The country needs a distribution strategy that our fragmented, multilayered health-care system can effectively implement. This will require more federal direction, a simpler priority structure and a different role for the states.
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Start with one easily understood criterion mandated by the federal government: age. The administration’s reported plan to replace the patchwork of state priorities is a step in the right direction. Begin with Americans 65 and older, then those 45 to 65 years old and so forth. Everyone will know when they qualify. They’ll also have ID to prove it. This system can’t be gamed.
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Next, national pharmacy chains would become the primary distributors. They already exist, and estimates suggest they can put as many as 100 million shots in arms a month. CVS alone has estimated that it could administer 20 million to 25 million vaccinations per month.
Switching gears won’t be easy. Complex plans that address public health priorities have made sense on paper. But consideration urgently needs to be given to the capacity of the country’s fragmented health-care system and the realities of implementation. Distribution should be redesigned to work in the health system we have.
