We noticed recently that the states leading in vaccination rates tended to be Republican-led states, and more progressive-led states like California, New Jersey, and Pennsylvania appear to be farther behind.
We wanted to learn why. Overall, it looks like red states are more concerned with simply getting the vaccines out as quickly as possible through organized partnerships and priority groups, whereas blue states may be losing time through byzantine bureaucracies and punitive policies towards providers.
West Virginia and Oklahoma are two leading states. We spoke to health officials in each to get a better understanding of their vaccine distribution strategy and why it’s been successful.
For starters, the process is expectedly complex, and communication is key.
Dr. Clay Marsh, West Virginia’s coronavirus czar, and Colonel Lance Frye, M.D, Oklahoma’s Commissioner of Health, both told us the process started with setting clear priorities and facilitating an all hands on deck approach.
Taking a page out of Stanley McChrystal’s book, West Virginia created a “team of teams” using the National Guard’s leadership to create an inter-agency control room of sorts. It’s made up of representatives from about 15 sectors of the state, and each team develops the best strategy for their respective sectors.
For example, there are about 250 pharmacies in West Virginia, and around 50 percent of them are privately owned. The chain pharmacies don’t have the necessary rural footprint to reach all West Virginians, Dr. Marsh said. So after being presented this information, the team of teams decided not to activate the federal pharmacy program to begin with, and instead focused their partnership efforts on independent, private pharmacies. While they still work with the chains, this was a characteristic unique to this state, which shows why allowing states, and even down to more local municipalities, makes for more efficient distribution.
Oklahoma, similarly, has a “centralized planning system but a decentralized execution system,” Deputy Commissioner Keith Reed told us. “We tell our districts what we want to achieve, how quickly we want the vaccines to turn over each week, but we also tell them, now you tell us which of your partners have the ability to help you meet these expectations.”
We’ve all read how extra vaccine doses are going to waste in some states to prevent them from going to the “wrong” person. But not in Oklahoma or West Virginia. While priority groups are where the focus goes, both states emphasize getting ahead of the new vaccine allocations — it’s better if demand exceeds supply at the end of the week, rather than the other way around. West Virginia seeks to get every allocated dose out in 4 days, and Oklahoma in 7.
“We can’t be afraid to try new things. We need people’s creative abilities to shine through,” Dr. Marsh said.
“We have to be flexible — there can’t be one solution for everybody,” Mr. Reed echoed in another conversation. These themes of resilience, flexibility, and trust in leadership but also among citizens have a big presence in both strategies.
Another was communication. Both governors hold briefings, sometimes multiple times a week. Leadership is also strongly data-driven, which when used in public outreach helps impart confidence. As does getting community and faith leaders out in the public advocating for the vaccine or even publicly receiving it.
Something specific struck us in these conversations. For as technologically equipped as they are and with the organizational structures in place, there’s a key intangible factor to West Virginia’s success.
“If I was going to say what the single most important reason why we’ve been successful is — it is because of our culture,” Dr. Marsh said. “We have a state where people still understand community and care about each other. We’ve asked people to sacrifice waiting for a vaccine until we have our more vulnerable population immunized, and people understand that…I think it’s that kindness that we haven’t forgotten, and we’re not so far in the race of how to figure out who is more important than whoever else, and just knowing this is a time to pull together — that’s been the secret.”
While you may be thinking population is an obvious factor here, look at Rhode Island (ranked 39), or Idaho (47). Of course it’s a natural variable, but it’s about more than that. It’s about leadership, doing the research and getting the data, executing a plan but remaining flexible, and above all else, working together for the common cause.
There’s more to it than what’s written in this short note — and we encourage everyone, if you haven’t already, to do similar outreach and learn how we can best move out of the pandemic and forward as a country.