America’s vaccination roll-out will improve with practice

ONLY EIGHT medical centres in the entire state of New York have managed to administer all the covid-19 vaccines they received. Cayuga Medical Centre, in upstate New York, is one such facility. It has used 100% of its vaccines—7,700 so far, about 700 each operational day—whereas the rest of the state has managed to administer only 77% of its supply.

With most Americans eager to get vaccinated, many are wondering why so many vials are sitting in storage. The answer mainly comes down to practice. Martin Stallone, CEO of Cayuga Medical Centre, attributes the system’s success to its ability to perfect complex logistics. Serving as a covid-19 testing site for nine months before the vaccination programme allowed Cayuga to streamline processes such as managing the flow of patients while keeping them far enough apart, processing paperwork and following-up with patients. “We have taken the lessons we learned by being an aggressive covid-testing site,” Dr Stallone explains. “We took that...and we applied it to our vaccine operations.”

Howard Koh, a public-health professor at Harvard University and former health commissioner for Massachusetts, emphasises the importance of such practice. He encouraged states to use a mass-vaccination campaign for influenza to “drill, work together and build a unified effort” in preparation for the covid-19 vaccine, but most did not. Furthermore, the federal covid-19 vaccination plan was released in September, just a few months before covid-19 vaccinations started in December. As a result, many sites lacked the time and preparation they needed to run efficiently.

Space helps too. Cayuga benefits from access to large, empty facilities to use as vaccination sites. The system made use of an empty Sears department store in the city to gain 50,000 square feet of vaccination space (almost the size of an American-football field). This gives Cayuga the ability to process as many as 2,000 people a day. It can also access an additional 40,000 square feet of retail space—a former Bon-Ton store—should it need the capacity.

Although Cayuga has the resources it needs to operate efficiently, many other sites need support. President Joe Biden has pledged $160bn towards a national vaccination plan, expanding testing and other public-health measures. His plan promises community vaccination centres and mobile vaccination units, to increase the share the federal government pays when reimbursing health-care companies for vaccine administration and to administer vaccines to 100m Americans by the end of his first 100 days in office.

Dr Koh reckons Mr Biden’s plan would give states what they need to meet their vaccination goals, and that over time the sites will gain the experience they need to run efficiently. “I’m confident [states] will rise to the challenge,” says Dr Koh. Meanwhile at Cayuga, vaccine supply is the constraint. Despite being able to administer 2,000 vaccines a day, Cayuga’s vaccination centre was closed on a recent Monday because it lacked vaccine doses. “The Sears building is...dark. It’s locked up. Nobody’s there, except maybe a custodian,” Dr Stallone said. “We can turn on the lights, and we can deploy our people to that location, if we are given the mission.”■