America's vaccine rollout is already a disaster

The U.S. is not Israel — it is a large country, much more rural, with a much more complicated (indeed, tattered) health-care system. There are probably some understandable, if maddening, reasons that we are not moving as swiftly as others to administer the vaccine. But it is an awful show of hot-potato responsibility that no entity or authority with the wherewithal to accelerate rollout is actually functioning properly. This is precisely as we were warned throughout the fall, as close observers noted that the federal government was dumping the responsibility onto states, most of which lacked the capacity to truly administer the rollout, and many of whom would push the job to local groups, hospitals, and even pharmacies. Keep in mind that, in 1947, New York City vaccinated 5 million people against smallpox in two weeks. Now just look at this chart from Bloomberg’s vaccine tracker:

As a whole, the country has administered barely 10 percent of even the first doses allotted — and 20 million (identical) doses are being reserved for a second shot. A group modeling the Canadian rollout suggested that rushing to get as many first doses as possible out, and waiting for new supply to deliver second doses, could avert as many as 34 to 42 percent of new infections, which is why Canada has now embraced that approach — as has the U.K. Here in the U.S., we are continuing to hold back half of the vaccine doses we have, and hardly any state in the country is significantly above 10 percent of that initial allotment — which is to say, 5 percent of available doses. Though refrigeration capacity varies from location to location, vaccines are only cleared for 30 days of storage in the most common units (including those in which they have been shipped). States have been rushing to build out their storage capacity, but have been warned of monthslong waits for ultracold freezers that could extend shelf life to about six months. That means that, in many places, this first batch of vaccine is set to expire in late January, around the time Joe Biden, who has been criticizing the rollout and promising to accelerate it, is set to take office. Presumably, the American pace will accelerate somewhat even before then. But on the current pace, by that point about 6 million Americans — perhaps 10 million — would have been vaccinated. And, depending on local bureaucracy and storage capacity, perhaps many million doses will be set to expire.