PA Vaccine Distribution: Was it Inefficient?

Just recently, Pennsylvania has moved onto phase two of vaccine eligibility, meaning all adults in the state are now able to make their appointments. This marks four months after the first batches of the Pfizer and Moderna vaccines were distributed across the country. Over the course of these four months, distribution in the state has been a large topic of controversy. So, how did we get here?

Vaccines were distributed across the country and the state in four phases: 1A, 1B, 1C, and 2. Each state decides what phase they are in and when they will move onto the next phase.

Phase 1A was the first eligibility group and was effective immediately after the first batches were sent back in mid-December. This group comprises of healthcare personnel (including those on front lines), those above the age of 65, and high risk patients vulnerable to hospitalization from infection.

Phase 1B began on April 5th. This group comprises of law enforcement, firefighters, grocery store employees, food & agricultural workers, educational workers including teachers, and more.

Phase 1C began on April 12th. This group comprises of transportation and logistics workers, water and wastewater workers, food service workers, construction workers,  government officials, and more.

Phase 2, the phase we are currently in, began on April 13th, one day after phase 1C. This group comprises of all Pennsylvania citizens above the age of 16.

While each state moves along in these phases, the federal government monitors the progress of each state and distributes vaccines accordingly to retail pharmacies, qualified health centers, and the Department of Health. The state then distributes to providers based on, in decreasing weighting, the remaining population above age 65, the amount of deaths, total population, and total cases. They also account for the provider’s ability to store vaccines, and the amount of vaccines they requested.

Despite this seemingly complex system, Pennsylvania has been average, at best, for vaccine distribution and this has been apparent. Pennsylvania is ranked 22nd on vaccine administration efficiency, meaning the ratio between vaccines administered to vaccines received at 79 percent. As of March 25th, Pennsylvania was ranked below average in fully vaccinated persons per 100,000 people, total doses administered, and above age 65 dose administration. With the last statistic, Pennsylvania is ranked 37th out of all 50 states.

Many people have complained about these statistics, and rightfully so. Gary Bauer, a high risk individual was eligible under group 1A. Even then, he was only able to get his first shot in late March. “I was worried that I wouldn’t be able to get my vaccine. This was especially dangerous because of the large amount of cases we had this past winter.” Grace Rabago, who works in food service would be under group 1C, just got her vaccine last Friday. She commented on the long wait for her vaccine saying that, “I feel they wasted a good number of vaccines in the beginning that could have been used. I think this was because they were focusing on phase 1A and might have received more vaccines than they could administer.”

The reason for this was a poor alternate vaccine distribution strategy. There is already federal protocol in the distribution of vaccines in the case of a pandemic called Medical Countermeasures or MCM’s. Under these MCM’s, vaccines would be distributed by the federal government, to the states, then to the counties, and finally to administration sites. This provides a balance between correctly distributing the number of vaccines via several middlemen and limiting the total amount of middlemen that would cause a slower process. This protocol was chosen by the federal government because it was deemed the most efficient. Pennsylvania however, decided to add another middleman: providers. Overall, this causes a shortage of counties’ supply of vaccines and complicates the system. The Philadelphia Inquirer, a paper located in the most populated county in the state, called it “reinventing the wheel.”

We have heard the word “unprecedented” for the past 13 months and while mass vaccine development and distribution in record time does fit under “precedented”, we still have protocols in place to prepare us for these unprecedented scenarios. The state of Pennsylvania chose to alter these protocols, and this led to a more inefficient system, to which we suffer the consequences.