@cyclingmad
Trump has made changes but its up to the states to take on board those changes. Majority of which are Democrats and my friends who live on those states say its not and its a shambles.
Its abit like London where its a Labour majority and the Mayor does everything to thwart doing what Government says to make Conservatives look bad.
Its ridiculous, playing for political points at peoples expense.
Perhaps some words from a public health expert in one of those Democratic states about the difficulties of ramping up the vaccine program would help you understand a little about the challenges all states are facing, and about how the idea that they are 'playing for political points' is complete bullshit.
"A number of you are asking what is taking so long to ramp up vaccinations? Here is my take on the situation. In countries with a universal health system, the system’s workforce is deployed and vaccines are administered and entered into a nation-wide electronic system. Although there are advantages and disadvantages to different healthcare systems, one disadvantage to ours is the inability to quickly ramp up such efforts as some other countries can do.
Across the U.S., public health agencies, hospitals and health systems, health centers, and other providers have different electronic medical record (EMR) systems. They make up a crazy patchwork quilt of systems. Each of them is working tirelessly right now to build into their systems the ability to schedule people for the COVID vaccine, to register people who are not their patients, to load information into the state’s immunization information systems (IIS, which is ImmPact in Maine), and to enter insurance information for vaccine administration reimbursement.
These systems were not built to identify patients by what type of work they do (e.g. being a health care personnel or other essential worker), so direct outreach to these populations is very limited. The federal requirements for information that must be submitted within 24 hours of a shot being given to the IIS are substantial, and this is very different from influenza and other vaccines. These reporting requirements are understandable, since these are new vaccines against a new disease, so it is important that information is tracked.
Why do these systems take so long to launch, and why didn’t they get built earlier? Some of these requirements are specific to the two current vaccines, the details of which we learned in mid-late December when they were approved. It also was unclear until recently what would be expected of providers versus what responsibilities would be taken on by federal, state, or local governments. What has been shocking is the billions of federal funds spent on the research and development of vaccines, with none for the systems and workforce needed to administer them.
Additionally, most states have public health agencies that regularly deliver care, including vaccines. Strapped for funds and overstretched by the pandemic surge, they are very challenged to build the systems needed and deploy a workforce to vaccinate. In Maine and the rest of New England, our public health agencies deliver very little routine health care including vaccines. For them, they rely on their very small health care workforce, such as public health nurses, and they rely most heavily on private providers such as hospital health systems and health centers.
During normal times and normal vaccines, clinics can be set up practically on street corners. However, with the technologies that are necessary on site as well as requirements for storage and narrow subzero temperature ranges for these vaccines, and the delicate reconstitution of one of them (Pfizer), current COVID-19 vaccines must be administered in certain types of settings. Because of the pandemic, these sites must be quite large, to allow for appropriate distancing, including for those vaccinated to sit at a distance for the required 15 minutes post-vaccine.
Implementing all of these requirements is taking place during the worst surge of the pandemic, with unprecedented demands on the health workforce. I am sure I can speak for other health systems and providers when I say that we are extremely grateful for the many volunteers who have stepped forward. Even with volunteers, we need staff to coordinate and schedule the volunteers, stay in touch with them, respond to their questions and requests for scheduling changes. We need staff to train volunteers, including training them in privacy laws and infection control practices. We need staff to check volunteers’ credentials, such as their licensing status and background checks. With that said, we're still very grateful, and are working hard to set up the appropriate support systems for volunteers.
The unpredictable vaccine supply chain is also a major constraint. Across the country, states and providers are not sure how much vaccine will be available from one week to the next. Ramping up and shrinking clinics on a weekly basis in response to vaccine supply has been commonplace.
Be assured there are people across Maine and across the country who are working tirelessly on the myriad of logistical challenges to stand up more mass vaccine efforts. One of the advantages of our country’s health system is the variety of health care and public health systems that reflect local styles and priorities. However, during a pandemic, mobilizing a large number and variety of electronic systems and workforces with the information reporting requirements and pandemic-driven requirements is daunting. The good news is those systems are launching. I hope in the coming weeks that the vaccine supply will also be more stable and plentiful."