The CDC and the Department of Health and Human Services (DHH) should seek input regarding how to speed up the rate of both the delivery and administration of COVID-19 vaccines. The following is a compendium of ideas for consideration in achieving that goal:
1. The country of Isreal has vaccinated approximately 9% of their population this month from December 20th-31st. Isreal is a relatively small, compact country which simplifies their efforts to achieve the 150,000 vaccinations per day that they currently state is their inoculation rate. However, they are utilizing a number of concepts that the United States should consider utilizing as well;
2. I first suggested that DHS/FEMA develop a real-time digitized phone app to report data on High Water Marks at flooding events that were determined to be federally-declared disasters under the Stafford Act, in a report I prepared at the Joint Field Office in North Carolina during Hurricane Matthew disaster response operations. The phone app I suggested would send data on a real-time basis to central collection points. Concerning the COVID-19 vaccination case, DHH, CDC, healthcare and other relevant organizations would be able to access the information coming into the collection points as live, real-time data that can be tied into the current virus distribution tracking system. Also, the use of this type of app can be made available to the U.S. public aged 16 and over to register for COVID-19 vaccine appointments, which would greatly enhance the speed of the appointment process. Residents could answer a series of screening questions to be assigned to a pre-defined vaccination group: 1a, 1b, 1c, etc. Then a date and location to be vaccinated would be assigned by a computer program, along with a registration number. Dividing the times for appointments into 1 hour blocks of time with a certain number of people assigned to each time block, would afford a smooth check-in and shot delivery process, reducing waiting line backups. The registration app should be developed to give out information on the process via text and phone messages, as well as allowing for those registered to cancel or change appointments;
3. Large refrigerated tractor trailer trucks should be used to store the Moderna vaccine and store the dry ice boxes the Pfizer-BioNTech vaccine is shipped in, at sites set up as drive-through vaccination clinics. The federal government should assist in this effort by utilizing the logistical expertise of the U.S. Corps of Engineers and similar DOD Logistical Units. These sites can use large parking lots in urban areas, and large fields in rural areas where large parking lots are not present. Medical personnel from the DOD and the National Guard can assist in delivering vaccine shots at these sites. In Isreal, the Pfizer vaccine comes in boxes with 195 bottles in each box. Therefore, approximately 250 shots a day must be delivered out of each such box. This fact is what necessitates the use of large, organized assembly line vaccination sites, best suited for drive-through clinics. Many separate drive-through lanes can be set up in large parking areas, such as the IX Center in Cuyahoga County, Ohio, where many hundreds of people a day could be vaccinated utilizing this process. Many States/Territories/Tribal Governments already have federally-declared disasters for COVID-19 response, meaning that federal funding they received for those declarations can be expanded to help setup and operate these sites. The use of FEMA funding through Disaster Declarations should be further explored;
4. States, Territories, Tribal and Local Governments need the assistance of federal funding through the Pandemic Relief Act, and the assistance of Joint Task Forces formed from personnel from DHH, DHS, and DOD/USACE to successfully setup a rapid, large-scale registration and assembly line distribution and vaccination system. And State governments additionally need to use the National Guard to assist in this effort. Large Community Centers, Exposition Centers, and similar large buildings can be added as necessary as indoor vaccination sites. GIS applications can map out the sites so they are evenly distributed around all geographic areas of each state/territory/tribal area. A Task force of GIS experts representing the U.S. federal, state, local, tribal, and territorial governments can work on forming one mobile app and centralized real-time data gathering and distribution system in order for the same software system to be utilized by everyone involved in the COVID-19 vaccination process.
B.A. Mills, FEMA