Wednesday, October 4, 2023

Speeding up U.S. vaccinations ‘easier said than done’, experts say

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When Florida decided to defy federal guidelines and open its first round of Covid-19 vaccines to anyone over the age of 65, queues of people built outside vaccination centers and the elderly flocked. out of state to receive a much sought after vaccine.

Now the Trump administration has recommended that other states follow suit in expanding vaccine eligibility, setting aside its initial concerns about whether the doses could be taken quickly enough and focus instead on the slowness of adoption. The decision more than doubled the number of people eligible for a jab from around 24m to around 50m.

This has raised concerns, however, that new federal guidelines to prioritize immunization for anyone over 65 could overwhelm already strained health systems, especially if states allow people to come forward. walk-in, as has happened in parts of Florida. According to initial guidelines from the U.S. Centers for Disease Control and Prevention, healthcare workers and people in nursing homes should have been the first to receive vaccines.

“We basically need to keep things simple, whether it’s simplifying the supply chain or simplifying vaccine eligibility levels,” said Celine Gounder, coronavirus advisor to President-elect Joe Biden. “But as we saw in Florida, it’s easier said than done.”

According to figures of the CDC, nearly 30 million doses of the two BioNTech / Pfizer and the Modern vaccine were distributed but only a little over 10 million were administered.

The federal government has expressed his frustration, sometimes criticizing state governors for being too prescriptive in determining who should take priority.

While some states strictly followed the original CDC guidelines – New York Governor Andrew Cuomo threatened to make it a criminal offense to allow people to skip the line – Florida did not, preferring to open the doors to residents and non-residents aged 65 and over.

After the CDC released its new guidelines, a number of states revised their criteria to include those over 65, including New York and California, making millions more eligible for one shot. States are also expected to see their allocations increase in the coming weeks, after the Trump administration decided to release all doses of the vaccine, rather than holding back halfway for booster shots.

While many experts have welcomed these steps, there are concerns that the problem may not be so easy to fix.

Florida’s approach appears to have generated huge demand for the vaccine, with people lining up overnight to receive their shots, including “snowbirds” from other states and countries overwinter in the Sunshine State.

Public health experts fear that those who need the vaccine may not be able to get it. Leslie Beitsch, public health expert at Florida State University, said: “[These] are the people who are least able to stand in line and camp overnight in the dead of winter. “

“I think the first come, first served method is terrible. Because it makes people wait in long, long, long lines, ”said Steve Geller, mayor of Broward County, the second largest in Florida. Even making appointments online or over the phone caused “immense frustration” when people couldn’t come by, he added.

Obviously, Florida’s approach has not improved adoption. According to the latest CDC figures, the state has vaccinated 705,398 people, or just 3.3 percent of its population. New York, which only decided this week to extend its stricter immunization eligibility to anyone over 65, has vaccinated 632,473 people, or 3.3% of its population.

The main problem seems to be resources. Hospitals and care homes must find staff to inject people while dealing with the latest wave of the disease itself, which has left more than 130,000 people in hospital, more than at n at any stage since the start of the pandemic.

The latest data from the US Department of Health show that more than 1,000 hospitals across the United States are reporting a critical staff shortage, nearly one-fifth of all hospitals in the country, according to a Wall Street Journal report. The health department has neither confirmed nor denied these figures.

Jessica Daley, vice president of the Premier Group, which represents more than 4,000 U.S. hospitals, said, “Members tell us that one of their biggest challenges is managing their clinical staff, under-staffing or overburdening the clinic. staff, as they are so much focused on the treatment and management of patients with Covid. ”

The situation has become so dire that Premier is now calling on lawmakers to call on members of the National Guard to help immunize people.

But the number of staff available to perform the injections is not the only problem. Some doctors say the vaccine rush means healthcare workers don’t even have enough time to get the vaccine themselves.

Many nursing home managers have reported problems scheduling appointments with CVS and Walgreens, the drugstore chains that run the government’s nursing home immunization program. Figures from the CDC show that the attendance rate in nursing homes is significantly lower than the overall figure, although CVS and Walgreens say they are vaccinating as many people as possible.

Mr. Biden on Thursday called Congress to approve An additional $ 20 billion for the immunization program, promising to launch community immunization centers and mobile units. Some cities and states have opened mass vaccination sites at sports stadiums and convention centers and even at Disneyland in California.

But some fear it’s too late for the money to have a big impact and argue the federal government should take control of the process rather than leave it to the states.

“The federal government could send a few thousand vaccinators,” said Ashish Jha, dean of the school of public health at Brown University. “They have public health staff. It’s just not for reasons that neither I nor the States can understand. “


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