The Corner

Politics & Policy

Slow Coronavirus-Vaccine Distribution Isn’t Due to Lack of Centralization

Registered nurse Kayla Johnson prepares a coronavirus vaccine at Boston Medical Center in Boston, Mass., December 16, 2020. (Erin Clark/Reuters Pool)

Who is surprised that the federal government fell far short of its promise to vaccinate 20 million people by the end of 2020? I am not, really. There are many factors, including the reluctance of health-care workers to get vaccinated when their turns are up (I think that those who don’t want the vaccine now should be free not to take it but go to the back of the line and be accountable for their decision, but that’s a topic for another day).

That said, even without this, we shouldn’t have been surprised by the slow rollout. It isn’t the first time that top-down institutions have failed to roll out whatever products they were designed to get out. Remember the rollout of Obamacare’s website?

And yet, forgetting the lessons of the past, we hear many people blaming this on the lack of central planning from the Trump administration. Virginia Postrel has a great piece over at Bloomberg Opinion explaining why this is nonsense and warning that, if the Biden administration decides to impose tighter government control, it will probably be a disaster. A tidbit here:

Whether you’re laying fiber optic cable or delivering packages, that last mile is the tricky, labor-intensive, expensive part. To reach individuals, the system has to go from centralized operations to decentralized ones. That’s why we have retailers rather than ordering our toilet paper from Georgia-Pacific, and why they, in turn, often rely on distributors. “Cutting out the middleman” is a catchy slogan, but intermediaries make the system work.

When the federal government turned state agencies into the country’s vaccine distributors, it bypassed the usual supply chains. Doctors and hospitals couldn’t get Covid-19 vaccines the way they order other inoculations.

Distribution also became politicized in ways that slow down vaccination. Every shot comes with a ton of paperwork, and the rationing rules are hard to understand. Who exactly qualifies as a health-care worker or an essential employee? Is it OK for hospitals to give shots to janitors or billing clerks?

She gives many examples of the unintended consequences of government micromanagements. She also offers an alternative:

Keep it simple. Use rationing rules people can easily understand. Worry less about queue jumping and more about getting vaccines into arms as quickly as possible. Trust medical professionals to do their jobs . . .

States could also make it much easier for medical professionals to organize vaccination drives. Allow any practice to set up days when they offer shots to their employees, patients and the community. Leave it up to them to decide who can administer the injections and how to manage sign-ups. Just provide the vaccines.

Going a step further, allow any organization — a church, an alumni association, a sports league or any other legally incorporated group — that can round up the necessary space and qualified volunteers to offer a vaccination clinic. . . .

Community groups offer two essential resources: trust and willing hands. For people who might be skittish about getting vaccines from strangers in impersonal institutions, having someone they know as the face of the injection can offer reassurance.

There is more here, including a link to John Cochrane’s post on this issue. If anything, I wish this would erode a little (or a lot) the belief that government organizations can do stuff like this effectively.

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