Second: Don’t vaccinate people who recovered from COVID-19. Current guidelines say vaccinate everyone, regardless of previous infection by SARS-CoV-2, the virus that causes COVID-19. But all the available data indicate people infected will develop a protective immune response that lasts for at least six months. And natural immunity from infection is generally superior to vaccine immunity. There are almost 25 million confirmed U.S. COVID-19 cases and potentially eight times as many actual infections as confirmed cases. Performing serologic tests for antibodies to confirm the immune status of people who had confirmed or suspected COVID-19 cases will forestall vaccinating people who are already immune and free up doses to vaccinate at least 25 million unprotected people.
Third: Use what you’ve got. President Biden has proposed mobilizing the Federal Emergency Management Agency (FEMA) and the National Guard to set up thousands of federally financed vaccination centers and mobile vaccination units and hiring 100,000 public health workers to encourage vaccination and testing in order to vaccinate 100 million people during his first 100 days in office. But it is unlikely large numbers of centers and mobile units can be set up in a short period of time. Moreover, the National Guard has no particular vaccination expertise that can be immediately mobilized. Finding, hiring and training 100,000 new health workers will take more than 100 days.
Rather than establishing new government programs, we should utilize the existing health system that every year vaccinates hundreds of millions against the flu at physicians’ offices and other health facilities, in local pharmacies, supermarkets, and groceries, and at workplaces. The National Association of Chain Drug Stores claims retail pharmacies could deliver 100 million COVID-19 doses in 30 days. Even if this is over-optimistic, other existing private entities could make up the balance. Governor Justice attributed West Virginia’s ability to administer over 70 percent of the vaccine they received to utilizing local pharmacies and health departments.
Fourth: Be flexible. Allowing providers to exercise judgment and deviate from the rules has allowed Israel to outpace the rest of the world in COVID-19 vaccinations. Israeli providers broke up the Pfizer 1,000 dose trays into smaller dose lots that can be more easily used by small providers and in more remote areas. Unlike American vaccinators who discarded excess vaccine after they had used the prescribed five doses per vial, Israelis used windfall sixth and seventh doses from overfilled vials. And Israelis vaccinated additional people out of prescribed order, rather than waste vaccine.
Finally, be prepared to mandate vaccines for workers who are in regular contact with vulnerable elderly and sick people. There are disturbing reports that some staff in medical and long-term care facilities are refusing vaccinations. Many hospitals and long-term care facilities require staff to be vaccinated against the flu. There are no statutory or constitutional barriers to employers requiring vaccination against communicable diseases as long as accommodations are made for people with medical contraindications or legitimate religious objections. If staff continue to refuse to protect the people in their care, these facilities should impose COVID-19 vaccination mandates.
President Biden’s goal of increasing vaccinations is laudable, but we need not spend a lot of money to accomplish it. Let’s try these five simple steps.
Joel M. Zinberg, M.D., is a senior fellow with the Competitive Enterprise Institute. He is also an associate clinical professor of surgery at the Mount Sinai Icahn School of Medicine and was senior economist and general counsel at the Council of Economic Advisers from 2017 to 2019. He wrote this for InsideSources.com.