When asked recently the Governor of New Jersey fumbled his articulation of the State plan, if there is one, for distribution of immunizations. The CDC put out a plan but the plan has many gaps needing completion. For example:
1. Phasing: There is essentially three phases. Phase 1 is critical workers such as physicians, nurses, Fire and Police, LTC staff and residents. Phase 2 is possible at risk such as those over 65 but relatively healthy, teachers, and those required for general economic welfare. Phase 3 is everyone else.
2. Distribution: How does the vaccine get from the manufacturer to a point of delivery?
3. Points of Delivery: Where and how do we deliver the vaccine to people. If we had a good Public Health system we could have used that for all Phase 1. Phase 2 and 3 could access it as we do now with flu shots; local drug stores.
4. Scheduling: How do we schedule the people? Phase 1 seems simple if and only if we had Public Health folks. Phases 2 and 3 can be done by Internet scheduling as is done with flu shots. However one must beware of baseless assumptions like everyone having and understanding Internet access.
5. Tracking: Since the corona virus has limited immunity we must be certain we drive infections to zero meaning annual immunizations. It also means testing. Thus, despite the concerns, we should photo each patient and give them an identity card showing what and when they were vaccinated. I had mine from 1949! Still do. Then this can be used possibly for travel, domestic and international.
6. Testing: Testing must continue unabated. That means massive random tests and not the type today. Percent positives are totally meaningless unless we randomly test a very large sample.
Just some thoughts.
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