the Pfizer one I guess) because they had done all the officially eligible people, but they had left over doses because they were shipped ~30 too many. Some other hostiapl
For a non Covid example of why logistics are hard: I used to run 6-12 organized running races a year, and I can't count on 4 hands the amount of times I've run by a water stop that was just either pallets of water/cups and no people, or a group of people and no water/cups, or maybe just gallon water jugs and no cups, or there cups/water/people and no tables, and every other possible combination thereof.
posted by sideshow at 10:02 AM on January 14, 2021 [2 favorites]
One of the first groups are people in long term care facilities, many of whom are not mobile. That requires a lot of travel and logistical work.
Administering the vaccine is slowed by the pandemic. You can't have a bunch of people in a room waiting in line: social distancing and room capacity limits slow things down. In much of the country it's too cold to have people (especially the elderly) waiting in line outside. And because of the risk of allergic reactions, there can also be a monitoring period after receiving the vaccine, which, again, leads to space limitations while people wait.
The nature of the currently approved vaccines means that nobody wants to waste doses, so there's a tricky optimization problem balancing getting enough patients lined up that it's worth taking a vial out of the freezer.
It'll go a lot faster when we have a fuller picture of who can safely be sent home immediately after receiving the shot. When we get through the targeted groups, then we can shift to mass vaccinations in large indoor stadiums and convention centers. That should go very fast and is likely to coincide with the US approval of another vaccine, probably Johnson & Johnson's, which is likely to be approved next month.
As for the root cause: the federal government gave state and local governments very limited financial assistance, both generally and for vaccine distribution preparation. The state and local governments themselves are all strapped for cash and having to make major cuts. We should have had fully fleshed out distribution and administration plans, have done training and dry-runs, and had a coordinated public communication campaign that made it clear how everything was going to work. Instead we got a cobbled-together patchwork across 50 states and thousands of counties.
posted by jedicus at 10:15 AM on January 14, 2021 [3 favorites]
Administering the vaccine is slowed by the pandemic. You can't have a bunch of people in a room waiting in line: social distancing and room capacity limits slow things down. In much of the country it's too cold to have people (especially the elderly) waiting in line outside. And because of the risk of allergic reactions, there can also be a monitoring period after receiving the vaccine, which, again, leads to space limitations while people wait.
The nature of the currently approved vaccines means that nobody wants to waste doses, so there's a tricky optimization problem balancing getting enough patients lined up that it's worth taking a vial out of the freezer.
It'll go a lot faster when we have a fuller picture of who can safely be sent home immediately after receiving the shot. When we get through the targeted groups, then we can shift to mass vaccinations in large indoor stadiums and convention centers. That should go very fast and is likely to coincide with the US approval of another vaccine, probably Johnson & Johnson's, which is likely to be approved next month.
As for the root cause: the federal government gave state and local governments very limited financial assistance, both generally and for vaccine distribution preparation. The state and local governments themselves are all strapped for cash and having to make major cuts. We should have had fully fleshed out distribution and administration plans, have done training and dry-runs, and had a coordinated public communication campaign that made it clear how everything was going to work. Instead we got a cobbled-together patchwork across 50 states and thousands of counties.
posted by jedicus at 10:15 AM on January 14, 2021 [3 favorites]
There are 2 doses needed, so the first wave come along and get their first shots and now you have the second wave coming along and also the 1st wave now needing their second does, now you have the third wave coming along, some of the 1st wave still needing a second does, the second wave still finishing & now some needing their second does and the third wave needing their first dose And it slowly becomes a scheduling nightmare on it's own, all without taking into account like having to schedule people so that wastage of vaccine is minimalized and people aren't getting exposed to the virus while waiting for the vaccine, or in the case of residents of old folks homes, having to go there to vaccinate them. Throw in lack of funding, political bs and line jumpers and honestly I'm amazed we've done as well as we have.
posted by wwax at 10:27 AM on January 14, 2021
posted by wwax at 10:27 AM on January 14, 2021
Anonymous answer:
Hospitals are being asked to coordinate the effort, but hospitals are overwhelmed, and this is a HUGE effort to operationalize.posted by loup at 11:01 AM on January 14, 2021 [8 favorites]
In our state, in order to receive vaccine you have to distribute a certain percentage internally (say, 65%), and then administer the remainder to groups external to your organization...while still following the guidelines about who can receive it. Internally we had an ethics committee guide us on who to prioritize within the 1a group, but externally those groups make their own decisions.
