Commentary: Washington must quickly build confidence in vaccine supply chain

The jubilation Americans felt about the speed with which Pfizer and BioNTech, Moderna, AstraZeneca and Oxford University, and other groups developed their respective versions of a vaccine for COVID-19 has met the cold, hard reality of just how complex supply chains can be.

On one hand we read about how Israel has vaccinated 20% of its population within three weeks. On the other hand we are confronted with record deaths from COVID-19 in the United States in the midst of a very slow start to the distribution and administration of the first two COVID-19 vaccines that have been approved by the Food and Drug Administration.

As if that were not enough of an obstacle, IBM reported there is a global phishing campaign targeting the COVID-19 vaccine cold chain, and there were reports of a pharmacist who deliberately destroyed 500 doses of the vaccine.

This raises concerns among the general public that unknown parties can surreptitiously tamper with the vaccine cold chain, raising even more concerns about the safety of the vaccines that are already being administered to millions of Americans in clinics and doctors’ offices all over the country.

None of this helps to inspire confidence among members of the general public that the vaccine supply chain is entirely secure and tamper-proof; I have listened in on several debates taking place on the Clubhouse app, sometimes in rooms with hundreds of people, during which some speakers openly express their doubts about the safety of the vaccine and their unwillingness to get vaccinated, while simultaneously often touting conspiracy theories and hyping homegrown remedies.

Because the experience of every person who should eventually get a vaccine is part of the COVID-19 vaccine supply chain, here are three issues the federal government must address to inspire confidence among vaccine skeptics, to change minds, and to ensure that enough people voluntarily get the vaccine as soon as enough supplies are available, in order to bring the pandemic under control.

First, the public needs to be educated about how scientists were able to discover vaccine candidates so quickly, and how companies were able to modify or adapt their manufacturing processes in such a short time. According to a report published on Nov. 17 by the U.S. Government Accountability Office, traditionally this process takes about 10 years or more. For COVID-19, that has been shrunk to 10 months. Ordinary citizens are rightfully concerned that this means shortcuts were taken, and that safety and quality control were sacrificed on the altar of speed and efficiency.

The government needs to communicate often and repeatedly that this is not the case. As part of this effort, the public needs to be educated about the quality control processes in place for the manufacture of vaccines.

Second, the public needs to understand what steps the government and its private-sector partners are taking to protect and secure the COVID-19 vaccine cold chain.

Much as the Cybersecurity & Infrastructure Security Agency (CISA) was central to communications with the voting public about the security of America’s election infrastructure, so too must CISA be conspicuously out front communicating directly to the public, in simple terms, what steps it is taking to ensure that the COVID-19 vaccine cold chain is not compromised.

Third, the public needs to understand the rationale that has gone into decisions about how the vaccine will be allocated once it is available. The question of allocation in this context refers to decisions about who gets priority for receiving the vaccine in a scenario characterized by acutely insufficient quantities at the outset, coupled with a distrust of the health care system among some demographic groups, for example, in the context of high levels of economic displacement, social stress and the preceding questions I have already outlined.

The issues around allocation are neither easily solved nor devoid of the potential to inflame passions if perceptions about unfairness and a lack of transparency start to set in.

For example, should people in elder-care homes be given priority at the outset? Or should priority be given to front-line health care workers only? How about other essential workers? How about undocumented immigrant workers who populate the agriculture and food supply chain across the United States?

Black Americans have been hit harder than other people. Should they have priority at the outset? Given the history of the “Tuskegee Study of Untreated Syphilis in the Negro Male”, how can the federal government reassure Black Americans, who still harbor a higher distrust of the health care system than their white peers, that getting vaccinated as soon as vaccines start becoming available is a good idea?

A survey conducted in France found that 26% of people would not get a COVID-19 vaccine. In the U.S. only 49% of people would definitely get themselves vaccinated. That is far below the 70% or more at which experts suggested herd immunity would start to set in when they were discussing the topic in April. More recently, Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, suggested during a Dec. 16 interview on CNBC that this threshold may be as high as 85%.

As I have already pointed out, the high degree of vaccine skepticism is evident from the volume of conversation taking place on social media platforms in which attendees publicly discuss their hesitance to get the vaccine because of fears that too many corners have been cut and that the vaccine is inherently unsafe.

To be clear, there is also a desperate and ongoing need for supply chain planning, logistics and distribution expertise in the ranks of the people who have been responsible for the COVID-19 vaccine rollout so far.

With the new administration coming into office, it is time for the federal government to play a more central and robust role in coordinating and orchestrating all the supply chain processes and activities required to successfully administer the COVID-19 vaccine to as many people as is required to bring this pandemic under control.

But, given how badly the U.S. has been hit, government authorities must also launch an aggressive public relations and marketing campaign to counter attitudes and biases that will prevent people from getting vaccinated against the virus. Not to do so will only prolong the devastation and suffering that have already overstayed their welcome.

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