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The COVID-19 vaccine rollout has been a nightmare for many Americans as they struggle through multi-step registration and appointment systems. The federal government had envisioned states using one national vaccine scheduling system, and it offered a contractor US$44 million to develop it. But that system turned out to be so poorly designed that all but nine states opted out before even trying to adopt it, even though it was being offered by the government for free. The few states that do use the Vaccine Administration Management System, or VAMS, have reported random appointment cancellations and unreliable registrations. Some vaccinators have had to resort to creating records on paper because of system glitches, slowing down the pace of getting shots into people’s arms.

Regularly testing for Covid-19 in K-12 schools can help identify cases and provide an extra layer of protection for staff and families, according to two reports commissioned by the Rockefeller Foundation released on Thursday. Implementing testing, however, is an enormous, logistically complex undertaking, and most schools need significant resources to make it feasible, the reports also found. One of the reports, conducted by research firm Mathematica, assessed programs in six pilot locations that either already have started or are planning to implement rapid antigen testing with the support of the Rockefeller Foundation, a philanthropic foundation that has focused on Covid-19 testing for much of the pandemic. Tests were provided by the Department of Health and Human Services.

Operation Warp Speed invested billions of taxpayer dollars to develop safe and effective vaccines to protect people against the worst outcomes from COVID-19. Under the Emergency Use Authorization (EUA), the pharmaceutical industry has delivered — in record time — two vaccines with the Food and Drug Administration (FDA) approval. Johnson & Johnson and Novavax have released promising efficacy data from their phase three clinical trials. Immunizing health care workers and those living in long-term care facilities was slower than expected, largely due to the logistics of getting people vaccinated. The vaccine supply chain is now beginning to show some structure, with the expectation that there will be ample supply and capacity to immunize everyone who wants to be immunized by the summer.  

In January 2017, a lengthy proposal showed up at the offices of the Biomedical Advanced Research and Development Authority in Washington. Running 112 pages, the document described a strategy for stopping future pandemics. It outlined a number of vaccine technologies to pursue, including messenger RNA and adenovirus vectors, and recommended that a team of 180 scientists, doctors, and other experts be created to carry out the plan. There were intricate technical details, an org chart, and an estimated cost: $595 million over 10 years.

Public health experts say the United States is lagging behind other countries in its COVID-19 vaccination efforts. Tinglong Dai- an associate professor at the Carey Business School at Johns Hopkins University, and an expert in health care analytics- has closely followed the COVID-19 vaccine rollout in the United States. He says other countries are doing a better job of making the shots accessible to the public. “Americans are working too hard to get a vaccine,” Dai says. “Look at people in the UK and Israel...you basically don’t have to do anything to get a vaccine.” UK residents receive a letter telling them when they’re eligible for a vaccine and where to go to get it. Then, they simply book an appointment online.