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Where Are the Vaccinations?

Execution is the chariot of genius.

The vaccines have been approved and many millions of them have been shipped to states. So, where are the vaccinations? The Centers for Disease Control and Prevention (CDC) estimates that 2 million people have received their first dose in the United States. The stated federal goal was to have 20 million people getting their first dose by the end of the year, which is now three days away as of this writing.

From the NY Times on Dec. 29 comes this quote: 

"There’s reason to believe the administration won’t be able to ramp up vaccination rates anywhere close to those levels. Yes, as vaccine production increases, more will be available to the states. And Brett Giroir, assistant secretary for health at HHS, argued on Sunday that the 2.1 million administered vaccines figure was an underestimate due to delayed reporting. So let’s be generous and say the administration actually administered 4 million doses over the first two weeks. But even that would still fall far short of the 3.5 million vaccinations needed per day. In fact, it falls far short of what the administration had promised to accomplish by the end of 2020 — enough doses for 20 million people. And remember, the first group of vaccinations was supposed to be the easiest: It’s hospitals and nursing homes inoculating their own workers and residents. If we can’t get this right, it doesn’t bode well for the rest of the country."

So, what's up? The CDC requested that each state submit their vaccination plans. I figure most complied with that, so they could receive the vaccines. 

What are some of the potential issues with getting people vaccinated:

  • Likely a shortage of staff to do the vaccinating
  • An inability to further distribute vaccines across the state
  • There could be the typical holiday staffing shortages
  • Or, as is the case in Southern California, the medical system is being overwhelmed with active cases
  • It is one thing to have a plan and quite another to execute on that plan
I do not think there is a shortage of people wanting to be vaccinated at this point. Maybe 10 months from now, but not at the moment. 

The need to do mass vaccinations is something that has not been done for decades. Being as old as I am, I recall going to the local junior high school and going through a line on Sunday to get the polio vaccine via sugar cubes with the dose in them. It's likely there wasn't much paperwork back then to be done. Line em' up and hand them out!

This is a great example of decentralized execution. It would be a great opportunity to use all the active duty military medical resources and reserve component military medical staff to augment the vaccination process, but I've not heard anything about that type of effort being planned or used. 

It will all be part of the much-needed after action report (AAR) that will document the failures, missed opportunities and yes, there have been some successes, like the record speed of the vaccine development. Yet, it is not vaccines that count, but vaccinations. Chalk this current situation up to something akin to the failure to have a national testing strategy that started that phase of the pandemic debacle. Now we are seeing the results of a lack of a national vaccination strategy. 

Eric Holdeman is a contributing writer for Emergency Management magazine and is the former director of the King County, Wash., Office of Emergency Management.