Consider This from NPR - America's Vaccine Plan: What's Working — And What Isn't

Episode Date: January 11, 2021

More than 25 million vaccines have been distributed by the federal government, but only slightly more than one-third of those have made it into peoples' arms. Vaccine mega-sites are opening in major cities around the country as local officials try to speed up vaccination.There's also been pressure to expand the groups of people who are eligible for the vaccines. From Nashville, WPLN's Blake Farmer reports on how that pressure is often forcing those who administer the shots will to take people's word for it on whether they qualify. One state is doing better than every other when it comes to giving shots: West Virginia. NPR's Yuki Noguchi explains why. Additional reporting this episode from NPR's Selena Simmons-Duffin, who's looked into how to improve America's vaccine rollout.In participating regions, you'll also hear a local news segment that will help you make sense of what's going on in your community.Email us at [e-mail] more about sponsor message choices: podcastchoices.com/adchoicesNPR Privacy Policy

The coronavirus is killing between 3,000 and 4,000 Americans each day. And the number of people hospitalized? Over the last few months, if you look at that number on a chart, the line is nearly vertical, from 30,000 in October to 130,000 today. Hospitals in Southern California are admitting infected patients faster than they can discharge them. In Orange County, All I see is sick, sick, sick, sick, sick, and a lot of death. in Southern California are admitting infected patients faster than they can discharge them. In Orange County, all I see is sick, sick, sick, sick, sick, and a lot of death. Dr. Dinorich and Chia says they've had to change the criteria for who receives critical care.

You have to be sicker to be admitted to the ICU now. Every time I see people on social media, like, having parties or gatherings, I literally say, unfriend, unfriend, unfriend. I just can't take it anymore. The selfishness. It's the same story in the northern part of the state. You spend a shift taking care of people in your own community and then you leave and you're seeing people protesting, having to wear a mask. Dr. Dawn Harris works at Sierra Nevada Memorial

Hospital outside Sacramento. And you're thinking, okay, but if you get sick, I'm going to be here for you. And that's hard. That is the thing that hurts me the most inside. And at Harris's hospital, many of the infections hitting now date back to Christmas. A New Year's wave is next. And the only hope of relief for hospital workers is a vaccine. It's the first time that we've used the word hope. Consider this. We have the vaccines. We have people willing to take them. It's the system to connect the two that's struggling. And now Joe Biden wants a different approach. From NPR, I'm Adi Cornish. It's Monday, January 11th.

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a hint of blackberry lavender flavor, and L-theanine. Designed to help you relax and unwind, DriftWell is a new way to cap off your day. With civil unrest, the pandemic, and the economic crisis, you want to know what's happening right when you wake up. And that's why there is Up First, the news you need in about 10 minutes from NPR News. Listen every day. It's Consider This from NPR. Here's the problem that cities and states are trying to solve. As of Monday afternoon, while more than 25 million vaccine doses have been distributed,

barely a third have actually found their way into people's arms. Well, first of all, I think you have to look at the circumstances of where we are with the rollout. It's the very beginning. Dr. Anthony Fauci told NPR this past week that the holidays slowed things down and some delays were to be expected. States have also been grappling with staffing and storage issues. I think it would be fair to just observe what happens in the next couple of weeks. If we don't catch up on what the original goal was, then we really need to make some changes about what we're doing. There are some signs that in the next couple of weeks,

things will pick up. Dodger Stadium is ending testing today and soon will serve as a vaccination site. Until this week, Dodger Stadium was the largest testing site in the country. Now it will be a vaccine megacite. They are going to be able to vaccinate up to 12,000 people per day. And similar plans are underway around the country, including at Petco Park in San Diego. The Padres' tailgate lot near 13th and K Street transformed into a vaccination superstation. A shopping mall in New Jersey.

At 30,000 square feet, it earned its designation as a mega site, one of six the state plans to open. And the ballpark in Houston. Thousands turned out to get shots at Minute Maid Park. The city's goal, to use every dose that's available immediately. Now, this is all about speed, consolidating resources and trying to get vaccines and the people who qualify for them together in one place. We believe it's too slow and that it needs to be sped up in order to... Another plan to speed things up, announced over the weekend by the incoming Biden administration, would release most of the federal supply of vaccine doses. Remember, it's a two-dose vaccine,

so the Trump administration has kept some in reserve for people who have already had their first. This does not mean those people wouldn't get their second dose. Here's how Biden's incoming press secretary, Jen Psaki, explained it. We have faith that the manufacturers can produce enough vaccines to ensure people can get their second doses in a timely manner, while also getting more people their first dose. Public health experts tell NPR that by and large, this is a good move. Although the plan assumes manufacturing can keep up, it's a plan the Biden transition team says will help them achieve a goal of administering 100 million vaccine doses

in President Biden's first 100 days. But states don't just need more doses of the vaccine. They need more money to set up distribution sites and get those doses into people's arms. And even though many states, with budgets decimated by the pandemic, have been pleading for help for months, Congress waited until December to pass $8 billion in state aid for vaccine distribution. There's been pressure on some states to expand the definition of who's eligible to receive a vaccine. In New York, for example, the governor recently did just that, after reports that vaccines were sitting in freezers for weeks or even being discarded.

