States push for more funds and guidance on vaccine distribution

  • New York state Gov. Andrew Cuomo speaks at a news conference on September 08, 2020 in New York City. (Spencer Platt/Getty Images/TNS) Spencer Platt

  • CDC Director, Dr. Robert Redfield, testifies during a US Senate Senate Health, Education, Labor, and Pensions Committee hearing to examine Covid-19, focusing on an update on the federal response in Washington, D.C, on Sept. 23, 2020. (Alex Edelman/Pool/AFP/Getty Images/TNS) ALEX EDELMAN/AFP

CQ-Roll Call
Published: 9/30/2020 5:26:11 PM

WASHINGTON — With just a month before a Nov. 1 Trump administration deadline for states to be ready to potentially distribute any upcoming COVID-19 vaccines, states are just starting to get their share of $200 million in preparation funds as Congress deliberates over whether to provide more.

Public health officials cite the relatively small amount of funding and tight time frame as examples of the many challenges they face in distributing any vaccines that potentially could change the course of COVID-19’s impact in the United States.

Local public health officials say they need billions more to stand up vaccination sites and improve software to track when individuals receive one vaccine dose or two and monitor side effects. They also want money to contract with health care providers to administer shots, buy medical deep freezers to store vaccines and encourage Americans to take vaccines amid unprecedented hesitancy.

“States are going to spend that money fast,” Marcus Plescia, chief medical officer at the group representing state public health officials, the Association of State and Territorial Health Officials, said in an interview.

The Centers for Disease Control and Prevention announced on Sept. 23 that it would send out the $200 million, which is divided among 64 states, territories and major cities, so that each will receive just a few million dollars or less as the nation faces a rise in cases and flu season begins. Together, the twin threats of COVID-19 and influenza are likely to cause a new wave of hospitalizations and deaths.

The money is needed right away, according to the group representing public health officials at the local level.

“It’s really hard to build out infrastructure, hire personnel, etc., to be ready to go and hit the ground running when a vaccine is available,” said Adriane Casalotti, an advocate with the National Association of County and City Health Officials. “Most local public health departments are tapped.”

The two groups say they want Congress to give states another $8.4 billion for distributing any eventual vaccines. Much of the distribution planning ultimately falls to states, with the CDC relying on jurisdictions to develop their own “microplans.”

CDC Director Robert Redfield told Congress earlier this month that $6 billion is needed, but negotiations on a new coronavirus relief bill have been facing difficulties on Capitol Hill. One sticking point has been allocating more money to states, which Speaker Nancy Pelosi sought but Senate Majority Leader Mitch McConnell balked at.

Some Republicans say they want to be cautious about offering more money, considering how much Congress has already provided for the COVID-19 pandemic response this year. For instance, a CDC official pointed to an agency spreadsheet showing that the agency has distributed $12 billion this year for coronavirus-related needs from two March laws.

Some of that funding is dedicated to increasing lab capacity or influenza, but other tranches could be leveraged for COVID-19 vaccination.

State and local government officials note that they face plummeting revenues this year amid the economic collapse. And advocates say public health funding was neglected for years before the pandemic.

“I’m not quite sure how Congress can assume that our states can run on a flat-line budget for a decade ... and deal with this crisis. A vaccine is due in a handful of months and we’re just getting some money now,” said Amy Pisani, director of Vaccinate Your Family, a vaccine awareness nonprofit.

Fourteen states, the District of Columbia and seven territories are receiving less than $1 million from the $200 million to prepare for distribution.

Public health departments began sounding the alarm this spring that the funding wouldn’t be enough.

“Back in May we were just trying to warn everybody: ‘We don’t want to build a plane while we’re flying it, so let’s get moving,’ ” said Casalotti. “Since then, there’s been no movement.”

The concerns are complicated further by mixed federal messages.

Sandra Ford, the health director in DeKalb County, Georgia, said she heard from state leaders that there would be 100 million vaccines by year’s end, in keeping with President Donald Trump’s statements, but a few days later learned from watching television that Redfield had testified to Congress that that was actually unlikely.

“It came from the state, maybe a week or two ago, that the goal was to have 100 million doses by the end of the year,” Ford said. “I was watching the news and Redfield said it would be a while. ... So we’re in sort of a holding pattern.”

Some experts worry that Trump’s promise of millions of vaccines this year has more to do with his reelection campaign than reality.

“In the heat of a presidential election, the people in the White House don’t care about the delivery of a vaccine; it just has to arrive at the front door. Once it’s at the front door, they can declare victory,” said Vanderbilt University professor William Schaffner, a nonvoting member of CDC’s vaccine advisory committee.

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