What Do We Need to Get COVID Vaccinations Back on Track? It Starts With Restoring Trust and Teamwork, At All Levels of Government
By Carlina Rivera
Even as COVID-19 continues to ravage our nation, and pandemic fatigue sets in, many Americans felt a glimmer of hope over the holidays that we were reaching a critical turning point in our fight against this disease with the approval and initial administration of the vaccine.
Nobody expected this campaign - the biggest logistical operation our nation has faced since World War II - to be easy. Many experts highlighted that the production of any vaccine always presents challenges.
But a month since vaccines were approved by the Federal Drug Administration, only about 2.5 percent of New Yorkers have been given their first dose of vaccine and only last week did the first New Yorker receive their second booster shot. The current daily rate of vaccinations, which is only now picking up after days earlier this month when as little as a few hundred vaccinations were administered, must still increase 3-fold if we are going to have a shot at achieving herd immunity in New York City by the middle of the year.
As thousands of Americans die every day from coronavirus, the lackluster start to the vaccination campaign is all the more tragic because we had ten months to prepare for a rapid rollout. But with new federal funds for vaccine distribution now available, it is not too late to prevent the loss of more of our neighbors. Our leaders must put aside personality and politics to address the clear gaps in vaccine administration immediately.
First, our distribution methods must be made more agile and able to flex with an unpredictable supply chain. I appreciate that our State Department of Health is finally striking the right balance after weeks of rigid structures that included limited eligibility, vaccine administrators facing six figure fines, medical license revocations, and criminal charges for potential violations. Now that teachers, public transit workers, police, firefighters, and people over 75 are eligible, vaccines will no longer be at the same risk of being disposed of because no patients are available to use them. While we must be cautious not to stray too far towards the open-season approach taken by states like Florida, where senior citizens have been forced into lines stretching for miles and camp overnight, it is critical that vaccine distribution locations are given latitude to administer any surplus vaccines to on-deck groups in order not to waste time or resources.
At the City level, there must be a clearly established local chain of command and leadership structure for vaccine distribution. The Mayor made an important decision this week to establish a Vaccine Command Center, led by Deputy Mayor Melanie Herzog and DOHMH Commissioner Dr. Dave Chokshi - although this should have been announced months ago. Ultimately though, the person leading this effort can not be an individual who has other serious responsibilities, such as a Deputy Mayor or the Health Commissioner. The Mayor must appoint a Vaccine Czar whose sole job is to lead an effective team of representatives from relevant agencies and departments and who will coordinate all efforts with state and federal agencies and private providers. We must learn from the shortcomings of the city’s COVID-19 response this spring when responsibility for COVID-19 planning and response was divided between the City’s Department of Health and NYC Health + Hospitals, the network of 11 public hospitals and clinics across the City.
The immediate priority of the Vaccine Command Center must be to open up more testing sites across the Five Boroughs in a variety of locations large and small, like community clinics, schools, fire stations, pharmacies, blood centers, homeless shelters, recreation and community centers and pop-up sites. In addition, at least one 24-hour site should be open in each Council district. We need to even bring the vaccine directly to people’s homes for those who may find it difficult to access the vaccine, as Rhode Island has already done in their public housing facilities. Additionally we must ensure individuals who have experience in vaccine administration, from the NYC Medical Reserve Corp, the Test & Trace Corp, Community Emergency Response Teams, the Help Now NYC and ServNY networks, FDNY EMTs, and Americorps Disaster Response Teams, are prepared to do so when the FDA hopefully gives municipalities the green light to pre-fill syringes.
Finally, effective public outreach and communication is critical. The City and State must work together on a coordinated digital and analog strategy to distribute uniform information in a clear and effective way. This includes maintaining a single website showing the eligibility groups, approximate calendar dates for when each group will be vaccinated and lists each vaccination site with links to any reservation and notification systems available. The separate efforts currently underway to do this can lead to confusion for everyday New Yorkers. Joint press conferences with City and State officials could similarly aid in dispelling misinformation.
And we know that many New Yorkers and Americans across the country will be hesitant to take this vaccine, even with countless scientific studies and data that supports its effectiveness and safety. To combat misinformation and mistrust, we must mobilize a community outreach effort in this City that matches the effort we made to get New Yorkers counted in the 2020 Census. We must in particular acknowledge in our outreach to communities of color the centuries of medical sterilization and experimentation practiced on minorities in this country and its territories, as well as the inequities and systemic racism in medical care that still exist today. From Borough Presidents, to Council Members, to Community Boards, Community Education Councils, faith-based institutions, and community groups, every single trusted voice in our neighborhoods must be working together, with adequate financial support, to broadcast a clear and effective message - that we all need to get vaccinated.
This coordinated, well executed effort would work wonders when paired with a new, responsible Biden administration that pursues the full use of the Defense Production Act, provides critical state and local funding for vaccine operations, empowers the FDA and CDC to make rules that speed up vaccinations, and explores pathways to temporarily amend intellectual property rules to allow for additional companies to produce vaccines.
I hope that our City and State leaders will be inspired by the goal that President-Elect Joe Biden has set for our nation to restore Americans’ faith in our government to address massive problems. If New York moves forward together with a plan such as this, I believe that we will be able to make that vision possible.
Carlina Rivera is a Member of the New York City Council, representing District 2 in Manhattan. She is the Chair of the Council's Committee on Hospitals.