The vaccine rollout is too complicated, but getting better

<p><img src="https://static5.businessinsider.com/image/5ffdd67bc8408b0019bd4190-2400/GettyImages-1230525833.jpg" border="0" alt="vaccine covid new york city" data-mce-source="Kena Betancur/AFP/Getty Images" data-mce-caption="A woman receives a dose of the Moderna COVID-19 vaccine at a vaccination site in the Bronx, New York City on January 10, 2021."></p><p></p><bi-shortcode id="summary-shortcode" data-type="summary-shortcode" class="mceNonEditable" contenteditable="false">Summary List Placement</bi-shortcode><p>I have tried not to be too negative about the United States' COVID-19 vaccine rollout process because we're doing better than most countries around the world, and we're doing better than we were doing a couple of weeks ago. The <a href="https://www.bloomberg.com/graphics/covid-vaccine-tracker-global-distribution/">Bloomberg vaccine tracker</a> for the first time registered over 1 million newly administered doses in a single day: jumping from 8 million as of January 10 to 9.3 million on January 11.</p><p>It's possible some of the leap is lagged reporting of doses administered over the weekend, but the trend over the last week is clear. About twice as many vaccine doses were administered in the seven-day period ending January 11 as in the seven-day period ending January 4. As states loosen restrictions on who can get the vaccine and <a href="https://www.latimes.com/california/story/2021-01-10/dodger-stadium-coronavirus-vaccination-site">opening more vaccine distribution sites</a>, that pace should continue to accelerate toward the trend that will be necessary to achieve widespread distribution by the end of the second quarter.</p><h2>Things are getting better, but issues remain</h2><p>People have good reason to be frustrated that so many vaccine doses are sitting in freezers at hospitals instead of being injected into people, and are reasonably infuriated by stories about <a href="https://twitter.com/ashishkjha/status/1348838568022732800">medical providers throwing vaccine doses in the trash</a> because they can't find the <em>right</em> people to administer vaccines to after they are thawed and before they expire.</p><p>I personally was exasperated to watch the city where I live, New York, ask the state for permission to start vaccinating people 75 and older so it could better make use of the vaccines that have been sent here, and <a href="https://www.lohud.com/story/news/coronavirus/2021/01/08/cuomo-refuses-expand-covid-vaccine-eligibility/6586928002/">initially be told "no" by state officials</a>.</p><p>Fortunately, Gov. Andrew Cuomo reversed himself and has allowed counties in New York to proceed this week to vaccination Phase 1b, which includes vaccinating people 75 and older and a significantly broader range of essential workers than were eligible for the first phase of vaccination. On Tuesday morning, he announced a further relaxation, opening vaccination to people 65 and older. Newly eligible people can book appointments online (albeit with <a href="https://twitter.com/NYCComptroller/status/1348456364394369029">some technical hiccups that must be addressed</a>) and vaccinators should be having a much easier time finding people to give the vaccine to.</p><p>The move to Phase 1b actually <a href="https://www.kff.org/coronavirus-covid-19/issue-brief/the-covid-19-vaccination-line-an-update-on-state-prioritization-plans/">puts New York ahead of most states in the vaccination process</a>, and <a href="https://twitter.com/mattyglesias/status/1348601028996980736">as non-New York based reporters periodically remind me on Twitter</a>, for all the complaining about Cuomo, New York state has administered vaccines faster than the national average and faster than California, Florida or Texas.</p><p>That's true, but I'd say a couple of things about why I expect better. First of all, New York has a world-leading medical and public health apparatus, and we pay a damn fortune in taxes to finance it. I expect superior state capacity hereit's not good enough to do better than Texas.</p><p>Second, we can see examples right nearby of states that are vaccinating faster, including Connecticut, Rhode Island and Vermont. <a href="https://www.bloomberg.com/news/articles/2021-01-09/connecticut-outpaces-new-york-in-race-to-vaccinate-residents">Connecticut has taken a more flexible approach</a>, both certifying more people for the vaccine earlier and giving vaccine administrators more flexibility to decide how to get it out faster, and it has paid off.</p><p>New York has moved in Connecticut's direction, which is great, and I'm hoping we'll catch up with them soon.</p><h2>Don't let perfect be the enemy of good</h2><p>A few weeks ago, there was <a href="https://www.slowboring.com/p/vaccinate-elderly">a big fight over some bizarre draft recommendations</a> from a Centers of Disease Control and Prevention advisory panel. The group had intended to propose vaccinating all essential workers before people over age 65 because in order to achieve a more racially-balanced group of initial vaccine recipients. The group was moving this way despite the fact that this approach was modeled to lead to more death, because the risk of dying from COVID rises so much with age.</p><p>The plan was even bizarre from a racial justice perspective, because it would have prioritized vaccinating working-age minorities over the most at-risk group, which is elderly minorities. After an outcry, the panel produced a revised recommendation that made more sense, placing the very elderly (75 and up) and frontline essential workers ahead of those aged 65 to 74 and less-exposed essential workers.</p><p>One thing I think we're seeing over the last couple of weeks is that these prioritization policies are going to be somewhat academic.</p><p>New York has moved onto phase 1b three weeks earlier than intended, in part because hospitals have had difficulty getting some members of phase 1a (medical and nursing home workers, and nursing home residents) to agree to take the vaccine. As states hit roadblocks trying to distribute vaccines in the precise order they'd planned on, an obvious way to address the roadblock is to relax the vaccine rules and make more people eligible.</p><p>On Tuesday, the Trump administration was <a href="https://www.cnbc.com/2021/01/12/covid-vaccine-trump-administration-to-expand-eligibility-to-everyone-65-and-older.html">expected to recommend such a relaxation</a>, encouraging states to open vaccination to all people 65 and older (as some including New York have already done) and to distribute all available doses as they are manufactured instead of holding some back for second-dose administration. The second step is one the <a href="https://www.axios.com/biden-vaccine-plan-f4c94912-0645-422a-8d48-46815adc99e0.html">Biden team had already signaled its intention to take</a>.</p><p>As Mike Tyson put it, everyone has a plan until they get punched in the mouth. States need to adapt and get more flexible, and we see positive signs they're already doing that. In the coming weeks, I am optimistic we will see a vaccine rollout that continues to get both faster and more straightforward.</p><p><a href="https://www.businessinsider.com/covid-19-vaccine-rollout-is-too-complicated-but-getting-better-2021-1#comments">Join the conversation about this story &#187;</a></p> <p>NOW WATCH: <a href="https://www.businessinsider.com/coronavirus-myths-debunked-wuhan-china-2020-2">Epidemiologists debunk 13 coronavirus myths</a></p>
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