01 Mar Vaccine Central Planning Fails Too
Three and a half months have passed since we first received news of a highly effective Covid-19 vaccination, yet in all but a few locales the rollout has proceeded at a snail’s pace. Part of the lag comes from an understandable push to prioritize the most vulnerable persons for a disease with a pronounced age gradient, yet simply being 65+ is still not sufficient to qualify for a vaccination in many states.
Instead, you’ll find that large swaths of the country remain mired in the early substages of “Phase 1-A” in a hyper-bureaucratized vaccine rollout plan. Depending on the state, this might entail some sensibly prioritized groups such as nursing home workers and patient-facing healthcare professionals, although it also displays a noticeable overlap with other “essential” jobs in government, law enforcement, and education.
To the majority of Americans though, vaccination sits out of reach. Instead, we face interminable delays from both the Food and Drug Administration (FDA) approval process and the state-managed multi-phase rollouts. To the average person in the general public, the effort to get vaccinated is currently akin to sitting at the back of a 9-month long DMV line. Welcome to your first experience in vaccine central planning.
The underlying problems of the central plan are easy to identify. The FDA’s bureaucracy has had the effect of artificially restricting the supply to the currently-approved Pfizer and Moderna vaccines despite the widespread availability of other known and safe options. A third vaccine from Johnson & Johnson only secured the FDA’s green light on February 27th after conducting its Phase 3 trials all the way back in September. A fourth vaccine by AstraZeneca is already in widespread use in other countries around the world, but has faced a string of setbacks that impeded it from conducting trials in the US and remains unapproved by the FDA.
These inexcusable delays arise not from science, but rather rigid adherence to bureaucratic procedure and the FDA’s inability to accommodate successful trials conducted abroad and outside of its own direct purview. Although propagated in the name of “safety,” these regulations have the practical effect of imposing multi-month delays on the existing rollout and artificially constricting the supply of available vaccines.
The resulting scarcity directly feeds the second dimension of vaccination central planning – the aforementioned state-level rollout. With a severely restricted supply of doses that falls far short of the general population’s desire to be vaccinated, states have resorted to the political system as its primary rationing mechanism. We now have many signs that government is simply not up to this task. Even if you are among the small minority of people who qualify for your state’s “Phase 1” rollout, expect to spend hours navigating a cumbersome online registration system that often differs from state to state or even county to county. These websites are not known for their senior citizen-friendly features, leading to the emergence of a small industry of young people volunteering their time to help the elderly fill out web forms and secure time slots through a user interface that makes the Obamacare website debacle of a few years ago look like ordering laundry detergent on Amazon by comparison.
In both the supply of vaccine doses and the ability to secure an appointment, the primary obstacle facing most Americans is not a lack of interest in vaccination or the fringe anti-vaxx groups that the media dwells upon. It’s the classic obstacles of central planning in allocating a scarce and widely desired good.
So how might we overcome these obstacles? Here are a few suggestions that could vastly improve U.S. vaccine distribution almost instantly.
- The FDA must approve the AstraZeneca vaccine and clear any remaining obstacles to the distribution of Johnson & Johnson’s vaccine. Both of these companies have produced safe and effective single-dose vaccines that are ready to ship and, in AstraZeneca’s case, have already seen widespread use in other countries. Opening up the United States to these options would alleviate the current rationing constraints on the Pfizer and Moderna options.
- Most states should scrap their current vaccine rollout plans in favor of a simple, streamlined alternative based on prioritizing high-risk age groups (I’d personally prefer going even further and opening up vaccination to a free marketplace, but simply de-bureaucratizing the current procedures is a more feasible goal for making important improvements along the margins). As additional vaccine options become available, even these restrictions must be removed. The end goal should be to make Covid-19 vaccination as widely available and simple to obtain as a seasonal flu shot with easy scheduling or even walk-in service. As more vaccine options become available, the existing bureaucratized rollout system will only serve as an impediment to effective distribution. Rescinding those impediments now will prevent clear and certain obstacles to making vaccination widely available to those who want it in the future.
- Public health officials need to drop their crusade to vaccinate people who have already recovered from Covid-19. Urging vaccinations of people who have already recovered from the coronavirus has become something of a monomaniacal obsession of CDC messaging and Anthony Fauci, often invoking the prospects of reinfection or strain mutation as a precautionary justification. The problem with this approach is that it creates additional strains on an already-scarce vaccine supply at a moment when time is of the essence. Our best scientific evidence so far indicates that Covid-19 produces long-lasting immunity, and that this immunity is comparable to vaccines. Reinfections are exceedingly rare, and sparsely documented. In the speculative chance that natural immunity dissipates over time, that is an issue to address in the future when vaccines are more abundant and easily accessible. As it stands though, the tens of millions of Americans who have recovered from a previous Covid infection possess natural immunities that protect them from the disease. Urging these people to get vaccinated right now at a time when tens of millions of other Americans have no such protection only creates an unnecessary strain on scarce vaccine doses.
- Eliminate conflicting messaging from public health officials on vaccination, which only undermines long term public confidence in scientific advice. As with the central planning of lockdowns over the last year, Anthony Fauci has become a primary culprit here by offering self-contradictory and even incoherent recommendations about vaccinations. In mid-February, Fauci offered a bizarre warning that urged vaccinated persons to avoid restaurants and other public places. Elsewhere he’s moved the goalposts backwards on the lifting of restrictions even with mass vaccination, most recently arguing that lockdowns, business closures, travel restrictions, masking, and similar measures must remain in place until at least December 2021. Fauci’s statements are not only scientifically unsound, they’re brazenly irresponsible as they remove one of the strongest incentives possible for the public to get vaccinated: a return to normal.
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