Most of you are too young to recall the last mass vaccination in the US, it was the Sabin oral polio vaccine. At the time it was ground-breaking, offering longer-lasting immunity than the Salk vaccine, and, by being oral, it lent itself beautifully for mass vaccination. Our family’s vaccination took place on a Saturday in early Spring 1962 at my sister’s junior high school. I was a month shy of my 7th birthday standing patiently in a fast-moving line with my mom and sister, neighbors, and friends, excitedly waiting to get my sugar cube holding the pink droplet of vaccine. What a different time on nearly every level.
The immediate issues facing the US mass Covid vaccination are myriad:
- The absence of a national strategy that recognizes the virus for the threat that it is to our life, liberty and pursuit of happiness
- The anti-vax movement that thwarts efforts to achieve herd immunity
- The complexities of multiple vaccines with complex supply chain requirements and dosing regimens
- The necessary limitations of the clinical trials conducted over a mere 9 months
- An uncontrolled surge that is both overwhelming our healthcare system and contributing to the increasingly rapid rate of mutation events.
- A complacent public that is sheltered from the devastation of Covid as their own safety prevents them from visiting their afflicted friends and family in the hospital, rather than witnessing first-hand the human tragedy they experience the pandemic in 30-second news feeds, impersonal bar graphs, and trend lines too reminiscent of modern military conflicts.
Our most pressing issue today is a vaccine administration problem — not a supply, demand, or distribution problem — only a quarter of the doses delivered to states has been administered in the first four weeks; and this landscape may quickly change for the worse as a post-holiday surge, powered by a mutation-driven doubling or tripling of transmission rates, impacts a healthcare system already beyond capacity. In such a nightmare scenario in which supply, demand, and distribution also become problematic, as is now the case in the UK, we will have to consider all options (1/2 dosing, delayed 2nd (booster) dose) to stem further transmission via a war footing vaccination strategy to achieve some level of immunity in 2/3 of the US population in the 2nd calendar quarter.
Throughout these updates, I have tried to find a silver lining in the cloudscape of Covid but this has never been harder. To actually have the vaccine in hand but fail to achieve its timely administration, knowing what’s at risk with a pandemic surge that is contributing to the mutation rate, is not just frustrating but scary. In my version of making America great again, I think back to that Saturday in 1962 a time when we embraced science when we dreamt of the impossible like putting a man on the moon, when we worked for the collective good of our neighbors and when we used the most foundational of infrastructure, our public schools, to deliver life-saving remedies to all who were at risk.