We know very little about America's vaccine debacle

Part of the problem seems to be a wildly ineffective vaccine management system. As the journal M.I.T. Technology Review has reported, the federal government gave the company Deloitte a $44 million no-bid contract to develop software that all states could use to manage their vaccine rollouts. The resulting product is so unreliable that many health departments have abandoned it. Other troubles abound. As noted by ProPublica, many states have not required health facilities to report vaccine waste, despite being asked to do so by the C.D.C.

If we don’t know where shots have gone, how can we possibly know what portion have been lost, tossed or even stolen? And if we don’t know where or how or why such waste is occurring, how can we possibly hope to minimize it?

The same goes for vaccination equity. We know that the 32 million or so shots that have been administered so far have gone disproportionately to wealthier, whiter Americans. But we don’t know exactly how bad those disparities are — only about half of all vaccinations logged so far include racial data — and we don’t know what’s behind that gap. Some people blame the inequity on vaccine hesitancy in marginalized communities; others point to online registration systems and clinic hours that make shots more difficult to access for low-income Americans. Each of those problems has different solutions.