Are mass clinics the solution for Covid-19 vaccination?


The deployment of the Covid-19 vaccine is going badly. Delivering More Doses Faster is at the Heart of the 200-Page White House Covid-19 plan, what was released last week, a day after President Joe Biden took office. The plan, which promises to vaccinate 100 million people within the first 100 days of the new administration, features a series of initiatives to speed up delivery: releasing almost all doses, relaxing eligibility criteria, adjusting distribution and development of new packaging to preserve temperature. sensitive products for transport to rural areas.

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All of this is good, but none of it will be enough if these better packaged and faster delivered doses cannot be delivered to more people in a timely manner. The plan also addresses this: it says the administration will create mobile vaccination vans, recruit pharmacists to do vaccines, and increase support for public clinics and federally qualified health centers that cover underserved areas. The most critical provision is the pledge to create 100 new vaccination sites, backed by the Department of Defense and the Federal Emergency Management Agency. They will be staffed with what the plan calls “thousands of clinical and non-clinical staff and contractors,” including staff from federal agencies and public health departments.

What the plan does not say, explicitly, is where – or when, or how big – these federally-supported sites are going to be. Outside of the new government, experts are starting to question whether it will be possible to create mass vaccination clinics, where thousands of doses can be administered every day.

There is no doubt that mass sites could get as many hits in as many arms as possible in the shortest possible time. But depending on where they are and how they are operated on, they can inadvertently exclude those who need protection the most. The choice of mass vaccination is effectively a proxy for deciding national priorities: quickly achieve collective immunity, by vaccinating as widely as possible in order to suppress infections, or whether to focus on protecting the most vulnerable, by targeting the first doses in to reduce serious illness, hospitalizations and death.

But if this conversation is urgent, it can also be moot – because there may not be enough health workers to staff the mass sites and keep them open, so many hours in the day and many days. in the coming months as needed.

Mass vaccination is a tall order, but there are ways Less complicated – in terms of dose allocation, transportation, and other logistics – than much of the United States is doing right now by distributing doses to hospitals, drugstore chains, and supermarkets. “If we want speed, the best way to do that is to set up mass vaccination clinics – say 10 or 20 in a state, instead of the hundreds of locations you have when you send doses of. vaccine to individual physician offices and hospitals and health departments, ”says Julie Swann, professor and chair of the industrial and systems engineering department at North Carolina State University. “It is slower to deploy the vaccine to priority populations than to mass vaccinate large numbers of people.”

This does not mean that mass vaccination is easy to organize or quick. An overview of what will be needed, Swann said, can be found in plans for the mass flu vaccination clinics that the Centers for Disease Control and Prevention compiled during the 2009 H1N1 swine flu pandemic. The presence of health workers licensed to administer injections is only part of the story. puzzle. “You need people who handle forms, people who do orientation or give directions to exit, and people who handle data entry or medical records,” she says. “Responsible for procurement, security, possibly translators, emergency personnel, IT support.”

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