The lack of an efficient federal strategy set Michigan’s vaccination campaign back, but progress is already being made to right the ship, officials say. 

LAPEER, Mich.—When Gov. Gretchen Whitmer said those in vaccination Phase 1B, which includes Michiganders 75 years and older and frontline workers, qualified for the vaccine, the Lapeer County Health Department was flooded with calls. 

But they simply lacked the capacity to meet the demand. That prompted the department to issue a public statement Jan. 7.

“We appreciate your interest in the vaccine. We, too, are anxious to get people vaccinated as quickly as possible,” the statement reads. “At this time we do not have sufficient amounts of vaccine to move into Phase 1B. The earliest we will have additional vaccine is the last week in January.”

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That problem isn’t unique to Lapeer, either. Hospitals and health departments across the state have been struggling to keep pace with vaccination schedules, often frustrating older Michiganders for whom the vaccine is desperately needed and frontline workers like teachers who see it as the only way to resume in-person education.

As a result, Michigan ranks among the worst in the nation for vaccines per capita. While Michigan has administered just under 300,000 doses of the vaccine as of the state’s most recent reporting, that number is barely 2% of the estimated 14 million doses that will need to be administered to achieve herd immunity. Crain’s reports that at the current pace of vaccination, that goal is two years away. 

But things are already starting to improve. The question is, how quickly can Michigan turn the rough start around? 

How Did It Go This Wrong?

No state has met its goals with vaccine rollout. Across the nation, the process has been far slower than expected. In no small part, the reason for this has been coordination and logistical hurdles. In that sense, Michigan didn’t so much bungle the rollout as it was particularly hard-hit by those barriers. 

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“Initially, administering the vaccine at hospitals did move rather slowly as hospitals were battling staffing shortages, holiday schedules, and difficulties with how much information they were getting from the federal government about when their vaccines would arrive,” Michigan Health and Hospital Association Communications Director John Karasinski explained to The ‘Gander. “It is hard to plan an employee vaccine clinic when you don’t know the exact date the vaccine will arrive, which did result in some planned vaccine clinics being canceled because the vaccine shipment had not yet arrived.”

Karasinski explained that while things have improved in that regard, they still are far from ideal. At present, hospitals and clinics are given a several-day window in which their doses of vaccine will arrive, which makes scheduling vaccinations a challenge even still. 

“Not having an exact date is logistically challenging,” he said. “While shipments seem to arrive within that range, they are frequently arriving on the back end of that range.”

And that, to Kalamazoo-based public health expert Dr. Matt Longjohn, is the core of the problem. When Longjohn spoke to The ‘Gander in November, he said a coherent national strategy would be crucial to a successful deployment of the vaccine. Leaving it up to the states, he said, would result in 50 different approaches to vaccination when the margins for error are small.

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Now, Longjohn is looking at the reality wrought by his biggest vaccination rollout fear. 

According to Longjohn, decades of undervaluing public health infrastructure have created a situation where the system often cannot function optimally or equitably in the best of times. He cited as an example the response to the Flint water crisis, and said Michiganders should prepare for a long year. 

“Approximately 50,000 public health jobs have been cut over the past decade, and funding for state and local public health agencies has been regularly raided by Republicans and Democrats alike,” he said. “The folks that are left are doing the work of many, under a lot of pressure, with absolute dedication, but with limited resources and little to no coordination from an inept federal political leadership.” 

The result, Longjohn says, is “real-time planning and execution. Without sufficient coordination with federal agencies, everything inevitably gets bogged down when vaccine supply is short, or local public health agencies don’t know how much vaccine they’ll be getting until it shows up, or both.” 

To that point, the Michigan Department of Health and Human Services (MDHHS) put Michigan’s troubles in a larger picture: the largest vaccination campaign in history. 

