There's growing frustration over the distribution of the coronavirus vaccine in Massachusetts. One of the people calling for changes to how the state administers the vaccine is Bill Walczak, founder and former head of Dorchester's Codman Square Health Center. Walczak spoke with GBH All Things Considered host Arun Rath. This transcript has been edited for clarity.
Arun Rath: You recently published an op-ed in The Dorchester Reporter pointing out that if current trends were to hold, it would take two and a half more years to get just the first dose of the vaccine in the arm of every Massachusetts resident. The state has now expanded who's eligible to get the vaccine in the next phase of the rollout that starts next week. It's just an incremental change. Run through the issues right now as you see them.
Bill Walczak: The first thing you have to realize, the first thing I want to say, is that the governor and Secretary of Health and Human Services Marylou Sudders came to a realization that the initial process wasn't working. So they're trying to update and change the way in which distribution happens, and that's very, very good for the state. But the other thing we have to understand is that, first of all, this is a preventable illness. COVID-19 is a preventable illness, and it's preventable by vaccine. Hundreds of thousands of people are getting COVID-19, and thousands are dying. So the most important thing is to get it out as quickly as possible.
But that's an enormous undertaking, because if you just do basic math, what you find is if there's a chance of getting this thing out, the doses out by September, it's going to require over 400,000 doses in Massachusetts per week. Per week. That's an enormous undertaking, but it can be done. But what we need is the infrastructure in place. And, of course, we need the vaccine to come in. But it seems as though the federal government is going to start delivering on that. We have to be ready, and we have to make sure that we don't miss any opportunities to get that vaccine into the arms of people, so that we can cut this thing back and prevent thousands of people from getting it and thousands of people from dying. That's the basic issue. People have to understand the enormity of this, and 400,000 plus doses per week is a really big undertaking in the commonwealth of Massachusetts.
Rath: If we can get the additional doses from the federal government the way that we're hearing about, what are the infrastructure issues that we would need to take on? What are the solutions that would make sense there?
Walczak: What seems to work in other states is having large places to go, like what we have with Gillette and maybe with Fenway Park. But if you look at 400,000, it means that we need twelve such sites which could process 5,000 doses per day immediately, actually starting in February. That kind of infrastructure is necessary, and why it's necessary is because it's not a very efficient vaccine to put into arms, because there's a waiting process, there's timing, and then 15 minutes at the end of it. So you have to have a large area in which people can go, get in line, wait for 15 minutes afterwards, and then have a process for people that may have anaphylaxis or some other kind of problem from it, which is very rare.
It's a really important that we understand that a larger type of entity can be much more efficient about getting it into arms. Not that I'm opposed to having local primary care facilities, health centers and all that doing it. No, I think that's really, really important. But what I think the state needs to do is take a look at, if epidemiologists are saying we need 80% for herd immunity, that's 80% of 6.8 million. How many doses do we need to do per week? How many do we need to get in per week? What's the likelihood of us being able to accomplish this so the kids can go to school in September and we can have a reasonable summer? Right now, it seems as though we're trying out these different processes, and we need to understand the data. You value what you measure, and we ought to be measuring these things on a weekly basis, at least, and be able to make changes as necessary to make sure that those doses get into arms as quickly as possible.
Rath: Something that relates to both infrastructure and scheduling — people who are 75 and older are trying to use the state's online system to make an appointment for the vaccine and are just having a devil of a time doing it. They weren't able to get it to work. Do you have any ideas about how the sign-up process could could be streamlined?
Walczak: I know that other states have call-in opportunities for people. I can tell you that one of the most frustrating things for neighbors of mine and people that I know that are over 65 or 75 is that they all know people in other states who have already gotten their vaccine. It's already happened. So other states have obviously figured out something. Part of it is — you look at, for instance, West Virginia — they have a call-in system, people know when they can get their doses, and they've been doing a really good job. We're Massachusetts. We're a great state, and we have the capacity to be able to do this. What we need to do is figure out what's working and how to get it out there quickly.
We also need to understand that we need to be flexible about getting the doses out. We can't miss opportunities to get it into arms, because the more people that have it in their arms, the more likely we are to reduce dramatically the number of cases that we have and the number of deaths. Don't miss any opportunities here by being really rigid about who gets it first and who gets it second and who gets it third. Even though I agree that first responders, health care people, older people and people with morbidities should be getting it first, we can do all of that at the same time. Health centers have done that for years and years. We also understand that sometimes people don't keep their appointments, and therefore you overbook to make sure that you have enough people for your services, for your staff. Those type of things are important.
The other part about being a large system is that you need the staffing, and right now we don't have the staffing necessary. We need to be able to train people very, very quickly — for instance, medical assistants, who usually don't put needles into arms. We need to train them very quickly so that we have staffing sufficient to be able to get that done.
Rath: We've learned a lot, I think, in the last year about how much community health centers like Codman Square do by seeing them tested in a pandemic. Given all that community health centers are doing, can centers like Codman Square play a big part in terms of the vaccination push? How would you be able to do that?
Walczak: They're all part of the solution. Health centers are part of the solution, because they have direct access to low-income people, people that are immigrants that trust the care that they're getting in the health centers. So they need to be there, and they need to do it. But they also need to be able to provide basic services too. So getting the staffing necessary into those locations is important, and that needs some central location where people can be deployed to make sure that residents in these communities that usually have difficult access or don't have cars to get places can get the kind of services that they're used to getting. But for the broader population, we need to set up these large facilities that just get it done.
Rath: You mentioned the word "trust," and something that we've talked about in the last year is that in some of the communities that you serve, vaccine skepticism is is high. There is distrust of the government. How are you working to win people over and to strengthen that trust?
Walczak: Health centers are largely staffed by people of color and have leadership that is people of color. The person who is in charge of Codman Square Health Center, Sandra Cotterell, is an African-American who lives in Roxbury. When we have a good public relations campaign, and that's really, really important, that says, hey, look, we were part of making this thing happen. We were part of developing the vaccine. An African-American was partly responsible for having the vaccine now. We need to do a really good public relations campaign, because, yes, the African-American population in particular understands what has happened in the past to them by research that's been done, Tuskegee being the most famous. But nonetheless, we do have a significant number of people in our African-American, Latino and other communities that are part of the health care system that are getting these vaccines. People need to understand that no, this is not something being foisted on them. This is something that's really part of your community and part of making your community safer. I think people will listen to that, but we just need to do a much better job of our public relations and getting that information out there and letting people see that this is not something that's being foisted on them. It's something that's really part of protecting our communities and making them safe.