We've tried to handle the distribution two ways; first by making individual appointments (which takes a whole team to manage / reschedule / communicate / and schedule the 2nd dose within the right timeframe), and then second by having 'open calls' for external groups (which end up being real shitshows as word spreads throughout the community like wildfire and then you have 500 people lined up outside your door at 6am). The actual vaccination part may only take 5 minutes, but then they have to be observed for 15 minutes before they can leave...and we have strict guidelines about how many people can be in the building at any time...it is a cluster.
And we haven't even gotten to the part about data collection for the public health department and how to meet those requirements (reporting within 24 hrs, requiring SSNs, etc). Or that when we place orders for vaccine doses, they might not show up exactly when we think (so we hold on making appointments until we have vaccine on hand). Or hey, a couple key people on the team are symptomatic and now they have to quarantine for 10 days.
It has been some of the most rewarding work of my life. But it is a new challenge every day. It has rearranged my Rules For Life. The first one now is, WRITE NEATLY on any form you are given. The second one is, be kind.
Another note about LA County, and CA in general: If every health care got their first dose on literally the first day the Governor authorized all health care workers (not just those who were initially authorized back in mid Dec) to receive their first dose, which only happened this week, they would just squeak in their second dose by the "end of the month" deadline you mentioned in your initial question.
posted by sideshow at 11:21 AM on January 14, 2021
posted by sideshow at 11:21 AM on January 14, 2021
Because logistics, it's very hard to give a dose out the same day it is "distributed". Right now, both doses distributed per day and doses administered per day are climbing rapidly, but the curve for administration will lag behind the curve for distribution, so even if they have the same shape, there will be an increasing number of un-administered doses sitting on shelves. Imagine that yesterday a hospital received 1,000 doses, and scheduled 1,000 inoculations. Today they performed 1,000 inoculations, but received 2,000 doses. The number of un-administered doses just doubled, even though they gave out everything they had! This doesn't account for the whole problem, but I'm sure it's contributing.
posted by agentofselection at 11:59 AM on January 14, 2021 [1 favorite]
posted by agentofselection at 11:59 AM on January 14, 2021 [1 favorite]
One problem I see (working for a hospital and also having family who work in health care) is that every pharmacy, hospital, clinic, etc. is basically making all of their distribution efforts up independently and without any central coordination. In my city, a handful of mostly small independent pharmacies received their first shipments of the Moderna vaccine last week. This was widely publicized in the news and via the state health department website, but each of these pharmacies quickly ran out of the doses they got and were inundated with calls from people looking for a shot. While simultaneously trying to operate their normal business and actually give shots, they had to try to keep track of these people calling but don’t necessarily know when they’ll get more shots. One place basically has a legal pad for people to put their info down, because of course people just showed up instead of calling, or tried to call but couldn’t get through because the line was busy and just tried their luck, etc.
At the same time all of the local hospitals have the Pfizer vaccine and are offering the vaccine to workers with no patient contact because a) they technically qualify to get the shot b) getting to their arms is easy and c) plenty of staff with direct patient contact who 100% qualify as phase 1A (nurses, doctors, environmental services staff, patient registration staff, phlebotomists, etc etc) are not getting the vaccine when offered. Each hospital is setting up community vaccination efforts for their actual patients and community members who qualify (70+ and other health care workers, and soon “essential workers” of any age but who knows who exactly that includes) but each system is separate, and staffing and setting up these clinics to be Covid safe and functional and handle the expected volumes is really challenging. And of course, you need nurses (or other trained personnel) to actually give the shots, but if your hospital is full of Covid patients you don’t necessarily have nurses to spare.
So if you’re a 70+ person, your options are to call around to pharmacies and put your name on a bunch of lists if you can even get through to an actual person, call your own doctor and find out that they don’t have the vaccine yet but might have it soon but they’ll try to call you back when/if they do, try to navigate your local hospital’s patient portal system online to see if you can sign up there (the patient portal is barely user friendly if you’re tech savvy, much less if you’re not or have vision/mobility challenges), call your friend’s granddaughter who works at a hospital to see if she knows an actual person you can call, etc.
