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Mass vaccination campaigns are extraordinary efforts that require extensive planning and execution. Here is a brief thread on how we plan malaria interventions like indoor residual spraying, with applications for vaccine distribution in the USA. 1/
Planning typically starts six months in advance. We use the term "micro planning" to ensure detailed operations to reach everyone that needs the intervention. Micro planning are simply the "who", "where", "how", "when" questions. 2/
Starting with the "who". Prioritized populations in NY are healthcare workers and longterm care residents. The "who" of the micro planning is a listing of all these organizations fitting this definition with estimates of how many vaccines are needed. 3/
Each "who" organization needs a "how" plan. The "how" is where the vaccine will be distributed (centralized location or mobile teams) and who the needle jabbers will be (organization supplies their own or relies on centralized team). 4/
Those two pieces of planning then provide a calculator for the "when". How many vaccines can be allocated per day with centralized resources, or by sending to organizations that supply their own. 5/
Qualified personnel (vaccine jabbers here) are typically the limiting factor in a vaccination campaign. So we end up with more doses of the vaccine than can be distributed through this prioritized population channel. What do do with the extra? 6/
Because supply is increasing, we want to move these vaccines as quickly into the public as possible. We plan for prioritized populations but there is no reason to sit on excess vaccines if the distribution system cannot handle the supply. 7/
Here's where multiple distribution channels comes into play. At the same time we're setting up the prioritized populations systems, we set up a general population distribution mechanism that can handle "excess" vaccines. 8/
The generalized population channel can be easily and effectively done at schools, churches, etc. Here we start at the "where", identifying locations that will be accessible and operational for mass vaccine clinics. 9/
Once geographic locations are determined as public clinics, then we figure out the "who" - again who can be the jabbers. Casting a wide net for people licensed to give vaccines and we bootstrap it with retired nurses, people on their day off, and health system donating staff. 10/
Mass vaccine distribution doesn't have to be this hard. The only reason we have an excess of vaccines sitting on the shelf is that we have failed to plan. The failure to plan is local, but certainly we have missed out on national guidance. 11/
What we have instead is Field of Dreams public health - "If you build it they will come" without any thought to how we get the interventions out. We're living the Fyre Festival of pandemic response. /fin. https://www.vulture.com/2017/05/fyre-festival-fiasco-the-complete-timeline.html