“This is the most massive vaccination effort ever undertaken in the country, and every state is grappling with vaccine distribution going slower than needed to end this pandemic as quickly as possible,” said department Public Information Officer Lynn Sutfin. “Vaccine is being delivered daily to providers across the state, and MDHHS is working with these entities to support their operational plans and provide additional staffing support to increase the speed at which the vaccines are being administered.”

In fact, Longjohn doesn’t see Michigan’s deployment of the vaccine as especially error-prone. He explained that the difference between being in the top 10 or bottom 10 in January becomes “somewhat less relevant” when the entire nation has been moving 10 times slower than needed for the past year. He says that states with the best current vaccination results may not be able to keep up with the spread of new strains of the virus.

“[Congress] took billions out of the Public Health and Prevention Fund, never replaced it, and also has failed to provide funding to state or local public health agencies in the latest coronavirus relief bill,” he said.

But Longjohn, Sutfin, and Karasinski are optimistic that the situation in Michigan will improve. 

Resolving the Current Problem and Planning for the Next

Karasinski says everyone, from hospitals to the government, knows what needs to be done. The challenge is in doing it. 

“There is a desire by both our hospitals and the state to have a more consistent expectation of what Michigan will receive so we can do more aggressive planning and rollout,” he told The ‘Gander. “The uncertainty that exists about incoming vaccine allocations makes planning difficult.”

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MDHHS is eager to continue the work alongside the hospitals Karasinski represents. 

“MDHHS is committed to accelerating vaccine delivery as we work to reach our goal of vaccinating 70% of Michiganders over age 16 as quickly as possible with the safe and effective COVID-19 vaccine,” said Sutfin. “It’s why we are collaborating with the federal pharmacy program to accelerate delivery and working to address vaccine hesitancy in nursing homes, and it’s why we are accelerating distribution with the National Guard.”

Already there have been signs of improvement in terms of the troubled logistics of the rollout. The federal government released a few more doses of the vaccine to Michigan and Gov. Whitmer is working with other states to help secure more. On top of that, progress with accurate delivery of doses to hospitals has been made, and holiday staffing shortages aren’t as much of an issue.

“Now that the holidays are behind us, we’ve already seen a significant uptick in our vaccination rate that we expect to continue to climb,” said Karasinski. “Every vaccine that hospitals have on hand is tied to appointments they have been scheduled or are actively being scheduled, and they’re administering as many vaccines a day as they can manage with their staffing and resource capacity.”

Longjohn also sees hope in the upcoming changing of the guard in Washington. Unlike the outgoing administration, President-elect Joe Biden has been focused on developing a cohesive national strategy for states to follow. In fact, he has called developing a national strategy his top priority, and pledged to see 100 million doses administered nationwide in his first 100 days in office.

“My number one priority is getting the vaccine to people’s arms as we just did today as rapidly as we can, and we’re working on that program now,” Biden told reporters after getting his second dose of the vaccine Monday. “It’s going to be hard. It’s not going to be easy, but we can get it done.”

Longjohn sees promise in that strategy, but also advises patience and cautious optimism to Michiganders because of the next big challenge, once immediate logistical problems are addressed. Easing the logistical problems will allow for things like drive-thru inoculations and mass vaccination campaigns, but Longjohn sees those only getting America about halfway to immunization goals. 

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A large part of getting the remaining Michiganders inoculated will be addressing vaccine reluctance. Many people have legitimate concerns about vaccinations and will need reassurance. Longjohn cited specifically the unethical and abhorrent Tuskegee experiment on Black Americans and the distrust of public health measures that has been sown by the Trump administration among those in rural Republican communities.

“Ultimately, we are going to need to see 75% or more of our communities achieve immunity through vaccination or through surviving the illness, maybe multiple times. We have a long way to go,” Longjohn explained.

The major takeaway from all of this for Longjohn is that the vaccination process won’t be completed quickly. The adaptations Michiganders have made to the pandemic will continue to be important in the months to come. But the light at the other end—herd immunity—will come, he said.