January 5, 2021

How to Run Mass Vaccinations

 I listened to an NPR report this morning about the difficulty of providing COVID-19 vaccines. Of course, different localities are encountering different problems. An underlying fact, however, is that vaccinating against the current pandemic is more complex than providing the annual flu vaccine. Because the vaccine(s) are scarce and valuable, it is important that mass vaccinations proceed as efficiently as possible.

The NPR story suggested that it may take half an hour to vaccinate a single patient. First, there are a number of intake questions to be answered, and the recipient may have additional personal questions. Although the actual injection is quick, the patient must be kept under observation for 15 minutes to assure that he or she has no immediate adverse reaction. Vaccine shortages aside, it is easy to see why the vaccination process often proceeds slowly.

Another problem, of course, is building the queue of patients awaiting treatment. Television news reports are showing hundreds of people standing in line outdoors or lined up in their cars, so this problem is being handled differently from place to place and is often not being handled well. There likely is not any universally ideal recruiting scheme, but, clearly, we need to collect vaccine recipients without creating an undue burden on them or, heaven forbid, exposing them to possible contagion by virtue of their proximity.

Recruiting is likely not much of a problem in nursing homes or hospitals. We need to think harder about how to recruit from the population at large. Having people call in for appointments is frustrating them with busy signals. There needs to be a better way. Probably, recruiting in urban areas will need to be handled differently from how it is in rural ones.

On the other hand, delivering the vaccine efficiently can be done expeditiously with a little planning. My model for this is the typical blood drive. Like the vaccination process, giving blood necessarily includes intake questions and a brief stay after donation to assure no ill effects on the donor. In this case, the main process takes a good deal of time. Therefore, there are multiple tables on which the actual blood draw takes place. Ideally, when someone has completed the intake form, a table will be available. Although the actual donation is time-consuming, the system is designed for acceptable throughput.

Applied to mass vaccinations, the procedure looks like this: Only one person need be performing the vaccinations, although the person will need to be relieved from time to time. Intake, on the other hand, is slow and needs to be performed by multiple questioners to assure that, as soon as one injection is given, another person is ready to the next one. One or more other workers can monitor the group of patients awaiting the all-clear after vaccination.

This system requires perhaps four or five workers not involved in an actual medical procedure. Crowd control might need other people. These people need not be medical personnel, although some training may be in order. I suggest that recruiting such people would not be difficult. Simply offer them their own vaccination in compensation. Perhaps they should be paid as well, but this may not be necessary.

The procedure outlined above is, I suggest, the “obvious” way of handling mass vaccinations. Why is it not being used?

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