The effort in the United States to produce and distribute a coronavirus vaccine appears to be a bright spot in the nation’s response to the pandemic.
The U.S. has managed to get at least one dose to nearly 24 out of every 100 adults in the country. Only Israel, the United Arab Emirates, and the United Kingdom have done better. In total, over 54 million Americans have received at least one dose of the vaccine since vaccination began on Dec. 14.
“I think when we look back at this, we will look at this as the turning point where we started to get things right and make some progress,” said Dr. Marcus Plescia, chief medical officer at the Association of State and Territorial Health Officials.
There are many factors that have contributed to the success of the vaccination effort in the U.S. Among the more important ones is Operation Warp Speed.
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“The Trump administration's Operation Warp Speed was designed to get doses manufactured, secure contracts, and get the vaccine to the states, and in that it succeeded,” said Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security.
Operation Warp Speed has spent over $12 billion, much of it on eight companies for developing and producing a COVID-19 vaccine. The U.S. has contracts to receive over 1.2 billion doses of the vaccine, including 700 million from Pfizer, Moderna, and Johnson & Johnson.
Adalja also gives credit to the Biden administration for improving the vaccine rollout.
“The Biden administration did recognize the problems with the rollout and moved the [Federal Emergency Management Agency] and the National Guard into the vaccination space,” Adalja said.
Julie Swann, a professor and department chairwoman at the Fitts Department of Industrial and Systems Engineering at North Carolina State, also credits the Defense Production Act.
“It has been helpful as it has been used not only for raw materials but also to produce low dead-volume syringes,” Swann said.
Low dead-volume syringes are ideal for extracting the last dose of vaccine from a vial, helping to prevent doses of the COVID-19 vaccine from being wasted. The U.S. did not initially have enough to use on every vial. Both the Trump and Biden administrations invoked the Defense Production Act to help boost production of syringes.
It may also be that state governments were more prepared to administer vaccines than previously believed.
“From a public health perspective, many states have been concerned about a more infectious and more deadly strain of influenza,” said Plescia. “So states have plans on how to handle a pandemic, and a lot of those plans really focus on the vaccination response.”
But others think that the slow start to the vaccination campaign was in part due to state governments’ lack of resources.
“There have been problems with that last mile of vaccination,” said Adalja. “Turning a vaccine into a vaccination and making sure state health departments had the resources to set up clinics, that fell short.”
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“I think people had unrealistic expectations that once we had the vaccine, we would be able to get vaccines into arms quickly,” Plescia responded. “It doesn’t matter how good your system is, even when you’ve been planning, it takes some time to scale up.”
