Logistical Quagmire: How Not to Rollout a Vaccine

The final 10 months of 2020 put a big bright light on the Healthcare system. We saw the heroism of individuals who gave of themselves in pursuit of keeping their patients healthy. Women and men across the country delivering care in hospitals, all sizes of healthcare organizations, urgent care, inpatient, outpatient, and telemedicine put patient care above personal risk to themselves. This sacrifice came at a grave price for many individuals who selflessly gave up their lives to care for their patients. The acts of individuals with limited resources and treatments were, and continues to be, heroic even as the death toll continues to rise daily.

These efforts are exceptionally remarkable given the Healthcare Machine logistical quagmire of bureaucratic and structural confusion. At a bare minimum, the lack of basic supplies, engaged staff, or needed ICU beds, the pandemic has cast a bright light on the warts that exist in our fractured system.

Notwithstanding, the seminal moment was the arrival of an FDA Emergency Use Approval of a vaccine for COVID-19. This was to be the crowning moment of modern healthcare achievement. While we knew supply would take time to ramp up, we believed with 6 months lead time the distribution would be smooth and structured. We were told that distribution of the vaccine would be fair and in a specific pre-determined manner led by the states and federal government.

We were given hope.

With an approval of one vaccine in hand, another soon to follow, and a promise to vaccinate 20 million people by the end of the year, our nation and the world could envision that the end was near. In mid-December, as UPS and FedEx trucks rolled out of the factories, covered on live TV, our hope continued to grow. As the first patients were being vaccinated, across the country there was a shared sigh of relief. In a fairy tale movie, the words “And they lived happily ever after...” would appear right before the credits roll. Unfortunately, we do not live in a fairy tale.

It should have been easier than this...

By the end of 2020 less than 3 million people were vaccinated for COVID-19.

Problems, some minor, other major, continue to hamper what should be simple—ship it.

Rural hospitals had difficulties storing the super frozen Pfizer vaccine. Administration was out into the hands of hospitals, who prioritized their staff, even non-patient facing staff, before outpatient or urgent care staff. Leaving many independent physician groups to publicly ask why they are being left behind on the frontline.

The Federal Government bungled distribution and necessary funding to enable the inoculation of mass individuals. Fraud was found in numerous localities vaccinating outside of the prescribed order or dumping the vaccine altogether. Rumors and speculation of the vaccine’s side effects have run rampant leading to high rates of “vaccine decline” (when a patient declines to take a vaccine being offered). Lastly, the lack of transparency in total numbers of vaccine distributed has led to speculation of nefarious activities.

Realistically, we need organizations who have experience in large scale distribution, administration, space, and who have the trust of the people.

Changes Needed (not in any order):

  1. Have Amazon and Walmart handle the distribution of all vaccines. They know how to handle returns (vaccine decliners) and how to manage global logistics.
  2. Utilize occupational medicine organizations, urgent cares, and pharmacies to administer the vaccine.
  3. Partner with professional sports leagues and universities to use stadiums as mass vaccination sites.
  4. Work with employers, religious organizations, and community organizations to organize mass administration locations.
  5. Work with existing technology companies to spin up an easy-to-use platform for signup, scheduling, and reporting.
  6. When approved, vaccinate every child at school, public or private. All on the same day.
  7. We have the knowledge, tools, and resources, let’s activate them.

If the vaccine rollout was a baseball game, we would be in the midst of a 6 run first inning. The good news is that this is just the first inning. Can our hitting get us back in the game? Can the pitching rebound to stop the bleeding?

I am hopeful.

The phrase “we’re all in this together” has never been more appropriate. A true coalition of private companies, Federal and local governments should be able to coordinate this process more efficiently.

The next days and months will show if the current rollout is just a small stumble out of the gate or a larger concern.

As average citizens, vaccinated or not, we need to focus on being patient and prudent wearing a mask, washing hands, and continued diligence with social distancing are easy and effective protocols we can all do without government support.

Do this in the memory of the heroes who sacrificed their lives.

Do this in honor of those putting themselves in harm’s way to care for patients.

Do this for humanity.

Etan Walls is Principal of Strong Walls Consulting and author of the upcoming book The Mega Factory of Healthcare. Strong Walls Consulting provides operational, strategic, and tactical assistance to healthcare organizations, large and small. Previously, Mr. Walls was the COO of the largest independent outpatient Pediatric group in the United States. He has mentored many startup Healthcare IT organizations with his brand of innovative, forward-thinking leadership. All inquiries should go to etanwalls@gmail.com