Getting to Herd Immunity Is Going to Require More Innovative & Spontaneous Ways to Get Vaccinated

Each week the federal government updates their 3-week vaccine allocation forecast and informs state health departments how many doses of the various vaccines are available for the following week. State health departments then make decisions about how to allocate the vaccines among the county health departments, clinics, health centers, and in some states like ours, large university-run mass vaccination sites.

From the beginning, Director Christ has been reserving the lion’s share of the Pfizer vaccine for their showcase state-sponsored &  university run mega-sites like the former State Farm stadium site. Moderna has been largely going to county health departments for community-based vaccine efforts (see breakdown).

The large stadium type sites were efficient (at least for wealthier demographics) back when the demand for vaccine was huge and people were willing to tolerate the state’s computer site and fight their way to the large vaccination site which was likely far from their home. It worked, because people were willing to put the level of effort it took to get vaccinated at a mega-site.

Fortunately, county health departments have been wise enough to prioritize more community-based sites, mobile sites, special events and other locations that are much better at getting vaccine to more difficult to reach populations.

Meanwhile, the federal government has recognized that many state health departments (like ours) weren’t being very effective at vaccine into hard to reach communities, and they began to ship vaccine directly to pharmacies and community health centers, which helped a lot.

As supplies increased along with manufacturing capacity (and as the more motivated persons have become vaccinated) we now find ourselves in a different world.

The new name of the game for reaching folks that have yet to be vaccinated (younger persons and those left behind in lower income areas) is convenience. If we’re going to get closer to herd immunity we’re going to have to change how vaccine is prioritized by the ADHS and move allocations away from the inconvenient mega-sites that are far away from people’s homes toward local sites and places that don’t require an appointment.

Indeed, last week the 7 state-financed PODs only administered an average total of  14,900 vaccines per day (104,500 for the week). That’s an average of less than 2,000 shots per large site per day.

Arizona’s ranking in vaccines administered per capita now ranks in the bottom half of states (about 31st). As other states have transitioned to a much more community-based and no-appointment needed sites the ADHS has been doubling-down on the very large mega-sites with high overhead costs (including expensive rent) that have been attracting less and less interest.

This week, ADHS allocated 179,000 doses of Pfizer vaccine to their financed sites despite the fact that last week they only administered a total of 104,000. At that pace, state financed POD freezers will continue to fill up and vaccine will continue to go unused that could have otherwise been used at a county community-based site, in community health centers or in pharmacies.

Note: state financed PODs have only administered 86% of their allocated vaccine vs. counties which have administered 100%.

Let’s hope that the ADHS senior leadership recognizes that the mega-site business model is no longer efficient and that they need to increase allocations to counties, community health centers, pharmacies, clinics and doctors offices.

A shift in the state’s business model for getting vaccine out has been in order for some time now. If they’re going to keep the large state-financed and university-run sites then they need to make them no-appointment needed sites immediately.