More than 22 million doses of Covid-19 vaccine have been distributed in the United States so far, yet only 6.7 million Americans have received the first of the required two doses. Many observers, including President-elect Joe Biden, have argued that the shortfall calls for additional spending and rapid government intervention to speed things up. But experience shows that governments do a poor job at disseminating vaccines. The solution is not more government, but less.
The federal government did an admirable job facilitating the development and manufacture of new Covid-19 vaccines in record time. This achievement included commitments to purchase and distribute, free of charge, 200 million doses from Pfizer and Moderna, as well as doses from other companies when their vaccines are authorized by the FDA. Two hundred million doses, enough to vaccinate 100 million people, should be available by March 31.
Unfortunately, state governments have done a poor job of getting the vaccine into peoples’ arms. Governors have complained that they are not receiving as many doses as they were promised, but they have routinely failed to utilize the doses they have received. A combination of restrictive rules over who can be vaccinated and administrative incompetence means that many doses are sitting unused in the freezer.
New York is typical. It has administered less than half the vaccines it has received. While Governor Andrew Cuomo has blamed local leaders, county executives complain that state officials have bypassed long established county-level vaccination plans. The state’s public-health law requires counties to develop vaccination plans each year, including training and practice sessions. But New York authorities ignored county plans, preferring to micromanage vaccinations at the state level.
Cuomo complicated matters by threatening to fine hospitals that don’t use vaccines within a week of receipt; he would also fine them if they vaccinate anyone out of the strict priority group order set down by the state. This stricture puts providers in a double bind. Hospitals may have trouble finding enough people in the eligible group willing to be vaccinated within the arbitrary one-week limit—a task made more difficult by partisan criticisms of the vaccine development effort that undermined public willingness to be vaccinated—but will be punished if they try to avoid wasting the vaccine by administering doses out of order.
President-elect Biden’s plan to set up federally run vaccination sites and mobile vaccination units is unlikely to improve vaccine utilization in the near term. Outside of the Veterans Administration, the Indian Health Service, and military hospitals—none noted for efficiency—the federal government does not normally provide direct health services. Federal vaccination sites and mobile units don’t exist, and setting them up will not occur overnight.
Read the full article at City Journal.