COVID Protection: We need a plan!

Ann Marie Kimball, MD, MPH

    In 1956 I rolled up my sleeve and received one of the earliest doses of Salk polio vaccine at Briarcliff elementary school in Magnolia. Seattle was one of the early sites to roll out the life saving vaccination, due in no small part to the courage of our local Health Department and strong cooperation between that Department, Public Schools and citizens.

   Today we are a pivotal moment in one of the most profound and deadly global pandemics in history. Coronavirus has not only killed 150,000 Americans in just 9 months, it has killed  more than 680,000 people worldwide. The race is on to find a vaccine to protect us, however that loud race is accompanied by an eery silence about exactly how any vaccine will get to us and our loved ones. Historically CDC has played a central role in vaccine roll outs in close cooperation with State and local health departments. Alarmingly that mandate has been given to the interagency “Operation Warp Speed”. More than $8 billion of our tax dollars have gone to companies with vaccine candidates in trials, or production capacity for vaccine related supplies (glass vials etc.). Nary a nickel has been announced to prepare State and local Health departments and their community partner organizations to plan and eventually execute successful vaccination campaigns. This is deeply troubling.

Vaccine introduction and successful “roll out” to the broad, diverse American population requires strong planning and extensive community consensus building. Unlike the days of polio in the 1950’s this rollout will be a huge challenge. Given recent history of the US Covid response, with its trail of shattered supply chains, garbled messaging, and mask chaos we have have no reason at all to be complacent.

We need a plan, or at least we need a conversation about a plan. The plan will change as we understand target age groups, dosage, frequency and other vaccine specifics—but the time for planning is now. While Operation Warp Speed may be a good vehicle to develop a vaccine, it has no performance history to suggest it can do a successful roll out. CDC and State and local health departments, currently standing behind the door in COVID relief talks, should be funded and empowered to get started.

State and local health authorities need all the coordination, federal cooperation, advocacy and dollars possible to be successful. This effort will be fraught with misinformation from the antivaxx advocates, foreign trolls on social media.

At global level access to vaccines has been an area of conflict between money and equity for poor countries. That struggle is well underway(seehttps://www.foreignaffairs.com/articles/united-states/2020-07-27/vaccine-nationalism-pandemic). While the global struggle is enormously consequential, Our American struggle, with poor population access to health services and beleaguered State and local health departments. threatens to be equally contentious

Americans cannot afford to be complacent about what happens here at home,.Even if this country as a nation has ample access to an effective COVID vaccine her people may not.