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Achieving efficient and equitable distribution becomes more complex as COVID-19 vaccinations ramp up

Here’s why a well-managed process will be the key to success.

With demand for vaccines far eclipsing available doses, people are going to great lengths to get their shot. Some wait on hold for hours when calling to schedule appointments while others camp out in long, pre-dawn lines at vaccination clinics. Some cross state and county lines to increase their chance of getting vaccinated, while others show up at vaccination sites in hopes of receiving “leftover” vaccines earlier than when they would otherwise be eligible.

Things are beginning to change, however. In the coming weeks, expansions in vaccine manufacturing will lead to dramatic increases in supply. At the same time, the Biden administration is launching whole-of-government efforts to ensure an army of nurses, physicians, pharmacist, and other healthcare providers stands ready to administer the expanded flow of vaccine inventories through an intricate network of hospitals, clinics, pharmacies, as well as temporary federal, state, and locally run vaccination sites.

Improvements in vaccine supply and distribution will mitigate the obstacles experienced by the first wave of individuals to get vaccinated. Nonetheless, expanding the vaccination program to new and larger population groups presents a new slate of potentially even greater challenges to government and health systems.

Based on our experience operating large-scale citizen engagement projects for COVID-19 vaccinations and beyond, we identified five critical functions to help governments manage these new challenges of distributing COVID vaccines at scale.

Manage the administrative burden: Enable local doctors and pharmacies to focus more time on patients and vaccinations.

Healthcare providers have high community trust and play a critical role as “vaccine ambassadors.” However, local healthcare providers could quickly become overwhelmed as the scale of vaccinations increases. As doctors’ offices and pharmacies are flooded with phone and email inquiries, they will struggle to maintain normal operations, let alone support the COVID-19 vaccination campaign. Allow providers and pharmacies to focus on patients and vaccines by shifting non-clinical tasks — from answering logistical questions and assisting individuals as they complete informed consents to appointment scheduling — to an administrative support and scheduling service.

Manage appointment scheduling: Coordinate and centralize scheduling across vaccination sites to reduce inefficiencies and waste.

Scheduling becomes increasingly fragmented and complex as the number and types of vaccination sites in a geographic area increases. This incentivizes “vaccine shopping” by individuals searching for earlier or more convenient appointments. Duplicate appointments tie up valuable vaccination slots and often result in no-shows or last-minute cancellations that exacerbate waste of reconstituted vaccines that must be disposed when they exceed their limited shelf-life. Eliminate the confusion by offering the public a centralized, convenient, readily accessed service that makes it easy for individuals to screen their eligibility and schedule their vaccination at a convenient time and location.

Manage the vaccination experience: Encourage vaccinations by making the process easier and more convenient.

Although those first in line are willing and able to persist through confusion, cancelled appointments, and other aggravations, as vaccination moves through the broader population, convenience will take increasingly greater priority when choosing if and when to get vaccinated. With more than a quarter of the public reluctant to get vaccinated, many are factoring in the experience of early vaccine recipients as they decide whether to get vaccinated — and how quickly. Begin work now to establish this reputation: It’s easy for people to make informed choices about vaccinations and to be vaccinated when the time comes.

Invest in a smooth vaccine customer experience now and continue focusing on it as the pandemic wears on into the spring and summer. This investment will pay off as fewer people delay or forego vaccinations because they have trust in the vaccination program.

Manage health equity: Take a whole-of-government approach to help the most vulnerable individuals in your communities get vaccinated.

Older, less tech-savvy, and historically underserved individuals already experience disproportionate barriers to accessing vaccines and are more likely to fall victim to the flurry of scams related to the pandemic. Because what gets measured gets managed, collect the roll-out data to track health equity. Improve access to vaccinations by providing culturally sensitive services that anticipate and address their special needs, from low health literacy and high vaccine hesitancy to language barriers, barriers to healthcare access and other social determinants of health. Leverage mobile clinics, in-home visits, and existing relationships through community partners and benefits programs to engage hard-to-reach communities in vaccinations. At the same time, use vaccination encounters to connect vulnerable individuals with other needed support services to start resolving complex unmet needs and address social determinants of health.

Manage public-private partnerships: The right community partner can empower you to deploy quickly, engage effectively, and build trust.

State and local agencies require much expertise, resources, and community trust to deploy COVID-19 vaccinations quickly — and adapt effectively as circumstances demand. The right partner can be key to success. However, the vaccine campaign is not a time for dilettantes — too much is at stake. It requires private-sector partners with a solid grounding in public health communications, privacy concerns, scientific knowledge, and technical expertise to effectively connect the right people with the right public health messages at the right time — and missteps will prove costly.

Success requires the involvement of the entire community.

To complete the monumental task of quickly vaccinating the entire population, state and local governments need to work closely with federal agencies, academic experts, and private-sector partners, including hospital systems and providers, community-based organizations, pharmaceutical companies, and the media. Close coordination, consistency in messaging and approach, and ease of use will be critical to establish and maintain public trust. Together, these actions will help ensure success in the next phase of the vaccination campaign and a way out of the pandemic.