Rapid Covid-19 vaccine rollout backfired in some US states

Despite the clamour to speed up the US vaccination drive against COVID-19 and get the country back to normal, the first three months of the rollout suggest faster is not necessarily better.

A surprising new analysis found that states such as South Carolina and Florida that raced ahead of others to offer the vaccine to ever-larger groups of people have vaccinated smaller shares of their population than those that moved more slowly and methodically, such as Hawaii and Connecticut, reported foreign news agency.

The explanation, as experts see it, is that the rapid expansion of eligibility caused a surge in demand too big for some states to handle and led to serious disarray. Vaccine supplies proved insufficient or unpredictable, websites crashed and phone lines became jammed, spreading confusion, frustration and resignation among many people.

“The infrastructure just wasn’t ready. It kind of backfired,” said Dr. Rebecca Wurtz, an infectious disease physician and health data specialist at the University of Minnesota’s School of Public Health. She added: “In the rush to satisfy everyone, governors satisfied few and frustrated many.” The findings could contain an important go-slow lesson for the nation’s governors, many of whom have announced dramatic expansions in their rollouts over the past few days after being challenged by President Joe Biden to make all adults eligible for vaccination by May 1.

“If you’re more targeted and more focused, you can do a better job,” said Sema Sgaier, Executive Director of Surgo Ventures, a nonprofit health-data organization that conducted the analysis in collaboration with international news agency. “You can open it up — if you have set up the infrastructure to vaccinate all those people fast.”

Numerous factors stymied state vaccination performance. Conspiracy theories, poor communication and undependable shipments slowed efforts after the first vials of precious vaccine arrived Dec. 14. But the size of the eligible population was always within the control of state officials, who made widely varying decisions about how many people they invited to get in line when there wasn’t enough vaccine to go around.

By late January, more than half the states had opened up to older adults — some 75 and above, others 65 and up. That’s when the real problems started.

South Carolina expanded eligibility to people in Steven Kite’s age group Jan. 13. Kite, 71, immediately booked a vaccination at a hospital. But the next day, his appointment was canceled along with thousands of others because of a shortage of vaccine. “It was frustrating at first,” Kite said. After a week of uncertainty, he rescheduled. He and his wife are now vaccinated. “It ended up working out fine. I know they’ve had other problems. The delivery of the doses has been very unreliable.”

In Missouri, where more than half of adults were eligible for shots, big-city shortages sent vaccine seekers driving hundreds of miles to rural towns.

West Virginia bucked the trend with both high numbers of eligible residents and high vaccination rates in early March, but the state started slow and built its capacity before expanding eligibility.

Similarly, Alaska maintained a high vaccination rate with a smaller eligible population, then threw shots open to everyone 16 and older March 9. The analysis found that as of March 10, Hawaii had the lowest percentage of its adult population eligible for vaccination, at about 26%. Yet Hawaii had administered 42,614 doses per 100,000 adults, the eighth-highest rate in the country.

Thirty percent of Connecticut’s adult population was eligible as of the same date, and it had administered doses at the fourth-highest rate in the country.

In contrast, Mississippi had the sixth largest percentage of its adult population eligible at about 83%. Yet, Mississippi had administered only 35,174 total doses per 100,000 adults, ranking 43rd among states.

Seven states in the bottom 10 for overall vaccination performance — Georgia, Tennessee, Texas, Florida, Mississippi, South Carolina and Missouri — had larger-than-average shares of their residents eligible for shots.

Among high-performing states, five in the top 10 for high vaccination rates — New Mexico, North Dakota, Connecticut, Wyoming and Hawaii — stuck with more restrictive eligibility. Another two high-performing states from the top 10 — South Dakota and Massachusetts — were about average in how many residents were eligible for vaccine.