The role of hesitancy and infrastructure in the equity and efficiency of COVID-19 vaccine administration.

Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE

Original Publication: San Francisco, CA : Public Library of Science

COVID-19 Vaccines*/administration & dosage ; COVID-19 Vaccines*/supply & distribution ; COVID-19*/prevention & control ; COVID-19*/epidemiology ; Vaccination Hesitancy*/psychology ; Vaccination Hesitancy*/statistics & numerical data; Humans ; United States ; SARS-CoV-2 ; Vaccination ; Federal Government ; Health Equity

After the first COVID-19 vaccines received emergency use authorization from the U.S. FDA in December 2020, U.S. states employed vaccine eligibility and administration plans (VEAPs) that determined when subgroups of residents would become eligible to receive the vaccine while the vaccine supply was still limited. During the implementation of these plans, public concern grew over whether the VEAPs and vaccine allocations from the federal government were resulting in an equitable and efficient vaccine distribution. In this study, we collected data on five states' VEAPs, federal vaccine allocations, vaccine administration, and vaccine hesitancy to assess the equity of vaccine access and vaccine administration efficiency that manifested during the campaign. Our results suggest that residents in states which opened eligibility to the vaccine sooner had more competition among residents to receive the vaccine than occurred in other states. Regardless of states' VEAPs, there was a consistent inefficiency in vaccine administration among all five states that could be attributed to both state and federal infrastructure deficits. A closer examination revealed a misalignment between federal vaccine allocations and the total eligible population in the states throughout the campaign, even when accounting for hesitancy. We conclude that in order to maximize the efficiency of future mass-vaccination campaigns, the federal and state governments should design adaptable allocation policies and eligibility plans that better match the true, real-time supply and demand for vaccines by accounting for vaccine hesitancy and manufacturing capacity. Further, we discuss the challenges of implementing such strategies.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2024 Chicoine et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

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0 (COVID-19 Vaccines)

Date Created: 20240614 Date Completed: 20240614 Latest Revision: 20240618

20240618

PMC11178164

10.1371/journal.pone.0304416

38875217