Despite its reputation as a health care mecca, Massachusetts’ performance in the seven weeks since the first shipments of the Pfizer vaccine started arriving has been abysmal and embarrassing.
Massachusetts ranks 36th in terms of distribution nationwide and last among the New England states, with 7.2 percent of the state’s population vaccinated and only 60 percent of received doses distributed.
Currently, it is estimated that 414,298 doses have not been used. If Governor Baker had relaxed his rigid vaccination plan and allowed people over the age of 75 outside of nursing homes to begin receiving these doses two weeks earlier (as 45 other states have done), we estimate that at least 3,500 infections and 150 deaths could have been avoided. This estimation is based on what we are seeing from Israel, where 50 percent of the population has been vaccinated and deaths among the elderly have dropped by 30 percent in the last three weeks.
On Thursday, Governor Baker finally admitted that the state’s vaccine distribution has been too slow and said he will back an accelerated rollout.
Here’s how Baker can get the unused vaccines out fast and achieve maximum impact.
First, he should simplify eligibility so that vaccines go to the elderly and hotspot communities. Proof of age and residency, and vaccinating by zip code, is much simpler than the current approach of vaccinating by occupation. Vaccinating these two groups will protect the most vulnerable while cutting transmission to fully reopen the economy faster, as we have argued previously.
Second, Baker should rapidly add mass vaccination sites across the state, and especially in or near the hotspots. The new centers at Gillette Stadium, Fenway Park and the Reggie Lewis Center at Roxbury Community College are a good first step. Another center is urgently needed on the north side of Boston to serve Chelsea, Revere, Everett, and other gateway cities that have been slammed by COVID-19. Hotspot communities need to be connected by van shuttles and other transport solutions so people can get from their homes to the mass immunization sites.
Third, the state needs to work with local leaders and health care networks like MGH Brigham, Beth Israel Lahey, and the Cambridge Health Alliance and smaller vaccination posts in pharmacies, schools, churches, and other locations close to where the most vulnerable live. Not everyone can be served at the mega vaccination sites.
Fourth, the state should quickly set up a central registration system so that eligibility can be confirmed and people can find an open vaccination slot. The current map of vaccination sites, which requires people to individually click on each of the 103 sites, is inefficient and disadvantages those without reliable Internet access and hours of free time to search. Other states, like New Mexico and Connecticut, have central reservation sites that avoid the wasted time and frustration we are currently suffering in Massachusetts.
Finally, as part of the state’s $2.5M vaccination campaign, special attention should be paid to reaching the vaccine-hesitant, particularly in communities of color. The falsehoods being perpetrated by anti-vaxxers must be swiftly addressed through traditional and social media and with messages from trusted individuals, just as was done to bring out the vote in November. Private sector communications expertise should reinforce public service announcements and messages from government and health care providers. Messages should be in Spanish, Portuguese, Haitian Creole, and other languages used in the hotspots, as well as in English.
Baker’s statement Thursday that Massachusetts is receiving too many vaccine doses to accommodate before their use-by expiration date is wrong and dangerous. We need to rapidly build the system to deliver the vaccines we have in the freezers and create the capacity to do more in the coming months. The virus, with all of its contagious variants, will not wait for us to act.
Shan Soe-Lin is managing director of Boston-based Pharos Global Health Advisors and a lecturer in global health at the Jackson Institute for Global Affairs at Yale University. Robert Hecht is the president of Pharos Global Health Advisors and a clinical professor of epidemiology at the Yale School of Public Health.