Study says stronger federal leadership needed to make COVID vaccine rollout work

Dec 3, 2020

A report released Thursday suggests a successful COVID vaccination effort will require at least 70% participation by the public. And it states the federal government will need to make a stronger effort to build public trust and help states successfully administer vaccine distribution.

The Commonwealth Fund, which conducted the study, examined past vaccination programs for influenza and H1N1 and learned that public participation was far below what experts say will be needed for a successful COVID vaccination program.

“People have said that we need to see at least 60-70% of the adult population vaccinated against COVID-19 to achieve the herd immunity that slows the transmission of the virus,” said Dr. Eric Schneider, the Commonwealth Fund’s Senior Vice President for Policy and Research. “We found that no state was getting above 51% and that states were really quite variable in terms of their ability to achieve even that level of vaccination.”

Turnouts for H1N1 during a 2009-2010 outbreak were even lower, according to the study, with states averaging about 23% participation in vaccinations for the "swine flu."

The study also finds continuing racial inequity with vaccination programs. Data provided within the study shows it is especially the case with Black adults in states where larger Black populations live, including Texas, Maryland and Georgia. There's also a significant gap between white and Latino adults. In six states, there are gaps of at least 20%.

One of the issues the study addresses is cost sharing. Out-of-pocket payments, Schneider tells WBFO, leads many to skip a vaccination. Schneider suggests the first phase of COVID vaccinations to healthcare workers and occupants of long-term care facilities will be covered by the federal government. But when it comes time to vaccinate the masses, the Commonwealth Fund recommends eliminating cost sharing.

"What happens is that those with fewer means, people who are unemployed, people who have very limited income, will opt not to get the vaccine if they have to pay out of pocket," Schneider said.

The study recommends the federal government take a stronger, more active role. As the Commonwealth Fund summarizes in its call for more federal involvement: "While states have a primary role in public health actions, particularly during disease outbreaks, the federal government can guide state allocation strategies and monitor vaccination progress. It also can expand state funding to bolster vaccination capacity, assist distribution to states by operating centralized storage and administration facilities, and sponsor and support state and local vaccine awareness campaigns."

"Congress is considering that right now, so that's really important that states have adequate resources - financial resources particularly - to get the personnel, get the training and make the vaccinations happen," Schneider said.

The study also calls for emphasis on racial equity with vaccine distribution, and leading a consistent media information and awareness campaign to build public trust in the vaccine.