Meanwhile, behind the scenes, none of these different entry points to vaccine access talk to each other or coordinate because the state doesn’t have the resources to manage a central registry or information sharing setup, none of the designated access points have been given any extra financial or infrastructure support to handle this, and they’re all trying to keep their normal operations running in the middle of a pandemic.
posted by MadamM at 12:02 PM on January 14, 2021 [1 favorite]
At the same time all of the local hospitals have the Pfizer vaccine and are offering the vaccine to workers with no patient contact because a) they technically qualify to get the shot b) getting to their arms is easy and c) plenty of staff with direct patient contact who 100% qualify as phase 1A (nurses, doctors, environmental services staff, patient registration staff, phlebotomists, etc etc) are not getting the vaccine when offered. Each hospital is setting up community vaccination efforts for their actual patients and community members who qualify (70+ and other health care workers, and soon “essential workers” of any age but who knows who exactly that includes) but each system is separate, and staffing and setting up these clinics to be Covid safe and functional and handle the expected volumes is really challenging. And of course, you need nurses (or other trained personnel) to actually give the shots, but if your hospital is full of Covid patients you don’t necessarily have nurses to spare.
So if you’re a 70+ person, your options are to call around to pharmacies and put your name on a bunch of lists if you can even get through to an actual person, call your own doctor and find out that they don’t have the vaccine yet but might have it soon but they’ll try to call you back when/if they do, try to navigate your local hospital’s patient portal system online to see if you can sign up there (the patient portal is barely user friendly if you’re tech savvy, much less if you’re not or have vision/mobility challenges), call your friend’s granddaughter who works at a hospital to see if she knows an actual person you can call, etc.
Meanwhile, behind the scenes, none of these different entry points to vaccine access talk to each other or coordinate because the state doesn’t have the resources to manage a central registry or information sharing setup, none of the designated access points have been given any extra financial or infrastructure support to handle this, and they’re all trying to keep their normal operations running in the middle of a pandemic.
posted by MadamM at 12:02 PM on January 14, 2021 [1 favorite]
With doses at risk of expiring, supermarket pharmacies are ignoring the vaccine distribution order—and people are lining up.
posted by 1970s Antihero at 12:51 PM on January 14, 2021
posted by 1970s Antihero at 12:51 PM on January 14, 2021
Bureaucracy seems to be a problem where I live - Alameda County in California, right next to San Francisco, put all the homeless in a higher tier but they literally have no idea how many there are.
posted by meowzilla at 2:47 PM on January 14, 2021
posted by meowzilla at 2:47 PM on January 14, 2021
If the experience of the UK and the Netherlands is anything to go by, it is significantly easier to roll out mass vaccination if you have a centralised or coordinated healthcare system. Resolving the lack of effective back office coordination delayed things for the Dutch, whereas in the UK it's been easier to roll out appointments through existing systems (there is only one NHS). I think in both places once up they've found it reasonably easy to roll through the pre-planned priority groups. So basically the more central planning there is normally, the easier to mass vaccinate. Obviously you can still stuff it up even with a more centralised system.
Otherwise, everyone has problems with the more finicky vaccines in making sure that they're distributed and not wasted (they have to be decanted, and then used up quicker). Everyone has problems with the vaccine hesitant and vaccine refusers, if nothing else time spent calling up people who decline is wasted. Everyone has the problem of effective and timely data reporting. Everyone has the problem of choosing a strategy for prioritisation that is maximises benefits and is actually deliverable by whatever system on the ground.
posted by plonkee at 3:01 PM on January 14, 2021 [1 favorite]
Otherwise, everyone has problems with the more finicky vaccines in making sure that they're distributed and not wasted (they have to be decanted, and then used up quicker). Everyone has problems with the vaccine hesitant and vaccine refusers, if nothing else time spent calling up people who decline is wasted. Everyone has the problem of effective and timely data reporting. Everyone has the problem of choosing a strategy for prioritisation that is maximises benefits and is actually deliverable by whatever system on the ground.
posted by plonkee at 3:01 PM on January 14, 2021 [1 favorite]
Response by poster: There clearly is something highly wonky about the numbers, as illustrated in this article about Vaccine reserve was already exhausted when Trump administration vowed to release it, dashing hopes of expanded access. I don't know how to reconcile "When Health and Human Services Secretary Alex Azar announced this week that the federal government would begin releasing coronavirus vaccine doses held in reserve for second shots, no such reserve existed..." with the statement in the same article from a Health and Human Services spokesperson that "states have ordered only about 75 percent of what is available to them." The answers to basic questions are unavailable or contradictory.
posted by wnissen at 9:58 AM on January 15, 2021 [2 favorites]
posted by wnissen at 9:58 AM on January 15, 2021 [2 favorites]
Response by poster: There's a pretty detailed (paywalled) article in the San Francisco Chronicle: California has neary [sic] 2 million unused doses of vaccine even as demand soars. Here’s why.
