Where Have All The Vaccines Gone?

Now that the government has turned responsibility for covid vaccine distribution over to the private sector, we are seeing delays and shortages that didn’t take place during the declared state of emergency. To be effective, vaccines must be made easily available. Government distribution worked pretty well. What is happening now is not.

Distribution has been uneven and unpredictable. Those who would be vaccinated must know the insurance system and deal with poorly designed websites. As of ten or so days ago, only 2%  of the US population has managed to get the latest booster, which is tuned to some of the newer SARS-CoV-2 strains of virus.

I signed up for a mass vaccination event, much like one I had gone to this summer, on a New Mexico state website that had some of the characteristics of the much snazzier one that had been built with federal government funds. With a few clicks last summer, I could find an appointment and sign up. This was the only event on the website – appointments for the commercial pharmacies had to be made on their websites, none of which were efficient or smooth.

The day before the event was scheduled, I got a phonecall from a human being, saying that the event was canceled because the vaccine hadn’t arrived. If this event was like others, there must have been hundreds of phonecalls made. By then, all the appointments on the clunky commercial websites were long gone. I was told that the appointments were released at midnight every day, so I could stay up until midnight and then maybe grab one. There were also rumors about vaccines appearing randomly at pharmacies and being available to walk-ins. Neither of these options seemed convenient.

I checked the pharmacy websites from time to time, and finally a few appointments opened up – in Española, two weeks on, twenty-some miles away.

Last Tuesday I took a trip to shop at Costco in Albuquerque, which I do every few months. My first stop in the store was at the pharmacy department. They had a covid shot for me! Yay! The pharmacist said that they had had to cancel appointments the day before because the vaccine didn’t arrive, but it had come in late in the day. So when I appeared somewhat randomly, I got a shot while others who had planned and set up appointments didn’t.

There are stories like this all over. Additionally, distribution seems to be haphazard among cities. Albuquerque is doing pretty well, but Santa Fe isn’t.

I’d like to know what is going wrong. I recognize that what we are seeing goes against the narrative that private enterprise does everything better than government, and thus it’s likely that few reporters will be tasked with finding out, but here is a starter set of questions in case anyone in the media is interested.

• Who is responsible for vaccine distribution – the manufacturers, the pharmacies, or a middleman logistics agency?
• Is the problem that not enough vaccine has been manufactured or is it in distribution? In either case, there are numbers from the past couple of years to project from. What went wrong with the projection?
• Are there additional interactions among the manufacturers and the pharmacies that are affecting the distribution? Kickbacks could be a part of this, or convoluted contracts.
• Early on, there was a problem with insurer code numbers. It was known ahead of time that the new vaccine would be rolled out. Why weren’t insurers ready?
• The Costco pharmacy didn’t even ask for my Medicare number or insurance. How did they do that when the other pharmacies were adding in as much paperwork as possible?
• How many appointments a day have pharmacies been allowing? Do they need more staffing?
• What can private enterprise learn from what the government did right?
• Infant RSV vaccine is in short supply, so the government is rationing it. What are the requirements for the government to step in? (BTW, the link is to a newsletter worth subscribing to if you want to follow disease outbreaks. Here’s the front page.)

More questions will emerge from any investigation of these questions.

Cross-posted to Nuclear Diner