Why West Virginia's Winning The Race To Get COVID-19 Vaccine Into Arms

West Virginia relied on strategic partnerships, collaboration, and efficient use of medicine to successfully outpace every other state in the U.S. in COVID-19 vaccine distribution. Rather than turning to nationally-run chain pharmacies to disseminate the vaccine, the state partnered with local pharmacies to better reach long-term care facilities and collaborated with the West Virginia National Guard to overcome logistical barriers.

A partnership between the White Earth Nation and Mahnomen County in Minnesota has been a key factor in the above-average vaccination rates in the county. Because the county is located within the borders of the White Earth Reservation, which is a sovereign nation, everyone living in the region – regardless of tribal affiliation – has been allowed to obtain the vaccine.

Rwanda, a country with the same population of Ohio, has emerged as an example of how to slow the spread of coronavirus, with only 1,500 cases reported so far. Besides initiating a lockdown, implementing free testing, and recruiting community health care workers, police, and college students to be contact tracers, officials also used "the same structure, same people, same infrastructure and laboratory diagnostics" that had been working to contain the spread of HIV.

Although Taiwan and Canada saw the beginning of coronavirus outbreaks within days of each other, Taiwan has been able to better contain the spread. Using tactics such as integrating "its health insurance database with its immigration database" and using the military to help produce protective masks for medical workers, the Taiwanese government's aggressive approach offers lessons in how to use big data and regulations to stem the spread of infectious diseases.

Political cooperation and an infrastructure of existing relationships and trust built by NGOs and community leaders during Hurricane Maria and a devastating 2019 earthquake allowed for a quick public health response to COVID-19 focused on prevention and vaccination. All trusted public figures, across political backgrounds, advocated wearing masks and getting vaccinated. As a result, Puerto Rico achieved the highest COVID-19 vaccination rate among all other U.S. state or territory. It also had among the lowest Covid-19 death rates since the start of the pandemic.

Spain achieved one of the highest vaccination rates among Western countries in part because of longstanding trust and confidence in the public health system and data-informed strategies. The public generally trusted the safety of the COVID-19 vaccine because of a history of cooperation and positive public health outcomes. The norm of inter-generational living also gave young people more incentive to get vaccinated to protect their elderly residents and officials used this as part of the public health messaging. Officials also personally called and set up vaccine appointments for everyone they could reach.

Wayanad is the first district in Kerala to have vaccinated the entire adult population with at least one COVID-19 vaccine. Rather than waiting for people to make appointments, officials went door-to-door providing all adults with appointment times. The district’s efforts started early, setting up vaccine infrastructure and assigning people appointment dates by where they live. Rapid Response Teams conducted outreach and education efforts, particularly among tribal populations, and made sure people showed up at their appointment. Getting vaccinated with their neighbors also decreased vaccine hesitancy.

Only a few states in the U.S. have had a successful COVID-19 vaccine rollout, but the ones that did relied on similar tactics: a centralized operation, local collaborations, and an early reliance on the National Guard to set up clinics. Although these strategies weren't without limitations, they have yielded better vaccination rates than those states that took other routes.

When nursing homes in North Carolina realized that the coronavirus pandemic had arrived within the state, facility managers and staff began enacting measures to prevent the spread of the virus amongst their residents. Adapting existing infection control and prevention plans, many were able to ensure a robust supply of PPE and reinforce their staffing numbers, which has paid off as most of the facilities have avoided outbreaks.

The state of Vermont has been able to keep COVID-19 cases to a minimal, at least in part by focusing on offering preventive protections for the most at-risk and vulnerable – such as the unhoused. The state's response has included "state-supported housing for the homeless, hazard pay, meal deliveries, and free, pop-up testing in at-risk communities," all of which prioritize high-risk populations rather than those who can easily self-isolate at home.