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Is There A Way To Speed Up COVID-19 Vaccine Distribution?

AILSA CHANG, HOST:

Nearly 5 million Americans have now gotten the first dose of a COVID-19 vaccine, but more than twice that many doses are still sitting in freezers, waiting to be administered, according to the Centers for Disease Control and Prevention. So what is behind that bottleneck, and is there a way to fix it? We will put these questions to Ashish Jha. He's dean of Brown University School of Public Health and joins us now.

Welcome.

ASHISH JHA: Thank you for having me on.

CHANG: OK. So, as we said, you know, many of these doses that have been shipped out are just sitting around, unused. In your mind, what is the main obstacle holding things up right now?

JHA: Yeah, so the main obstacle is just a lack of planning. You know, the administration has been - had been saying we'd have 20 million people vaccinated before December 31. Obviously, we missed that target by a mile, largely because they didn't actually plan on the last mile. They got the vaccines to states, but they didn't plan on and think through, how were the states going to then get the vaccines into people's arms? And the states didn't have the resources. So right now states are setting up the infrastructure. I do expect the numbers to start getting better. But this is just another example of lack of federal planning.

CHANG: OK, so you do expect states to catch up at some point. But do you think that some large percentage of doses could end up spoiling due to the lag in actually getting shots into arms?

JHA: So obviously, all of us hope not. I think most of them are in storage in a way that should allow for these vaccines to get out and get into people's arms. But obviously, states have to move quickly. And resources - not just money, but staffing and logistics help - is what a lot of states need. And I'm pretty hopeful that most of these vaccine doses will be able to get delivered before they get - before they become unusable.

CHANG: I want to ask about setting expectations about these numbers. As you pointed out, the administration said that about 20 million people would get their first shots by the end of 2020. We're only - what? - at a quarter of that today. Do you think expectations were simply set too high, too unrealistically?

JHA: Well, I actually think that it was entirely possible that we could have hit that 20 million goal if we had done planning, if we had really thought through how to achieve this. You know, Ailsa, this is not something where nobody knew a vaccine was coming, right? But I would say by September, we all had a pretty good sense that we would have vaccines in late November to December. We weren't sure, but we had a pretty good sense. We easily could have set up the infrastructure, made the plans, been ready so that the day the vaccine was authorized, we could have started vaccinating more or less right away. We didn't do many of those things, and now we're stuck with trying to play catch-up. I don't think the problem here was expectations. I think the problem here was execution.

CHANG: Interesting. OK. So on this idea of catch-up, you know, in the U.K., they're delaying the second round of shots in order to give the first dose of the vaccine to as many people as possible. I know that you have proposed doing the same thing here, but the Food and Drug Administration said yesterday they do not support that approach without more data. So I'm curious. How would you propose that we study that to figure out quickly if it's worthwhile to just spread out the first dose, you know, more widely?

JHA: Yeah. Given the crisis situation we're in, given that there's a new variant now identified in six states and likely spreading quickly across the U.S., it is absolutely essential that we get vaccines out very, very quickly, particularly to high-risk Americans. So that's why many of us are proposing that we get the first shot out immediately. Take the whole 40 million doses or so that we have, most of which are sitting in freezers, and get them into people's arms and then follow up.

I think we can study it. We have health care workers, for instance, who've gotten their first shot. We could do randomized trials in hospitals and have some of them get their second dose immediately, and others can wait. We can do - we can look at the U.K. experience. U.K. is doing one shot and waiting on the second. There's lots of ways of generating more data to make people more comfortable with this strategy.

CHANG: Interesting. Well, you know, we spoke with a hospital leader in Chicago last week who said many of her health care workers were hesitant to get the vaccine but that others who don't qualify right now for a vaccine want their shots now. Do you think that this tiered system that is giving health care workers and those in long-term care facilities first priority - do you think that tiered system is working? Or do you think there should have been more of a mass vaccination program for anyone who wants one?

JHA: Yeah. So I think we should have had a broader approach. I mean, I - look. I'm very supportive of the idea of frontline health care workers being among the first people to get it. But we should have had a clear contingency plan that if some chunk of people did not want it that we would move immediately to other high-risk people. I mean, there are a lot of Americans in their 70s and 80s, incredibly high-risk, who are not getting vaccinated right now. And while - and we have vaccines sitting around. So, yes, I think we should have taken a more comprehensive approach and made sure that we could get vaccines out to other people if that first group was hesitant at all.

CHANG: Dr. Ashish Jha is the dean of Brown University's School of Public Health.

Thank you very much for joining our show today.

JHA: Thank you so much for having me on. Transcript provided by NPR, Copyright NPR.