Making sense of COVID-19 vaccine distribution
February 3, 2021 | Megan Carr
The effort to develop vaccines against COVID-19 has been extraordinary and the process to distribute the vaccines needs to be just as successful---not only for the country overall, but also for people worrying every day about how to get their parents vaccinated and safe.
The General Accounting Office (GAO) published COVID-19: Critical Vaccine Distribution, Supply Chain, Program Integrity, and other Challenges Require Focused Federal Attention on January 28, which provides 13 recommendations for federal agencies to improve ongoing response and recovery efforts.
Of note, one of the recommendations restates GAO’s September 2020 recommendation to create a national plan for distributing and administering COVID-19 vaccines. Health authorities across the country have been working hard, yet struggling to vaccinate health care providers and other top tier risk groups. The recent recommendations to expand priority access to everyone 65 and older and those 16 and older with one-high-risk medical condition will challenge even the best organized plans.
With 61 million Medicare beneficiaries, 75 million Medicaid enrollees and millions of people with one of the identified conditions, it will be several months before there are enough vaccines available to meet the demand. There may be gains in efficiency by opening up the process, but as Kristen Ehresmann from the MN Department of Health stated in a recent STAT news article, “There would be significant losses as it relates to equity, racial justice and the ability to prevent morbidity and mortality in high-risk groups.”
Dr. Sanjay Gupta recently told his CNN viewers how his parents waited in line for nine hours to get vaccinated---and they were among the last five to get the allocated amount for their county. I congratulate his parents for enduring the lines to get the coveted shots, but know that my parents, with their compromised health and advanced years, could not wait in such a line. They are not online, so my sister and I have been frantically searching websites and following links (like Dr. Arghavan Salles of Arizona) trying to sign them up.
What we don’t want to see right now is competition between patients, such as camping out overnight in line or battling for online appointment slots, that will disadvantage those that are probably at the highest risk, such as the elderly or those without internet access. What we do need is a way to prioritize high risk groups of patients based on their clinical burden of illness, whether it be for vaccination prioritization or follow up care as we manage and learn more about “long-haulers.”
3M has worked with health plans in the U.S. and foreign countries to undertake patient stratification efforts related to COVID-19, with the goal of identifying patients at highest risk for poor outcomes if they were to catch COVID-19 so they can be prioritized for outreach and vaccination scheduling.
Using sample Medicare data, 3M researchers identified the 16 percent of Medicare beneficiaries with the highest chronic illness burden that should be vaccinated first---and this can be expanded to additional tiers to aid rollout.
It is this kind of work that can be done for Medicare and/or Medicaid, and other patient populations to help ensure the highest risk patients are vaccinated and managed. 3M provides clinically based methodologies to address this problem and we stand ready to help and ensure that the distribution effort is successful and equitable for all Americans.
Megan Carr, head of the Regulatory and Government Affairs team at 3M Health Information Systems.
