Baker built a reputation as a managerial expert. The sluggish vaccine rollout is testing it

“Look, I’m not happy with where we are,” said Governor Charlie Baker. “But one of the best things a good manager does is recognizes and understands that they have a problem and then busts their butt to figure out how to fix it.”Matt Stone/Pool

Governor Charlie Baker campaigned on his record of turning around Harvard Pilgrim Health Care more than a decade ago. He has touted retooling a porous state budget. He has kept a ball cap reading “JUST FIX IT” on a shelf in his office.

But that well-honed reputation for managerial prowess is now facing its biggest test: mounting criticism of Massachusetts’s rollout of life-saving coronavirus vaccines.

Despite its world-renowned cluster of teaching hospitals and biotech companies, the state has consistently ranked behind most others in inoculating residents. Both lawmakers and constituents have fumed about the nuts and bolts of the technocratic governor’s early approach: the initial sole reliance on a clunky website for helping make appointments or shifting plans for who gets vaccinated when.

“I’ve heard people who were supporters of Governor Baker talk about how, ‘We thought this guy was a manager,’” said Bill Walczak, a former health care executive and Boston mayoral candidate. “He clearly is a manager. He ran a gigantic organization. But he’s taken a hit, for sure.”

Baker is keenly aware of the criticisms that have roiled the vaccine rollout, using near-daily news conferences to preach patience and highlight progress as the number of vaccination sites statewide ramps up. The Republican governor also acknowledged missteps and vowed to correct them.

“Look, I’m not happy with where we are,” Baker said last week after touring a mass vaccination site at Fenway Park. “But one of the best things a good manager does is recognizes and understands that they have a problem and then busts their butt to figure out how to fix it.”

He’s also defended some choices that may have initially slowed early distribution of doses, such as prioritizing some marginalized and hard-to-reach groups for shots over others — a decision, he said, “I do not apologize for.”

The intense scrutiny of the rollout isn’t, of course, the first time Baker has faced criticism about breakdowns in state government during his six years in office.

After a 2019 crash that left seven motorcyclists dead, the Registry of Motor Vehicles acknowledged that it failed for years to suspend the licenses of hundreds of drivers who committed offenses in other states, a problem that began before Baker took office and continued under his administration.

Dozens of state troopers have been accused of fraudulently scooping up overtime pay. And the Massachusetts Bay Transportation Authority has been dogged by safety lapses and complaints of uneven service since Baker promised to turn around the long-struggling agency.

Few, if any of these problems, have dented the Republican’s popularity. His approval rating entering 2020 was consistently among the highest in the country, according to polling by Morning Consult, and Baker has received high marks for his handling of the pandemic. The MassINC Polling Group found Baker had a 73 percent approval rating in December.

Steve Koczela, president of the polling group, said Baker’s enduring popularity has been “remarkable,” if partly a mystery. Whether the problems distributing vaccines could dent it remains to be seen. (Koczela said he plans to poll Baker’s approval again in the coming weeks.)

“This is not like some past scandals, where it’s something peripheral to most people’s eyes,” said Koczela. “Everybody is focused on COVID.”

Doug Rubin, a political strategist who served as chief of staff to Governor Deval Patrick, said some crises are unavoidable, given the sprawling bureaucracy that makes up state government.

“It’s how you address them,” Rubin said. “The more transparent, the more open and inclusive you are, the better off you are.”

But when it comes to the vaccine rollout, some advocates and community organizers charge the Baker administration has taken an insular approach, shutting out voices that could help formulate the plans. Major decisions, including moving those 65-and-older up in line, for example, caught many by surprise, even as state officials said it came after a federal recommendation endorsed by the Biden administration.

“There’s no input process . . . and there’s no genuine opportunity to comment on these policies,” said Colin Killick, executive director of the Disability Policy Consortium. “Something just gets announced.”

Baker created a vaccine advisory group with health care professionals, lawmakers, and academic experts, which helped develop the criteria for the state’s phased vaccine plan. But several members told the Globe the group was not charged with offering recommendations on how to distribute the doses. That plan rested with Baker and the COVID-19 command center headed by Baker’s health secretary, Marylou Sudders.

“We did the easy stuff first,” said House Speaker Ronald Mariano, an advisory board member who said “communications and operational shortcomings” have hampered the rollout. “Now it gets more challenging as you try to deliver this throughout the state and to areas where it’s more remote.”

State officials have since announced a series of moves to address the early troubles. Baker said Friday the state was launching a 500-person call center to help set up appointments after complaints from seniors and others having trouble navigating the state’s website. He also announced plans to redistribute unused vaccines to hard-hit communities and designate specific days at a Roxbury site for local residents, especially people of color, to help address concerns about equitably distributing doses.

Dr. Paul Biddinger, who has served as a medical adviser to Baker during the pandemic and led the vaccine advisory board, said there are parts of Baker’s plan “to be proud of,” including giving priority for vaccinations to home health care workers and the homeless.

“I think what’s most important right now from a management perspective is to identify where there are problems and find solutions and fix them,” said Biddinger, director of Massachusetts General Hospital’s Center for Disaster Medicine. “There is an unbelievable amount of focus and effort and attention to do exactly that.”

To critics, Baker’s changes are welcome developments, if not a tacit admission that the rollout has been hampered not just by a short supply of vaccines, but also the administration’s missteps.

“Trust me, I wouldn’t want to be in his shoes. This is the biggest challenge of anyone’s political life,” said Dr. Regina LaRocque, an infectious disease specialist at Harvard Medical School who helped organize calls for Baker to reshape his vaccine plans.

“But it looks and feels like something that has been thrown together,” she said. “And that is the managerial failure.”