As if the COVID-19 pandemic has not caused us all enough stress, a new wave has hit the nation-the vaccination process. Getting in line to receive the vaccination is all but impossible for some people. Every state manages its process, none of which is proving to be the shining star for all others to emulate. Case managers find themselves in the middle of a messy situation trying to do the right thing for their clients by securing access to limited appointments and transportation for getting to and from these sites.
As has been reported, the vaccine supply chain is improving, but it is not nearly as robust as indicated in January. The federal government is working with manufacturers to expand production and grant emergency use authorization to new vaccines. With the entire world trying to get supply, there is only so much to go around. There are no quick fixes for this issue. In the interim, the supply and delivery chain needs to ramp up capacity. People have been trained to deliver vaccinations, but many of them need to be vaccinated themselves. As part of this essential chain, it stretches supply further. The health care delivery chain must remain healthy; one way is to ensure that is getting people working in this chain get vaccinated with priority.
The access issue remains a moving target. For example, Massachusetts decided to change course and centralize its administration process. This move effectively removed vaccines from health care providers and systems working to vaccinate their eligible patients. The increased volume further taxed the mass vaccination appointment website. Although the site functioned, there was minimal availability, and then eligibility criteria expanded, the traffic caused the site to crash within minutes. The following screen appeared to thousands of people trying to do the right thing and get vaccinated:
Appointment setting infrastructures must be able to handle the persistent volume. The frustration that results from scrambling to get signed up is a source of renewed anxiety for many, and it is an emotional tax that no one can afford to pay. These latest developments may push some people over the edge of caring because the system does not appear to care about the people it was created to serve. One 90-year-old woman who I work with gave up trying to get an appointment because none of the mass vaccination sites are within a reasonable distance from her home. She honestly believes that someone will come to her when it is her time to get a shot.
This situation raises another challenge-mass vaccination site locations and underserved populations. Many states are trying to get vaccines to disproportionately underserved populations. Community centers and other places (e.g., sports venues) have helped create vaccination sites. Still, these are not always conveniently located where people live, especially those without safe public transportation to get them where they need to go. There is no single best way to manage the vaccination process. Still, public officials need to do a better job anticipating the gaps and proactively find ways to remove or minimize the obstacles to getting vulnerable people vaccinated.
As case managers, we must continue to support our clients through these challenges and the anxiety produced each time there is an interruption in the supply chain. We must maintain awareness of the numerous factors influencing vaccine distribution and administration. We may not be able to cut through the red tape as we have done before, but we must again draw a deep breath, stare frustration in the face, and continue doing the next right thing.
Thank you to all case managers working through the pandemic with patience and grace. You are all rock stars!