Last week’s blog post on vaccine rollout took longer than expected to write as I compiled multiple resources and articles to comment on and share. With the vaccine rollout as massive an undertaking as it 
is and so many stories (good and bad), I decided to do part 2 this week highlighting best practices, technology challenges, and health disparities.
Best Practices
Last week, I mentioned Atrium Health and their local partnership to do mass vaccination events. It was encouraging to see their update on vaccinating over 20,000 people had a special emphasis on underserved communities. We need more focus on underserved communities – more on that in a bit.
Another health system doing drive thru vaccination clinics at scale is Memorial Hermann in the Houston area. They are getting calls from health systems across the U.S. asking for guidance on how to design similar large-scale vaccination events and are more than willing to share their blueprint for others to replicate according to Binita Patel, Vice President of Pharmacy Services for Memorial Hermann Health System. The location (NRG Park) and staffing (700 people including many volunteers) were key to their success.
We cannot forget that there are many people leery of the vaccine, sometimes referred to as “vaccine hesitancy”. Education and public health messaging campaigns will be key as the vaccine rollout continues over the next several months. Based on the Kaiser Family Foundation’s latest COVID-19 Vaccine Monitor report, there are key messages that resonate with people. They are listed in this short article from Becker’s Health IT : “8 most convincing messages to promote COVID-19 vaccines”.
Many health IT vendors pivoted their products and services to support COVID-19 over the past year. Vaccine scheduling is the latest focus area for vendors like Kyruus which shared best practices and insights from their customers in their recent blog: “Eight Best Practices for COVID-19 Vaccine Scheduling Online: Insights From Our Health System Customers”. A great transition to the next topic.
Technology Challenges
I mentioned the Vaccine Access Management System (VAMS) in my post last week as a system provided by CDC to states and other organizations for pre-screening, registration, scheduling and tracking. Not surprisingly, a software solution developed quickly and made available for many different but similar situations and workflows has experienced problems as captured in this article from MIT Technology Review. I would hope the problems can be resolved so organizations using it do not have to switch systems midstream with vaccine rollout already in process and moving rapidly.
On a positive note, the Vaccination Credential Initiative (VCI) is developing a standard model to make credentials available in an accessible, interoperable digital format. According to a post in Healthcare IT Today by Anne Zieger on February 3, “Technology Partners Come Together To Make COVID-19 Vaccination Records Shareable”, the ultimate vision is to make it easier for individuals to obtain an encrypted digital copy of their immunization credentials. The initiative includes the CARIN Alliance, Cerner, Change Healthcare, The Commons Project Foundation, Epic, Evernorth, Mayo Clinic, Microsoft, MITRE, Oracle, Safe Health, and Salesforce. A promising development.
Health Disparities
We have seen health disparities throughout this pandemic in the disproportionate number of cases, hospitalizations, and deaths among people of color. And we continue to see disparities as the vaccine rolls out. Essential workers are disproportionately people of color and they have experienced increased exposure to COVID-19. An advisory panel to the CDC initially recommended vaccinating people 75 and older and frontline essential workers in the second vaccine priority group after health care workers and nursing home residents. But when vaccine access was extended to 65 and older in mid-January in most states, essential workers were bumped down in the priority groups. An article in The Washington Post by Lena H. Sun, Isaac Stanley-Becker and Akilah Johnson on February 1 frames this issue well – “Essential workers get lost in the vaccine scrum as states prioritize the elderly”.
According to a February 4 press release from The Lawyer’s Committee for Civil Rights Under Law, they along with 145 medical professionals issued letters to 29 states and the District of Columbia calling on them to follow the CDC race and ethnicity data reporting directive for vaccine distribution. Without this data, it is even harder to address systemic racial disparities.
Looking beyond the U.S., vaccines are far more available in developed countries. A New York Times article by Lynsey Chutel and Marc Santora on January 31 paints a picture of disparities across the globe – “As Virus Variants Spread, ‘No One is Safe Until Everyone is Safe’”. Excerpts from the article:
That disparity is at the heart of what Tedros Adhanom Ghebreyesus, the head of the World Health Organization, says could soon become a “catastrophic moral failure,” as rich nations rush to buy up vaccine stocks while leaving poor and middle-income nations struggling to find supplies.
Orin Levine, the director of global delivery programs at the Bill and Melinda Gates Foundation, said “the bare facts are that by the end of this year, probably 75 percent of population in high-income countries will be vaccinated,” compared with 25 percent in low-income countries.
In my last post, I referenced two trackers. The Johns Hopkins Coronavirus Resource Center tracks cases, testing and vaccines by state. You can see how your state is doing and where it ranks on vaccinations. The Bloomberg tracker shows how your state is doing by percent of doses used and number of doses administered. A third one I have found from The New York Times gives a good view of the vaccine rollout including percent of population vaccinated, percent of doses used, and who is currently eligible by state.
As I have said before, the vaccine rollout is a multi-factorial challenge. With my optimist hat on, I will close with this. There are many smart, well intentioned people working hard to get the vaccine in as many arms as quickly as possible. As a country we do not have time to waste on politics, bad policies, or technology glitches. We must address racial disparities. And we cannot lose sight of the fact that we are part of the global community. There is plenty to learn from one another (be it another country, state, county, or health system) on what is working well and what needs to be improved.
Related Posts:
Vaccine rollout – it takes a village
400,000 lives lost – finally a national strategy
Health leadership and priorities in the Biden Administration