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Essay – Enlist U.S. Retailers for Vaccine Distribution

Covid-19 vaccine given at long-term care facility in Hartford, Conn., 18 Dec. 2020 by CVS Health, (Scott Eisen/CVS Health via AP Images)

31 Dec. 2020. The Trump administration’s promise of 20 million people vaccinated against Covid-19 by the end of December — today — is falling way short. Centers for Disease Control and Prevention says, as of yesterday, some 2.8 million people in the U.S. received a Covid-19 vaccine out of 12.4 million doses shipped from the developers. Trump himself, via Twitter, blamed state governments for the shortfall, telling them to “get moving.”

As a commentator on CNN said last night, “get moving” is not a plan. And there appears to be little planning for vaccine distribution, beyond current commitments to health care workers and long-term care facilities, two high-risk populations. But a promising solution is staring policy-makers in the face, on street corners and shopping centers across the U.S., retail chain stores.

Using retail stores for vaccine distribution makes sense. More retail stores and pharmacies are now adding walk-in clinics, taking on primary care functions. As reported in Science & Enterprise, these retail clinics are even providing specialized services, such as diagnostics for diabetic retinopathy and mental health screenings. Having clinicians on hand is also important for Covid-19 vaccines, since recipients need to be monitored for adverse effects for a short time. Plus, pharmacy chains CVS and Walgreens are already helping with early vaccinations at nursing homes.

19 store and pharmacy chains signed-up

To the Trump Administration’s credit, Department of Health and Human Services already recruited many national and regional store chains and pharmacies for vaccine distribution. In November, HHS says it received commitments from 19 pharmacy and other grocery and larger store networks with pharmacies, like Wal-Mart and Costco, for expanding access to Covid-19 vaccines. Those store chains, says HHS, represent 60 percent of all pharmacies in the 50 states, District of Columbia, Puerto Rico, and U.S. Virgin Islands.

From the announcement, however, the actual role for these stores appears undefined, other than providing physical store-fronts to give vaccinations. And judging by comments from Trump and others in the administration yesterday, they’re still putting the onus on state health departments to do the job, and running out the clock for the incoming Biden administration.

The retail chains’ brick-and-mortar stores are a good start for vaccine distribution, but they can offer a lot more. One of the excuses given yesterday by administration officials for the low number of vaccinations is delays in reporting from the sites giving the vaccines. In the modern world of retail, there’s no such thing as delays in reporting.

A big part of the store networks’ operations are their inventory systems, which use bar code scans to track the status of inventories throughout the supply chain. Wal-Mart, for example, can tell you how many cans of Progresso minestrone soup are on their store shelves in Laredo, Texas, as well as at warehouses and in transit at any time. And Wal-Mart shares that level of data with suppliers, so they can keep items in stock at stores, without paying to warehouse the items for long periods.

Keep vaccines off the black market

Tracking vaccine inventories this way and sharing those data can mean getting the right number of doses to the right locations at the right time. Tight inventory control could also be coordinated with vaccine manufacturing, to avoid supply gluts and having time-sensitive vaccine doses expire.

Tight inventory control can also help minimize theft, and keep these valuable items off the black market. News reports say a worker at a medical center near Milwaukee, Wisconsin is alleged to have removed 57 vials with more than 500 doses of the Moderna vaccine from refrigeration yesterday, leaving them out overnight, and forcing the hospital to dispose of the vials. The unauthorized removal of the vials led to the worker’s firing and a referral to “appropriate authorities for investigation.”

Even with full cooperation of retailers, there’s still plenty to do for state and local health departments. Health authorities can provide centralized registries for appointments to receive vaccines, and keep records of vaccinations. California maintains a statewide registry of immunizations, with Los Angeles County, currently a Covid-19 hotspot, sharing vaccine recipient data with digital health company Healthvana, for those data to appear in recipients’ iPhones. Plus, state and local health clinics can provide vaccinations in locations not served by retail stores in rural regions and tribal areas.

Getting the Covid-19 pandemic emergency under control in the U.S. will take all resources in our society, not just government agencies. And there’s no time to waste.

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