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Why It's Easier To Get Coronavirus Vaccines In Some States


There's so many questions about where and how to get a COVID vaccine. The rules for access differ from state to state, from town to town. Dr. Rebecca Weintraub is faculty director of the Global Health Delivery Project at Harvard and associate faculty member of Ariadne Labs. She joins us now from Boston. Thanks so much for being with us.

REBECCA WEINTRAUB: Thank you for having me.

SIMON: So many variables - whether you're in Florida, Oklahoma, Washington state - can govern, whether when you can get a vaccine. But suppose a local government says you qualify, but then you can't find a shot.

WEINTRAUB: First, let's take a step back, that the states began this process in December determining how do I allocate the scarce resource, knowing that they would only have a limited supply of doses each week. Now, as of March, they have a predictable supply. They actually are receiving three weeks of an estimate of the supply they will receive of Moderna, the Pfizer vaccine and now Johnson & Johnson. So the question they're asking now is, how do I distribute this to the adult population within my state?

SIMON: Well, what accounts for all those variables?

WEINTRAUB: This is a free federal vaccine that's going into states that have different public health systems, that have different distribution channels, that have different geographic reach, for example, of pharmacy, retail chains, mass vaccination sites, as well as local and community-based organizations that are able to distribute the vaccine.

SIMON: Some places better prepared than others?

WEINTRAUB: That's correct. So first, we have to remember that certain states, for example, Connecticut, started changing the rules of eligibility very early on in January and February. And then as of a few weeks ago, President Biden asked all states to insure all adults in America become eligible for the vaccine as of May 1.

SIMON: So at the moment, it sounds like manufacturing capacity is ahead of distribution, and distribution has to figure out how to catch up.

WEINTRAUB: That's exactly right. We now have a predictable supply where states can plan first dose, second dose. They can improve the scheduling and the number of scheduling appointments that can be provided to local channels. What we now have to think about it is, how do we vaccinate the American public 24/7, seven days a week? So, for example, Utah, Rhode Island, Virginia and the Veterans Association have had robust vaccination services on Sundays. More of this needs to occur.

SIMON: Let me ask you about equity because I suspect at some point months ago, the whole idea of the register on your iPhone, your laptop - the whole idea was equity, so nobody would get preference over another. But that left out a lot of people, didn't it?

WEINTRAUB: That's correct. Actually, online scheduling became a fence for equity. No. 1, it assumed you had a computer, you had access to an Internet, you could fill out an online code. So one of the recommendations we made in an op-ed in the Hill this week is we need to simplify the appointment scheduling not only to centralize it, but we need to create offline options for our vulnerable populations.

I want to also just mention that this is a free federal vaccine. You do not need to show a Social Security number. You do not need to show your insurance card or your immigration status. And we have to remind the public the COVID vaccine should never cost you money, ever. It's the law. You should not receive a bill or a request for a fee related to your vaccine being administered.

SIMON: How soon do you think everyone who wants the vaccine, who should get the vaccine, might be able to get it?

WEINTRAUB: I think President Biden made this clear when he put out the idea of coming together for July 4, that we will have sufficient supply for those interested in receiving a COVID-19 vaccine - that means your first and your second dose - and then that two-week waiting period after that second dose to be able to congregate with family members and households as of July 4. So we're talking about weeks away from those interested in getting a vaccine being able to access it and receive both the first and second doses or, of Johnson & Johnson, the one-dose regimen.

SIMON: And, Dr. Weintraub, what, if it turns out, as some research is going on now, that we have to get another shot to essentially recharge our immunity? Will the same challenges present themselves, or will we have learned something?

WEINTRAUB: First, we have to remember that the variants that we're seeing that are circulating not only within the U.S. but across the globe are coming from the unvaccinated. So we need to finish vaccinating Americans and do everything in our power to accelerate vaccinations across the world, and that the vaccines we have today are excellent at covering these variants. And we set up better systems of surveillance to understand the variants and the platforms. The mRNA vaccines have shown to be quite robust and then may be able to produce the booster we'll need if necessary.

SIMON: Dr. Weintraub, what if - let's say, ideally, you're vaccinated, but you have relatives in another state that are having trouble?

WEINTRAUB: So first, we have to remember that every week, the states will be receiving the replenishment. So we request that people stay within their states to receive the vaccine if possible. And in many ways, this is a very short window of scarcity where you may not be able to receive a vaccine in your local entity, but it will soon be available across your state.

SIMON: Dr. Rebecca Weintraub at Harvard University and Ariadne Labs, thanks so much for being with us.

WEINTRAUB: Many thanks for having me.

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