Many interesting points. One, the federal and state government does not take delivery of the vaccines at any point. They go straight from the manufacturer to counties or (this was new to me) larger health systems like Kaiser and Palo Alto Medical foundation. So that's one potential bottleneck removed. The article also claims that large majorities of the doses are "designated" for the following days or weeks, either scheduled for upcoming appointments or as second doses. There is also some reporting lag. I dunno. Still kind of hard to tell if the situation is terrible or not.
posted by wnissen at 5:27 PM on January 16, 2021
Many interesting points. One, the federal and state government does not take delivery of the vaccines at any point. They go straight from the manufacturer to counties or (this was new to me) larger health systems like Kaiser and Palo Alto Medical foundation. So that's one potential bottleneck removed. The article also claims that large majorities of the doses are "designated" for the following days or weeks, either scheduled for upcoming appointments or as second doses. There is also some reporting lag. I dunno. Still kind of hard to tell if the situation is terrible or not.
posted by wnissen at 5:27 PM on January 16, 2021
Response by poster: More concrete information, this time from Kaiser. They only received 20,000 first doses last week. They have given 170,000 doses including first and second (so equivalent of 85,000 people completed) out of over 12,000,000 they cover, 1,500,000 of whom are 65 or over. Perhaps this is due to independent hospitals getting more of the early doses, or the allergic reactions causing some Moderna to be withheld, but at the current rate it would take a year and a half to give a first dose to every Kaiser patient over 65. 8 years to do 75% of their members. At least for Kaiser, it seems to be purely a supply issue, as they have administered 93% of their doses.
posted by wnissen at 12:36 PM on January 21, 2021
posted by wnissen at 12:36 PM on January 21, 2021
Response by poster: Some more visibility. Santa Clara has a vaccine tracker. Kaiser has given out 80% of their first doses and has enough appointments scheduled in the next 7 days to use up their supply. Stanford is doing slightly better than that. Kudos! Planned Parenthood, used to dealing with meager resources, has actually given out 108% of its doses, due to the weirdness with the high-efficiency syringes allowing extras. North East Medical Services appears to be sitting on its hands, having given out less than 10% of its 1600 doses. Sutter / Palo Alto Medical Foundation only has 63% dispensed but is on track to give the rest out within the week. Not bad overall.
The other aspect this reveals is that there are at least three distribution channels. The federal health agencies (which aren't reporting to this tracker at all) get theirs from the federal government. The large health agencies get theirs from the state. And the small ones are getting theirs from the county.
posted by wnissen at 7:18 AM on January 22, 2021
The other aspect this reveals is that there are at least three distribution channels. The federal health agencies (which aren't reporting to this tracker at all) get theirs from the federal government. The large health agencies get theirs from the state. And the small ones are getting theirs from the county.
posted by wnissen at 7:18 AM on January 22, 2021
This thread is closed to new comments.
I personally have no path to getting the vaccine yet, as I don't contribute in any meaningful, emergent way to society. I can work from home, I am relatively young and healthy. My friends who are healthcare professionals have been getting the vaccine. My coworkers who are in their 60s with various medical conditions have been getting the vaccine.
It's analogous to all the hoops someone has to go through to get welfare or food stamps, when it would just be so much easier and make more sense to give poor people money. Just give poor people money! Just give the vaccine to as many people as possible! We have the money! We have the vaccine! But there are stringent requirements right now for who is "worthy" enough to get the vaccine, putting artificial limitations on access.
And of course, people who are highest need SHOULD get the vaccine first. There is no good answer to this. But the failure point of prioritizing with best intentions is that it's limited.
posted by phunniemee at 8:00 AM on January 14, 2021 [4 favorites]