Hot COVID-19 Topics: Vaccine Rollouts, Variants

January 11, 2021
Saskia v. Popescu, PhD, MPH, MA, CIC
Saskia v. Popescu, PhD, MPH, MA, CIC

For vaccines: Delivery doesn’t mean distribution. For variants: Their appearance underscores the importance of infection prevention methods.

Vaccine Rollout Challenges

The United States continues to struggle with vaccine distribution for coronavirus disease 2019 (COVID-19). Despite a federal goal of 20 million first doses by the end of December 2020, roughly 6.7 million people have been vaccinated so far. In fact, only 151,000 have been fully vaccinated. Over 22 million doses have been delivered to states, but as we know, delivery does not translate to distribution. A population-scale vaccinate rollout is no easy feat and with each state doing things a little differently, it’s not surprising that things are slow. Moreover, as hospitals and public health departments are primarily responsible for coordinating and managing the actual rollout can we blame these already stressed systems for falling behind? The goal of vaccinating as many as possible in a quick fashion is hard though and despite some reports, the issue isn’t really about people jumping ahead in line, but rather a larger, institutional failure to adequately resource large-scale vaccine rollouts. Vaccines sitting in freezers do us no good, so as we struggle with healthcare worker vaccine hesitancy and work to combat the bottlenecking, it’s important to look at the larger roadblocks that set the stage for these issues. Considering that only 30% of the distributed doses have been given, there is a lot of work we need to do and that isn’t just education and combatting hesitancy, but also making the process more accessible and easier to understand. Transparency about the hurdles and challenges helps people understand that this isn’t reflective of the importance or efficacy of the vaccine, but that such efforts require a lot of logistics and resources.

Communicating SARS-CoV-2 Variants

The news of two new SARS-CoV-2 variants over the past few weeks wasn’t particularly surprising, but something that added more stress. The two variations—B.1.1.7 first identified in the United Kingdom and 501.V2 first identified in South Africa, raised the red flag for the continuing challenge that is COVID-19. Perhaps the hardest piece to this is navigating what we know and what we don’t know, while there is continued and often sensational press coverage. This can make it hard to answer questions we’re getting in infection prevention—whether it be about the impact to testing or vaccination or even isolation precautions. The term “mutation” often triggers images of scary gain of function in the virus that concurs images of super strains. It’s important that we communicate to healthcare workers (and the public) that genomic changes in a virus are exceedingly normal. Moreover, we should be supporting more genomic surveillance to identify these more swiftly. What we do know is that the new strain B.1.1.7 is likely more transmissible, but does not appear to be causing more severe disease. The good news is that it does not impact vaccine efficacy either. As we learn more information about 501.V2, more information will be released, which is why communication to frontline staff is so important. This doesn’t change the routes of transmission, but with a new strain that is more adept at spreading between people, it’s critical we are vigilant in infection prevention measures in the healthcare setting, but also outside of it. If nothing else, these new variants should serve as reminders of just how important these infection prevention measures are and our need to truly follow them.