By Chris O'Brien, Nini Donovan, Hillary Thompson, and Jordan Reisner, Guidehouse 

On November 16, the second vaccine candidate to demonstrate efficacy against COVID-19 was announced – yet another positive signal in the fight against the virus.

The question is: Are state and local governments prepared for effective vaccine deployment?

The answer to this question is urgently needed as the US continues to hit record coronavirus counts – around 150,000 new cases daily – and Americans increasingly experience pandemic fatigue and depression.

The good news is that the Centers for Disease Control and Prevention (CDC) has confirmed that four vaccines have begun large-scale (Phase 3) clinical trials in the US. With first doses expected before the end of 2020, devising a COVID-19 vaccination program is now more important than ever.

On October 29, the CDC released an interim playbook for jurisdiction operations that mandates a centralized system to order, distribute, and track COVID-19 vaccines. The federal government will act as the central distributor. Vaccine providers will place all orders through the CDC, and in coordination with the Department of Defense and manufacturers, the orders will be fulfilled.

However, besides being vested with the broad authority of distributing vaccines to end-user sites in an equitable manner, state and local governments have a far less clear role.

It’s not just a challenge of coordinating resources, but also managing people.

State and local governments need efforts in place to navigate program management, recovery planning and strategy, resilience assessment, and execution of recovery operations. Despite the ambiguity of the present circumstances, Guidehouse’s extensive expertise in this area informs five key considerations for state and local governments in rolling out the vaccine effectively.

1. Master the Coordination Challenge
   The federal government has now been mandated to work directly with vaccine manufacturers, and state and local administrators should align their previously formulated vaccination management plans with this directive.
   
   
2. Manage the Distribution Effort
   Effective program and project management, as well as governance amid uncertainty, require constant adaptation, including to frontier physical and digital infrastructure.
   
   
3. Instill Public Confidence
   Uptake of the vaccine is predicated on public confidence, which is currently low, but this could be corrected by investing in data transparency and public health communication.
   
   
4. Address Equity and Inclusion
   Removing or reducing structural barriers where possible will promote mass participation, as the virus and vaccine can exacerbate disparities between populations, with low-income communities and communities of color most at risk.
   
   
5. Brace for Financial Impact
   The rapid mobilization of resources will undoubtedly encumber state and local budgets. However, integrating federal funding standards during operations will accelerate recovery.

So, what’s next for state and local entities?

An event with this level of complexity and urgency requires innovative, collaborative, and rapid responses to plan, execute, evaluate, and adjust effectively.

• Plan: Understand the CDC’s vaccination program playbook, and how it interacts with your state’s previously formulated management plan. Fortify supplies of personal protective equipment (PPE) and other necessary supporting materials.
  
  
• Execute: Stand up an implementation team that owns your vaccine program, from data collection to public education and community engagement. Leverage frontier technology, including advanced and predictive data analytics, to supplement legacy Immunization Information Systems (IIS) and manage physical elements such as cold storage, dosage, and delivery requirements.
  
  
• Evaluate: Engage resources with expertise in FEMA, HHS, CDC, and other federal funding sources to consider federal funding requirements at all stages of the vaccination effort.
  
  
• Adjust: Evolve as more is known about vaccine supplies, supply chain requirements, and demand.

To learn more about the CDC COVID-19 Vaccination Program Interim Playbook and Guidehouse’s five considerations for state and local governments, download our Guide to COVID-19 Vaccination Deployment for State and Local Governments.