What Can COVID-19 Testing Teach Us About Vaccine Rollout?
by Kayla Hui, MPH
Article Originally Published in Verywell Health.
The largest vaccination campaign in history has begun, with more than 11.1 million COVID-19 vaccine doses administered in the United States.1 The initial goal, put forth by the Trump administration’s Operation Warp Speed, involved vaccinating 20 million people before the first of the year.2 But states have been unable to coordinate efforts to make that number a reality, and vaccine doses have even been discarded along the way.
Early in the pandemic, COVID-19 testing unfolded in a similar fashion. Testing’s rocky start meant limited quantities available, long lines, and unreliable turnaround times for results. But gradually, testing increased nationally, and wait times decreased.
Despite the current bumps in vaccine distribution, experts hope to streamline the process in the coming months. Verywell spoke to experts tasked with local COVID-19 efforts about the challenges they faced in rolling out COVID-19 testing, and how they’re carrying the lessons they learned into their vaccine distribution plans.
COVID-19 Testing Challenges
Tomás León, MBA, interim executive director of the Equality Health Foundation, leads the organization’s COVID-19 efforts in Arizona. By mobilizing volunteers and finding hosting sites, Equality Health Foundation was able to test over 1,600 people on Saturday, January 9.
But arriving at that number didn’t come without its challenges. As the pandemic unfolded, León tells Verywell they struggled with a lack of data. “Data was important so that we understood where there was a lack of testing,” León says. Real-time and accurate data is essential guidance for organizations working to control infectious diseases like COVID-19.
“We need data to point us in the right direction and reach the communities that needed us most,” he says. As data emerged, “counties were reporting the disproportionate impact on people of color, especially among the Hispanic community.”
Another hurdle involved finding host sites large enough to accommodate hundreds of people. “We had to find hosting sites: churches, schools, and businesses that had large parking lots,” León says.
The Equality Health Foundation community was not alone in this struggle. Community Health of South Florida, Inc. also faced similar obstacles. Community Health of South Florida, Inc. was the first to implement drive-through COVID-19 testing in Miami-Dade County.
“One of the major challenges was where would we set up testing,” Saint Anthony Amofah, MD, chief medical officer for the organization, tells Verywell. “We had to ensure that even if lines got long, we had the right spaces that could accommodate hundreds of vehicles.”
Staffing shortages also posed a problem. According to a national pulse survey conducted by the Department of Health and Human Services, hospitals reported inadequate staffing levels.4 There were shortages of infectious disease providers, respiratory therapists, and physicians and nurses who could provide critical care.4
To combat this issue, “we reached out to health care partners to help us with providing additional nursing staffing,” Amofah says. In addition, he built out a call center to handle the increase in call volume.
Rolling Out COVID-19 Vaccines
Amofah anticipates facing similar challenges during vaccine distribution. But unlike COVID-19 testing, vaccinations involves a wait time. “Folks can’t just drive away after receiving the vaccine,” Amofah says. “They have to wait.” That 15-minute grace period allows vaccine administrators time to ensure the vaccine does not impair driving or cause an allergic reaction.
León anticipates further logistical roadblocks. “We’re having to ramp up and build capacity to make sure there are enough testing sites and locations, and making sure we don’t overlook underserved communities,” he says.
When it comes to vaccination in communities of color, mistrust is also a barrier. “We know that there’s this historical legacy of the U.S. healthcare system treating marginalized patients poorly,” Michelle Ogunwole, MD, health disparities researcher and social epidemiologist based in Texas, tells Verywell. “And so, they’re rightfully distrustful of this system.”
Ogunwole says that vaccine transparency is key in building that trust. ”I’ve kept a video diary, keeping a log of symptoms,” she says. “[I’m] trying to help with the transparency and hoping that’ll improve uptake.”
Amofah is hopeful that the lessons learned from ramping up COVID-19 testing can be applied to vaccine distribution.
Amofah stresses the importance of strong partners. “We had partners who provided needed testing kits and nursing staff,” he says. “To pull this off on the scale we did took all of us working together, and we did.”
Amofah hopes that they can address the staffing and resource shortage with the help of the local government and partners. “Bringing all the right people to the table is critical when it comes to the vaccine rollout,” he says.
Another key lesson Amofah learned was the need to evaluate the organization’s workflow. “We had to constantly monitor that the plan on paper was a plan that was really effective on the ground, and make changes as needed,” he says.
Similarly, León believes that more coordination is needed. “We not only need partners, but to meet and organize, and be coordinated in our effort,” he says. He hopes that coordinated efforts will strengthen vaccine rollout. León and the foundation formed their own coalition called the rapid COVID-19 coalition. There, partners and community organizations meet on a regular basis to discuss public health challenges and ways to handle these issues together.
To make testing and vaccination more equitable, Ogunwole encourages communities to “center at the margins.”
“It’s important to center the priorities of the marginalized in the vaccine distribution, and make sure they’re getting vaccinated,” she says.