The Morning Jolt

Health Care

Why Is Tracking the Vaccine So Difficult?

A pharmacist fills a syringe with the COVID-19 vaccine at a pop-up vaccination site in William Reid Apartments in Brooklyn, N.Y., January 23, 2021. (Mary Altaffer/Reuters)

The Senate trial on the second impeachment of Donald Trump begins today, and NR will have a special tracker on the site keeping you updated. You’ll want to check out Zach Evans on the trial rules, Andy McCarthy on why Rand Paul is wrong to call impeachment the “criminalization of speech,” Mairead McArdle on Republicans rallying around Trump, and my observation that if you’re going to have an impeachment trial, have an impeachment trialdon’t rush through it without calling witnesses because you want to move on to other business.

The irony is that the trial, which would ordinarily be huge news, feels like a second-tier concern at the moment. Barring some dramatic turn of events, 17 Republican senators choosing to convict is just about inconceivable. At least for now, Trump’s fate appears to be a resolved issue — particularly when compared to the pandemic-relief bill, woke culture-war fights, and this newsletter’s continuing obsession: the vaccination rollout.

Why Is Tracking the Vaccines So Difficult? Why Are Vaccination Events Getting Canceled?

In a world where Amazon, UPS, and the Postal Service can tell you precisely where your package is, and when all boxes of vaccines are “equipped with a GPS beacon, a temperature monitor and a barcode that’s scanned upon receipt,” it is still baffling that the government — whether it’s Operation Warp Speed, the CDC, the HHS, the White House, the Pentagon, or state and local governments — can’t get a clear sense of where the vaccines are in the distribution chain, how many will arrive at a certain time, how many will be available to be distributed, and how many people to schedule for an appointment.

And yet, more than eight weeks into the vaccination process, certain hospitals and medical centers say they aren’t getting what local governments and counties promised, localities say they aren’t getting what the state promised, and states say they aren’t getting what the federal government promised. Why is this process so hard? Where in the supply chain are the numbers getting lost? If you know that you have 10,000 doses in a shipment rolling off the assembly line in Kalamazoo, Mich., and you’re putting them in a truck headed to Missouri, why is it difficult to track and distribute 10,000 doses in that state?

I didn’t pick that state at random:

St. Louis County officials said on Monday they may have to delay some COVID-19 vaccinations this week after the state told the county it would not send doses as expected.

The state said last week it would send 3,900 doses to St. Louis County this week, county officials said on Monday, and the county announced several mass vaccination sites in preparation. But by Friday, the state told the county it wouldn’t send the vaccine after all, the officials said.

“St. Louis County continues to be uncertain when and whether it will receive vaccine doses,” County Executive Sam Page said in a news release. “This makes it incredibly difficult to plan a distribution network and effectively communicate with those who have signed up and are anxiously awaiting an appointment.”

For the third week in a row, the county has not received any direct shipments of vaccine. When it opened its first mass COVID-19 vaccination site last week, it did so using 3,900 doses that were redistributed from a local hospital.

The county will receive 1,950 doses later this week through another redistribution from area hospitals, officials said, but that’s almost 2,000 fewer doses than expected, and some appointments will likely have to be rescheduled or canceled.

Missouri Department of Health and Senior Services spokeswoman Lisa Cox did not respond immediately to a request for comment.

Stephanie Zoller, spokeswoman for the St. Louis Metropolitan Pandemic Task Force, which represents area hospitals, said the state announced last week it would send 15,600 doses to the region’s large health systems. But she said she didn’t know if the task force was supposed to redistribute those doses, and it certainly wasn’t clear last week.

How can it be that Saint Louis County in Missouri hasn’t received a shipment in three weeks? That county has almost a million people!

Apparently, everyone who tries to use the Deloitte-designed Vaccine Access Management System (VAMS) hates it. Has anyone tried tracking the shipments using paper and clipboards and cell phones? Why is crappy software preventing shots from getting into arms?

These stories of dysfunction are getting absurd. In a corner of South Carolina, just west of Columbia:

In Saluda, Emmanuel Family Clinic Officer Manager Debra Cleveland said her office has administered one out of 400 doses it has received in the last three weeks.

Cleveland said her first dose is the only dose that’s been administered.

She said VAMS, the federal scheduling program, has crippled her community’s ability to get vaccinated.

“There are a lot of people who do not know how to read, how to write,” she said. “There are people who have other languages, a lot of the people, especially 70 or above, there are people who have no computers, who have never worked on a computer in their life. They have no idea what to do.”

The doses are nearing their expiration of 30 days, so Cleveland and her staff will be instituting a paper-based model on Tuesday, where patients will schedule appointments and fill out questionnaires onsite. Staff will later fill the data into VAMS.

