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The real issue here is that federal and state governments didn't think through the logistics of distributing vaccines even though it has been many months since

The real issue here is that federal and state governments didn't think through the logistics of distributing vaccines even though it has been many months since we've known a vaccine would be coming. Where I live, there are about 10 different places that vaccinate, between county governments, pharmacies and hospitals. All of them have separate registration systems. Meanwhile, appointments go quickly and appointment availability is often announced on Twitter, which is probably isn't the best place for the 65+ crowd. What they needed to do starting in December is create a state-wide (or at least county-wide) registration system. Essentially model it as a priority queue with different buckets: 1) covid ward healthcare workers 2) other front line healthcare workers 3) 65+ 4) preexisting conditions 5) etc. You can disagree about which buckets go first, but that's not my point here. This should have been setup and publicized well before the vaccine rollout started. Now, you get a sense of exactly who wants to be vaccinated, so you don't get wasted doses when 45% of a nursing home's staff doesn't want the shot. You also ask people how far they would be willing to drive for a shot. I know people who drove a few hours. I know others who didn't want to drive more than 20 minutes. So it's relevant. You also ask times of day that people are willing to be vaccinated and if they want to be notified if earlier slots open up. Once vaccines are actually available, you have a central queue and you pick randomly within each priority group. So let's say you are up to 65+ adults in the general population (which is a large group). 1000 appointments open up at a hospital in zip code 12345. You send out a text message and email to 1400 (since not all 1400 are going to respond to the text message) randomly selected people in zip code 12345 or who are willing to drive there. For some elderly people, you might need to make phone calls. You give people some time to respond and if they don't, then add them back to the pool and send messages to more people until you get all slots filled. There are thousands of people in any major city who would drop what they are doing and run out to get the vaccine on a moment's notice. With a better system in place, this should never have fallen on the doctor in the first place.

ageitgey 6y ago
The system you describe is exactly what is happening in the UK. There is a country-wide registry of everyone (already existing, because the NHS covers everyone's healthcare) and everyone is assigned a place in line to get vaccinated based on their estimated clinical risk, from highest to lowest. Everyone gets a letter in the mail when their turn comes up allowing them to register for any of the currently open vaccine appointments at one central website. There's little to no fight to book slots because the appointment system is paced by the letters. When a whole risk group is nearly completely vaccinated (so far, that includes age 80+, 75+, 70+, and social care workers), then that group switches over to open registration to encourage any stragglers to get vaccinated. Anyone who has an invitation letter or is in one of the nearly-finished groups can get an appointment scheduled on a simple central website or by calling their local doctor: https://www.nhs.uk/conditions/coronavirus-covid-19/coronavirus-vaccination/book-coronavirus-vaccination/ https://www.nhs.uk/conditions/coronavirus-covid-19/coronavir... The priority queue of people left to vaccinate (and the logic behind it) is widely publicized and progress through the steps widely tracked in the media: 1. residents in a care home for older adults and their carers 2. all those 80 years of age and over and frontline health and social care workers 3. all those 75 years of age and over 4. all those 70 years of age and over and clinically extremely vulnerable individuals 5. all those 65 years of age and over 6. all individuals aged 16 years to 64 years with underlying health conditions which put them at higher risk of serious disease and mortality 7. all those 60 years of age and over 8. all those 55 years of age and over 9. all those 50 years of age and over It is estimated that taken together, these groups represent around 99% of preventable mortality from COVID-19. The UK is currently working on group #5 and catching any remaining people left in #1 - #4. My point is not that the UK is doing everything perfectly (obviously not). It's just that a mass vaccination system like this is doable and easily could have been done in the US if the government was more together over the last year. And organization works - the UK is not only significantly ahead of the US in number of shots administered per capita, but it also has a much higher percentage of age 70+ citizens reached (well over 90%) while the US vaccinations so far are more spread across age ranges.

ageitgey 6y ago

The system you describe is exactly what is happening in the UK. There is a country-wide registry of everyone (already existing, because the NHS covers everyone's healthcare) and everyone is assigned a place in line to get vaccinated based on their estimated clinical risk, from highest to lowest. Everyone gets a letter in the mail when their turn comes up allowing them to register for any of the currently open vaccine appointments at one central website. There's little to no fight to book slots because the appointment system is paced by the letters. When a whole risk group is nearly completely vaccinated (so far, that includes age 80+, 75+, 70+, and social care workers), then that group switches over to open registration to encourage any stragglers to get vaccinated. Anyone who has an invitation letter or is in one of the nearly-finished groups can get an appointment scheduled on a simple central website or by calling their local doctor: https://www.nhs.uk/conditions/coronavirus-covid-19/coronavirus-vaccination/book-coronavirus-vaccination/ https://www.nhs.uk/conditions/coronavirus-covid-19/coronavir... The priority queue of people left to vaccinate (and the logic behind it) is widely publicized and progress through the steps widely tracked in the media: 1. residents in a care home for older adults and their carers 2. all those 80 years of age and over and frontline health and social care workers 3. all those 75 years of age and over 4. all those 70 years of age and over and clinically extremely vulnerable individuals 5. all those 65 years of age and over 6. all individuals aged 16 years to 64 years with underlying health conditions which put them at higher risk of serious disease and mortality 7. all those 60 years of age and over 8. all those 55 years of age and over 9. all those 50 years of age and over It is estimated that taken together, these groups represent around 99% of preventable mortality from COVID-19. The UK is currently working on group #5 and catching any remaining people left in #1 - #4. My point is not that the UK is doing everything perfectly (obviously not). It's just that a mass vaccination system like this is doable and easily could have been done in the US if the government was more together over the last year. And organization works - the UK is not only significantly ahead of the US in number of shots administered per capita, but it also has a much higher percentage of age 70+ citizens reached (well over 90%) while the US vaccinations so far are more spread across age ranges.