Flu vaccine in 2009 offers lessons for COVID-19 vaccine distribution now: money and structure needed: WaPo

In 2009, an epidemic of H1N1 influenza was countered by a vaccination program that was plagued by delays. This program was described in a Washington Post article published November 17, 2020 (not paywalled.)

The first delay was due to inadequate supplies. Unexpected problems with production led to availability of less than a quarter of the vaccine that was expected. Vaccination clinics had to be cancelled. By the time enough vaccine was available, the epidemic had begun to subside and people lost interest in getting their shots.

The second problem was widespread concern about the safety of the vaccine. Even prior to the disinformation and misinformation campaigns of today, many people had doubts about the H1N1 vaccine. It was based on previous influenza vaccines with only minor changes, but there was still plenty of anxiety about its safety.

The third, and most important, problem was the lack of ongoing investment in public health infrastructure. This problem persists today, and is even worse than it was eleven years ago. Public health budgets have been cut even further since then, and state public health departments are overworked and underfunded even before the novel coronavirus’ onset.

From the article:

…the biggest stumbling block of 2009 still hasn’t been resolved: There is no broad adult immunization network engaged with federal and state immunization programs, meaning there is no database ready to recruit the thousands of clinicians who will be needed to administer coronavirus vaccines.

https://www.washingtonpost.com/health/covid-vaccine-lessons-h1n1-vaccine/2020/11/17/b5626596-1ac1-11eb-aeec-b93bcc29a01b_story.html

Massive investment will be needed to gear up for administration of vaccines in the next few months. There is a critical need for federal legislation to pay for this as well as all the other financial shortfalls that have come about as a result of the pandemic. Cooperation will be needed in Congress, and there is much uncertainty as to whether the Senate will be up to the task two months from now.