Because the Trump administration did not take a nationwide approach to rolling out administration of the COVID19 vaccine, it has been an uneven and slow process to implement. The problem, as the Biden administration quickly recognized, wasn’t just transporting the vaccines around the country, the states also needed to address the logistical challenges of delivering a statewide vaccination program to millions of potential recipients. As Biden has often said, you need people to give the vaccinations and that takes planning and coordination.
Here in Virginia, the Department of Health created an online registry where people are placed on a list to be notified when an appointment is available. My wife and I registered January and then we waited. My guess was that we wouldn’t be called until mid to late April at the earliest. One of the reasons for my lack of optimism was that our health district was receiving just 3,600 doses of vaccine a week for a district that serves 300,000 people.
So imagine our surprise and elation when we were notified that we could make an appointment at our local hospital for the first week of March. That, thanks to Biden’s directive to quickly achieve the goal of administering over a million vaccinations a day. According to the email we received, the hospital was scheduling five people every five minutes. As I write this, there are no commercial pharmacies in our immediate area, such as CVS or Walgreens that are administering the vaccine. When we arrived for our appointment, I was impressed by how well organized the health facility was to accommodate the number of people there to be vaccinated. Augusta Health operates a large health care campus including inpatient hospital, outpatient clinic, physicians’ medical office complex, educational center, and health and wellness center. The latter was where they set up the vaccination program.
The roads and parking area were clearly labeled with signs directing us to the building where the vaccinations were being administered. First step was a kiosk in the parking lot where they checked our names and gave directions to the entrance of the building. Once inside we were directed to a sign-in booth to verify our appointment and then to a workstation with a privacy screen to get vaccinated. We met with a nurse who took a short medical history, described potential side effects, and had us sign an acceptance form. After we were given our vaccinations, we were directed to another room to wait 15 minutes to be observed for potential adverse reactions. During that waiting period a volunteer met with us to schedule our second dose. Then it was check out. From start to finish it took about 45 minutes and that was because each step was spaced out to accommodate the large number of people getting vaccinated; I asked the nurse and she said between 800 and 1200 a day.
Here are my takeaways about this experience.
I worked in a “helping profession” all of my life, primarily in psychiatric hospitals. People choose that line of work because they want to make a difference in the lives of others. That helping, caring attitude was on display throughout our experience at Augusta Health. So, a big and deeply felt THANK YOU to the employees of Augusta Health, other health providers who are contributing their skills, and all of the other employees and volunteers who are giving their time and effort to vaccinate our community.
When I was chatting with the nurse who administered the vaccine, I pointed out that we seniors were not strangers to mass vaccination programs, as we participated in one when we were kids to get the polio vaccine. “I understand that everyone got the vaccine, no one asked if you wanted it,” the nurse, who was probably in her 30s said. “Yes, we got them at school” I replied. Her comment made me stop and think. Polio was a scourge in the first half of the twentieth century. President Franklin Roosevelt was crippled by it and what made it particularly scary was that it was highly contagious among children. So, when Jonas Salk’s and later Albert Sabin’s polio vaccines became available, people did not question its utility. For parents it was a godsend.
The public’s attitude toward public health programs and disease prevention was also different seventy years ago. Immunization, antibiotics, sanitation programs, and pharmaceuticals saved and extended the lives of millions. Therefore, the majority of the population believed in public health initiatives as well as the promise that medical research had for the future. Public health addresses the needs of individuals by addressing the needs of the population. For example, your immunity to COVID19 increases as the immunity of the entire population increases (an upcoming blog, on herd immunity, speaks to this concept). World War II had unified our nation, so seventy years ago, it was unthinkable that anyone would not participate in a vaccination program that can help save the lives of fellow Americans.
Finally, I couldn’t help but wonder how a universal health care program, like I describe in my book, would have helped in this process. Actually, quite a bit. Under the National Health Program (NHP) I advocate, the entire process would be coordinated and administered by one agency. It would work with local providers and state departments of health to provide guidance in setting up vaccination centers, calling up providers to administer the vaccine, and allocating delivery of the vaccine to each of those locations so that there are no delays in supplies.
Because all Americans would have a health card and be registered in the national medical records data base, they would be contacted directly by the NHP as to when and where to report for their vaccination. A fleet of mobile units, created to provide health care in rural and underserved areas, would be available to provide vaccinations to patients in nursing homes, students at school, and workers at their job site. Had the NHP been in place, even something as dysfunctional as the Trump administration could have done a much better job at implementing the vaccination program.
And this brings me to a final point. This country (and the world) is poised to confront a number of health crises in the future. They may be brought on by natural disasters such as earthquakes, extreme weather events created by climate change such as monster hurricanes, and new viral pandemics. All of these have the potential for mass casualties. As the COVID19 pandemic has demonstrated, we are ill prepared to address these threats. That makes a national health program, with the capability to plan and prepare for these emergencies, essential for our country’s safety.
We need to vaccinate about 300 million Americans to obtain a level of herd immunity that will return us to more normal conditions. That goal, according to the CDC and the Biden administration’s COVID19 task force should be achieved by late summer/early fall of this year. But we shouldn’t stop there. If we are the society we claim to be, then we must work with other countries to provide immunization to the rest of the world. First and foremost we should do it for humanitarian reasons, i.e. because it is the morally right thing to do. Second, we should do it for “selfish” reasons. By reducing prevalence of the virus in other countries we also reduce the risk that new variants will make their way to the United States. Third, we should do it for economic reasons, as we are part of a global economy and a strong world economy helps create a strong national economy.
THANK YOU again to the providers, staff, and volunteers at Augusta Health who are making the vaccination program in my community a successful endeavor.