Now, public health officials say when in doubt, err on the side of getting more vaccines out more quickly. But that could also mean that those who administer the shots will often have to take people's word for it on whether they qualify. Here's Blake Farmer of member station WPLN in Nashville. Like a growing number of states, Tennessee has opened up vaccinations to seniors here at 75 and up. So Frank Berguzzi signed up his father and went ahead and put himself on the list, though he's 63. I just jumped on. He's 88, so I jumped on his

bandwagon. I'm going to blame it on him. I talked to the Berguzzis in their truck at an office complex in Murfreesboro, being used as a mass vaccination site. Workers were giving the shots through the window. The younger Bargatzi says he does work a few days a week with people in recovery from addiction, so to him he might qualify as a health care worker. The truth is health departments aren't doing much vetting, says Dr. Lorraine McDonald. That's a difficult one.

I don't get the sense that there's a whole lot of investigation that like you are that person or you do live here. Is that just something? It's pretty much honor system. Really? Yeah, pretty much. McDonald is the local medical examiner and has been working at the county's drive-through vaccination site this week. Tennessee's local health departments are not required by the state to check IDs or proof of qualifying employment. Their directive is to err on the side of getting shots out. McDonald says if people make it through the sign-up process online and show up for their appointment, they're not going to be turned away.

She acknowledges that some people under 75 need the vaccine more than those over the line. I told her about Gail Boyd. I'm 74. But she's also in remission from lung cancer. She says she was so eager to get the vaccine, she joined her slightly older husband. Well, I mean, nobody's really challenged me on it. You had to tell them you had lung cancer. Well, I mean, I do tell them that first off, so maybe that eliminates the challenge.

But either way, no, everybody's been exceptionally nice. Now, technically, in Tennessee's vaccine plan, having lung cancer doesn't make her eligible in the current phase though she is high risk. A few cars down 57 year old Gina K. Reed sits in the back seat with her husband and mother up front. She says she didn't consider trying to slip in with them who are both over 75. We try to be responsible because you think you know if you take one and don't necessarily need it you're knocking out somebody else that is in that higher risk group. These debates about who deserves vaccine more are destined to continue until there are more than enough shots to go around.

That's Blake Farmer in Nashville. And that story came from NPR's partnership with Nashville Public Radio and Kaiser Health News. The one state in the country doing better than any other when it comes to vaccine distribution is West Virginia. So we got the vaccines on Tuesday, December 15th. And we got the vaccines at the pharmacy around noon. And we were out in the nursing home by 2 p.m. administering our first doses. Gretchen Garofali is a pharmacist in Morgantown. Her state was the first to complete the initial vaccination in all its long-term care

facilities. Now it's delivering boosters and initial doses to others, including teachers age 50 and over. A lot of people are looking to us as a state because after the first week we had, I believe, around 90 percent of doses that were allocated to our state into arms, which was really unheard of elsewhere. Garofali spoke to NPR's Yuki Noguchi, who looked into what's working in West Virginia. West Virginia is charting its own path to vaccination. Every other state signed on to a federal program to contract with CVS and Walgreens to vaccinate elder care facilities. Instead, West Virginia delivered its vaccine supply to 250 pharmacies, many of them small, independent stores.

Garofali is also a pharmacy professor at West Virginia University. She says the federal plan to rely on big chains wasn't going to work for her state. We have a lot of independent pharmacies or smaller pharmacies that are in those more rural communities. So in order to get the vaccine out to some of those areas, we needed to follow something a little bit different. So the state set up its own distribution system. Krista Capehart was a key architect of that plan. She says many long-term care sites already use local pharmacies for twice-weekly COVID testing of residents and staff. By piggybacking on those existing relationships, the state was able to start scheduling appointments and securing consent forms two weeks ahead of others. When it got here, we already had pharmacies matched

with long-term care facilities, so we were already ready to have vaccinators and pharmacists go into those facilities and start providing first doses. The vaccination process isn't easy. The approved vaccines require special storage and handling. Plus, patients must make appointments and sign paperwork. Those factors are tripping up delivery in some states, and patients is wearing thin. Claire Hannon is executive director of the Association of Immunization Managers, representing state and local public health officials. They're trying to get CVS and Walgreens to come to their facilities, and CVS and Walgreens are moving at the pace they're moving. By contrast, she says, West Virginia controls its own vaccine supply. It's a smaller operation that can adapt and switch gears,

while other states must navigate the bureaucracy of huge national chains. They're not as flexible, they're not as nimble as public health to make adjustments. You know, add 500 people, move 100 people, you know, go to more facilities at one time. CVS and Walgreens insist they are on track. Both say they will complete initial vaccinations in all long-term care facilities by January 25th, about a month after West Virginia hit its milestone. Mark Parkinson is CEO of the American Healthcare Association, a long-term care trade group. What I would be doing if I was governor is I would be on speed dial with the CEOs of CVS and Walgreens every single day.

Parkinson is, in fact, a former governor of Kansas. He credits West Virginia Governor Jim Justice for mobilizing resources early. The challenge is handling the more complex phases of vaccine rollout to the general public. NPR's Yuki Noguchi. On that issue, vaccine rollout in the general public, Anthony Fauci told NPR he's still optimistic it could be possible by April. I would expect by the time we get to April, it will be what we call open season on vaccines. Everyone will be able to get a vaccine. So I think by the end of the summer, if we get 70 to 85 percent of the population vaccinated and get a good herd immunity,

I think by the fall, we could start to approach some form of normality. The voices you heard earlier of health care workers in California came to us via reporting from Leslie McClurg of member station KQED in San Diego. You're listening to Consider This from NPR. I'm Audie Cornish.