As a volunteer nurse, I was fortunate to get vaccinated for COVID-19 this past week. I counted 17-plus healthcare workers directly involved in a safe and seamless process that was completed in 30 minutes. The sheer brute force of human capital needed to pull this off at scale nationally can’t be overstated.
While I was impressed by the local team here in Florida, it’s hard to ignore the pockets of national dysfunction. My mom is still in the hunt for her vaccine, and we had senior neighbors camping out overnight in lawn chairs hoping for a shot, only to be turned down.
There are a few takeaways for those in public health running a program:
- Teams working under a deputized local leader, with a cohesive mission, and empowered to make game-time calls in the field, go faster. Local teams need to have regulatory obstacles removed, and be able to spend resources on staff to deliver their mission.
- We have gone from high science developing the vaccine to a massive operational deployment, bigger than any concert, parade, or Olympiad combined. Those leading this effort must adjust in real time to mistakes, misfits, and misfires. We have to allow them to fail fast.
- Leaders must master the art of logistics relay. This is more analogous to an airport hub-and-spoke model — the use of a digital front end to manage demand while microtasking every step to vaccination with clean handoffs and clear accountability. It’s fair to say safety needs its own leader, and, in my case, several people had eyes on me for the 15 minutes post-inoculation, assessing for adverse effects. When the alarm chimed on my iPhone, I was carefully escorted out the door for the final leg of the relay, while waving to the National Guard who were Step One when I parked.
- Public/private partnership. The case is irrefutable to leverage private assets and talent (CVS retail, hospitals, labs, urgent care, tech). They have been doing relays at scale for decades; are intimate with the patients, and their healthcare data. They also have a speed and quality advantage. They know our seniors, and can help access the underserved. These partnerships are coming online, but slowly. Having spent 25 years in corporate America, I have seen healthcare companies turn on a dime during natural disasters and emergencies. They have decades of experience, training, and infrastructure that can be used quickly.
- Recognize that seniors and the most vulnerable among us are without a network both physically and electronically. Many live alone, and are having trouble with online bookings and procuring transportation. And they are scared. We need staff and resources to help them enter this relay with support and care.
And for those waiting on a vaccine for themselves or a loved one in the first wave, here are some ideas to help you manage the process:
- Go online and review your local public health site. Set up a Google alert for your county and department of public health that will send you notices, as the rollout is fluid and varies by county with hospitals, public health departments, and local stadiums all hosting the events. The process isn’t nationally centralized or well organized, so you will have to be part of the process.
- Set alarms or reminders before online bookings start. Expect crashes, move to the next opportunity, and stay at it. For me, it was analogous to playing online Scrabble as you sort out opportunities and combinations. And if offered, go on any available waitlists.
- Be the squeaky wheel. You should call (not stalk) your own primary care provider, health department, or local hospital. Someone may give you the jump on a pending allotment, and you’ll know where to go. Go out of your way to thank these teams, as they are working through a Herculean task, and many are volunteers.
- Don’t try to cut the line, or worse, aspire to pay for access. It’s important to note that any extra vaccine in the packaging vial is being tagged and allocated as official doses. This overage is common with injectable meds and vaccines, and not a strange conspiracy. There will be bad actors running scams, so be cautious.
It’s OK to be frustrated, but don’t panic. We will have enough vaccines. Right now, it’s like a snake eating a big meal, as the body chokes on the initial demand, but slowly passes that initial bulk through the system. Depending on where you live and which cohort, assume this will take a minimum of four to 12 weeks, and just get your head around that. Plan for another quarter of prudence, and keep after your parents to mask up and stay the course.
In fact, slow and steady might be your best course. Run your own race, and pace the hills. We just did six-plus years of vaccine development work in six months, and many failed to prepare for the enormity of the more mundane but critical part of the process. We are in mile 25 of the marathon, and for those who run, it’s the last mile or so that can be the toughest. We shouldn’t let anyone trip and fall, so close to the finish line.
And for those who work on the frontlines, volunteer, and can get the vaccine, please do. No one should make you feel shamed or guilty. This incredible feat wins with calm order and herd immunity.
Take care of the herd.
Meghan FitzGerald is an adjunct associate professor at Columbia University’s Mailman School of Public Health. She is author of the book “Ascending Davos: A Career Journey from the Emergency Room to the Boardroom.” She resides in Aquinnah with her husband and rescue Weimaraners.