Where US’s vaccine triumph fell short

It’s not surprising that pharmacies are turning out to be fantastic at distributing Covid-19 vaccines. As Alex Tabarrok and I pointed out in February, they are literally everywhere — 86% of the US population lives within 5 miles of one. And they have significant experience in large-scale vaccine delivery, giving out 40-50 million flu vaccines annually.
But the success of pharmacies raises an important question about another part of the effort: the federally-run mass vaccination sites. Managed by FEMA, staffed by the National Guard and flush with federal funds, they are underperforming the Biden administration’s expectations, according to Politico.
There’s a broader lesson here about how the government can combine its strengths with those of the private sector to deliver for its citizens during crises and beyond.
When it comes to committing enormous amounts of capital to provide public goods — like developing vaccines as quickly as possible — the US government is hard to match. That’s what it did with Operation Warp Speed, putting over $10 billion into vaccine development and production, and securing manufacturing and pricing commitments that ensured Americans would benefit from any of the vaccine bets that paid off.
The government can also use its authority to get firms working towards a shared goal. In the past few months, the Biden administration has helped coordinate supply chains for vaccines and the manufacturing of personal protective equipment. It also brokered a vaccine production collaboration between competing pharmaceutical manufacturers Merck & Co, Inc and Johnson & Johnson.
The federal government is also well-positioned to set standards for ensuring orderly, transparent and equitable access to public resources — such as figuring out how to stage the vaccine rollout across different groups. Unfortunately, however, the prior administration mostly left that task to states, leading to inconsistent — and sometimes heavily politicised — vaccine allocation processes. National-level guidance on priority groups, coupled with provider subsidies to ensure equitable access, should have been clear from the outset. America’s Covid-19 response has also suffered from a lack of centralised standards for the vaccination process itself. The government could have provided technology recommendations for appointment registration and eligibility verification, or developed a platform that distribution partners could plug into.

—Bloomberg

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