Improving and speeding up COVID-19 vaccinations

We all breathed a sigh of relief when Sarasota County finally overhauled its broken system for registering for COVID-19 vaccination. The tens of thousands of people who had spent weeks devoting their days to clicking the link on their computer to try to book an appointment, only to fail again and again, were finally able to get into the queue. 

Other counties didn’t have this problem. They appear to have planned better or been quicker to adapt when their original plan did not work. There is a lesson in this about single-payer health care: When there is one point of failure in a system, and it fails, it hits everyone.

Even now many Sarasota County residents are getting their vaccinations in other counties. In particular we have heard praise for the use of Publix pharmacies to administer the vaccines. And in that there are additional lessons. We still have close to 300 million doses to administer, so it is worth thinking about how it might be sped up. 

Overly complicated prioritization schemes have been a plague on getting vaccinations done. Counties in Florida seemed caught off guard by the state’s prioritization guidelines, stuff that should have been worked out months ago. And the people should have known the plan well in advance. 

Going forward, government officials should focus on delivering vaccines as quickly as possible to those who want them. Here are a few proposals that could help achieve that goal.

Rely upon existing vaccine distribution mechanisms to the greatest extent possible.

Most of us go to Publix, CVS, Walgreens, Walmart and many smaller pharmacies to get flu vaccines each year. These pharmacies have the infrastructure, staff and logistical processes needed to rapidly immunize the general public — they just need doses of the vaccine. And if that is not enough capacity, perhaps dentists and doctors and nurses in private practice could be asked to volunteer a few hours a week to help create a pool to staff county vaccination facilities. 

Avoid wasting doses of the vaccine.

Distributors in possession of doses that are within 24 hours of expiring should be free to administer the vaccines to anyone, regardless of eligibility because a wasted, expired dose of the vaccine is worse than vaccinating an individual with less need. Avoid the mistake of New York — there should not be criminal penalties on health care providers or vaccine recipients. And avoid “damned if you let your vaccines expire, damned if you don’t let your vaccines expire — by using them on anyone outside of the approved hierarchy.”

Do not withhold vaccine supplies to ensure second dose availability to those who have already received their first shot.

Preliminary research suggests that the first dose of the Pfizer/BioNTech vaccine is 82% effective — well above the 50% threshold the U.S. Food and Drug Administration set for vaccine approvals. Also, as vaccine production ramps up, it will be possible to allocate second doses from new supplies rather than keeping existing supplies in inventory.

Extend “right to try” to allow anyone to receive a vaccine approved in other countries.

This one is really up to the state, but the governor should go around the FDA and allow Floridians to directly purchase vaccines outside the government pipeline if they want to. Currently, only the Pfizer/BioNTech and Moderna vaccines are approved for emergency use in the U.S. But the Oxford AstraZeneca vaccine has been approved in the U.K. and India. Other vaccines that have been approved for emergency, limited or general use in at least one large country include Sputnik V, EpiVacCorona, Convidecia and BBIBP-CorV. Just as right-to-try laws currently allow terminally ill patients to seek investigational treatments, because vaccines aren’t readily available here, high-risk patients and others should be able to seek vaccines approved elsewhere.

Rather than relying too heavily on central planning and top-down approaches, these steps could help ensure that COVID-19 vaccines are distributed rapidly and with minimal waste, just as decentralized markets do with a wide variety of products, including flu vaccines. The sooner we achieve widespread immunization, the more lives will be saved, the faster society can fully reopen, and the more suffering can be avoided.

Marc Joffe is a senior policy analyst, Adrian Moore is vice president, and Vittorio Nastasi is a policy analyst at Reason Foundation. Moore lives in Sarasota.