“[It’s] extremely frustrating because of the fact that everybody talks about we’re having such a hard time getting the shots and this stuff, and I’m like, ‘No, that’s not the problem. We have the vaccine. We can’t give the vaccine,” she said. “And they’re like, ‘But you’ve got it? Why not?’ I’m like, ‘That’s the way because that’s the way it’s written up. That’s the way the rules are. You have to go by the rules.’”

From coast to coast, it is not difficult to find planned vaccination events getting canceled or dramatically scaled back because of limited supplies or supplies not appearing when and where they’re supposed to arrive.

Los Angeles:

With COVID-19 vaccine supplies still scarce, Los Angeles County residents can only make appointments to get their second doses at the large county-operated sites for the rest of the week, officials said. Starting Tuesday, only those with proof of getting the first dose of the COVID-19 vaccine will be inoculated at the Pomona Fairplex, the Forum, Six Flags Magic Mountain, County Office of Education in Downey, Cal State University Northridge, Balboa Sports Complex and El Sereno.

Pennsylvania:

This week both Montgomery County and Delaware County Departments of Health received only 1,000 first-dose vaccines. That’s compared to a typical shipment of 2,500 doses.

Denver, Colo.:

A COVID-19 vaccination event in Denver was overrun Saturday when Jeffco Public Schools alerted 14,000 employees that 200 extra doses of vaccine were available to those who could get to the National Western Complex within an hour. Hundreds of people rushed to the complex on Humboldt Street to try to get the vaccine around 5 p.m. Saturday. Traffic backed up at the exit and into Interstate 70. Drivers wouldn’t let others merge into the line. Some people leapt from their cars and ran the final stretch to the building. One man arrived in a bathrobe; he hadn’t stopped to put on a shirt.

Plano, Texas:

Days after overbooking forced some people to be turned away at one of Collin County’s largest COVID-19 vaccination sites, things appeared to run more smoothly Monday at John Clark Stadium in Plano. Hundreds of people with appointments to receive the vaccine were turned away on Thursday after Collin County Health Care Services said it overbooked appointments because it saw large numbers of no-shows on daily appointment schedules earlier in the week.

Memphis, Tenn.:

More than 80,000 people in Shelby County have had at least one dose of the COVID-19 vaccine. Now, thousands are on deck to get their second dose and many don’t know when that will be. WMC heard from several people who said they’re set to receive their second dose this week, but there aren’t any appointments left. Only one day and one location is set aside this week for second doses, but appointments are filled, and that’s leaving thousands of people with worries.

Alabama:

On Monday, Alabama makes about 1 million more people eligible to receive the vaccine. That’s people over 65 and teachers and others in 1b, the second wave of the rollout. Yet the state is only getting about 60,000-70,000 first doses per week. At that rate, Alabama would be stuck in this second phase until June.

Down in El Paso, Texas, when people get their first vaccination, they’re given a card that shows a date for the second dose. But apparently that date is a suggestion, not an appointment:

Over 100 people were turned away from the City of El Paso’s George Perry mass coronavirus vaccination site on Monday morning after confusion over their appointment to receive the second dose. People waited for hours in line thinking they had a second appointment although they didn’t. When they were told to leave, many refused to go. Cops were called in to come and disperse the crowd. A police officer at the scene told ABC-7 that the same thing happened the day before.

The great former Food and Drug Administration commissioner Dr. Scott Gottlieb — now appearing on a special edition of The Editors — recently wrote that “especially with improved delivery, at some point, perhaps in April, supply will start exceeding demand. The challenge won’t be how to ration a scarce resource, but how to reach patients reluctant to get vaccinated.” I hope he’s right. That feels a long way off right now. Oregon has just now moved on to octogenarians.

Meanwhile, California recently declared those in the medicinal-cannabis industry are now eligible to be vaccinated alongside health-care workers.

ADDENDUM: As discussed on the Three Martini Lunch podcast yesterday, the U.S. Office of the Director of National Intelligence recently released a report about the Chinese government’s efforts to collect the DNA of American citizens:

For years, the People’s Republic of China has collected large healthcare data sets from the U.S. and nations around the globe, through both legal and illegal means, for purposes only it can control. While no one begrudges a nation conducting research to improve medical treatments, the PRC’s mass collection of DNA at home has helped it carry out human rights abuses against domestic minority groups and support state surveillance. The PRC’s collection of healthcare data from America poses equally serious risks, not only to the privacy of Americans, but also to the economic and national security of the United States.

Read Hunting Four Horsemen while it’s still fiction. And note that everything from pages 65 to 68 about the Chinese government’s secret biological-weapons programs and gene-editing research is nonfiction.

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