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Who will get the first COVID vaccines? States race to decide

By Noam N. Levey, Los Angeles Times on

Published in News & Features

"A lot of health departments have learned a lot of hard lessons over the years," said Dr. Cameron Kaiser, who directs public health in Riverside County, California, and serves on the board of the National Association of County and City Health Officials.

Nevertheless, the vaccination effort is being shadowed by the nation's struggles to stand up effective COVID-19 testing and the persistent inability of the federal government to get hospitals and other health care providers the protective equipment they need for their workers.

"I'm terrified that we're going to see a repeat of the disasters we saw with testing," said Trish Riley, head of the nonpartisan National Academy for State Health Policy, who has worked for decades with state health officials around the country.

Also missing, according to many state and local health officials, is money to fund a massive vaccination campaign.

To date, the federal government has provided only about $200 million to state and local agencies, far short of the $6 billion that the U.S. Centers for Disease Control and Prevention has acknowledged will be necessary for a robust vaccination campaign.

Dr. Helene Gayle, a former CDC official who now heads the nonprofit Chicago Community Trust, said avoiding a repeat of past mistakes will require much better federal leadership.


"For a long time, we've been lacking a strong national response to this pandemic," said Gayle, who co-chaired a committee of the National Academies of Sciences, Engineering and Medicine that published recommendations last month on how to equitably allocate COVID-19 vaccines.

Further complicating efforts has been the refusal of the Trump administration to work with President-elect Joe Biden's transition team on the coronavirus response.

Nevertheless, there are some signs the vaccine initiative is being better coordinated than the Trump administration's other pandemic efforts.

Health officials have indicated clearly that vaccines will be distributed to states based on a simple population formula.


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