Tuesday, January 5, 2021

Comptroller Stringer Proposes Recommendations to Expedite COVID-19 Vaccine Rollout across New York City and Utilize Every Available Dose

 

Calls on the City to move more quickly to vaccinate as many New Yorkers as possible and utilize every available dose – including creating “standby’’ lists of high-risk individuals, developing a central database of information, and doubling down on outreach to communities to disseminate crucial information on eligibility and vaccination sites

Comptroller Stringer: “It is our obligation to do everything in our capacity to ensure the City’s role in the vaccine distribution is unassailable.”

  New York City Comptroller Scott M. Stringer sent a letter to New York City Mayor Bill de Blasio calling on the City to streamline and expedite the vaccination of as many New Yorkers as possible and to utilize every available dose. The letter comes amid concerning data indicating only 25 percent of total vaccines allocated to the city have been administered citywide and only 31 percent of vaccines allocated to the city’s public hospital system have been administered, as compared to more than 90 percent administered by some private hospitals. Comptroller Stringer called on the City to act with urgency to vaccinate healthcare workers, nursing home residents, staff and residents of congregate care settings and other frontline New Yorkers; create a robust centralized database to track demand and usage; and increase outreach to disseminate crucial information on eligibility and vaccination sites.

Comptroller Stringer outlined recommendations for an expeditious and equitable vaccine rollout program:

  • In situations where bottlenecks or other delays develop in the distribution of shots, the City must be ready to administer shots to “standby” lists of high-risk individuals. While the City may not yet have State permission to vaccinate beyond the current phases, it must be gathering names of willing participants from subsequent phases to immediately vaccinate as soon as the City gains permission.
  • Develop a database that can be used to help the large and diverse networks of hospitals, community health centers, primary care physicians, pharmacists, and urgent care clinics report and track demand and usage. Given the real logistical challenges of deploying vaccines with stringent storage requirements and an uncertain supply chain, centralized reporting, procurement and stock management would help by allowing the city to forecast citywide needs more clearly, allocate and potentially redistribute vaccine doses where they will be needed, and provide targeted technical, administrative and financial assistance as needed, to ensure all providers can meet their vaccine demands quickly, efficiently, and effectively.
  • Double down on outreach to New Yorkers. Misinformation, mistrust, and vaccine hesitancy continue to plague rollout and uptake of the vaccine. The City must increase investment into public education and communication campaigns to increase uptake, especially by enlisting community leaders, trust agents, and other influencers to relay messaging about the safety and efficacy of the vaccine. Additionally, the City should immediately and widely publicize information on who is eligible, where to receive vaccinations, and how to advance register people.

The full text of the letter can be found below and here.

Re: COVID-19 Vaccine Rollout 

Dear Mayor de Blasio, 

After months of waiting, unprecedented social, emotional, and economic hardship, and thousands of deaths caused by COVID-19, the prospect of widely available vaccines has offered New Yorkers new hope for the end of the pandemic and the resumption of normal life. The moment demands a vaccine rollout that is transparent, expeditious and equitable, but I am concerned that early delays in utilizing our initial allotment of vaccines have left New Yorkers confused and concerned about our vaccination plan. Your goal of distributing one million doses by January and adding 250 vaccination sites is a good start to the rollout; however, New Yorkers deserve more information and better communication about the programs and policies that will enable the City to make that commitment achievable, and not just an aspiration. While the City’s plan must be guided by Federal and State directives about the triaging of the vaccine, our foremost priority must be getting as many shots in arms as possible, particularly before the arrival of the hyper-contagious COVID-19 variant now circulating in the United States. 

I am alarmed by data indicating that only 25% of the total vaccine allocation delivered to sites around the city have been administered to people. I am especially concerned that the foundation of our city’s healthcare system, NYC Health+Hospitals, has only administered 31% of its vaccine allocation, while several private hospital systems have administered upwards of 90%. Reports of vaccine doses languishing in freezers rather than being deployed to those that need them should be as unacceptable to you as they are to me and every New Yorker. We need to act with more urgency to get help to healthcare workers and vulnerable New Yorkers, such as nursing home residents, staff and residents of congregate care settings, and other frontline and at-risk individuals. I hope that the coming days will see the maximum number of possible doses administered. While I appreciate the need to supply second booster shots, we should not be reserving existing stock for this second round of vaccinations. Our private systems are not doing so and neither should our public ones, and arguments otherwise simply perpetuate structural inequity in our health systems and in our city. 

I would urge you to consider several suggestions for how to better logistically coordinate a vaccination plan that can move as quickly as possible to reach as many New Yorkers as possible: 

  • In situations where bottlenecks or other delays develop in the distribution of shots, the City must be ready to administer shots to a “standby” cohort of high risk individuals. While the City may not yet have State permission to vaccinate beyond the current phase, it should be gathering names of willing participants to immediately vaccinate upon permission. Many states are doing just this — vaccinating high-risk elderly patients and maintaining waiting lists and registries so that unused vaccine stock can be deployed rapidly. I believe DOHMH should be starting outreach now to eligible cohorts in each phase and urgently organizing community healthcare providers and social service CBOs to create standby registries. These organizations have worked tirelessly on the frontlines during this crisis, but they will need resources and guidance to develop uniform registries that can allow the vaccine to get quickly to their staffs and high-risk clients. 

  • The City should develop a database that can be used to help the large and diverse networks of hospitals, community health centers, primary care physicians, pharmacists, and urgent care clinics report and track demand and usage. As we’ve learned from our testing operations, real time data is crucial to ensuring an effective response to this virus. Given the real logistical challenges of deploying vaccines with stringent storage requirements and an uncertain supply chain, centralized reporting, procurement and stock management would help by allowing the city to forecast citywide needs more clearly, allocate and potentially redistribute vaccine doses where they will be needed, and provide targeted technical, administrative and financial assistance as needed, to ensure all providers can meet their vaccine demands quickly, efficiently, and effectively. To the maximum extent possible, providers should know with as much advance notice as possible the number of doses they can expect, on what schedule. 

  • We must double down on our outreach to New Yorkers. Misinformation, mistrust, and vaccine hesitancy continue to plague the rollout and uptake of the vaccine. The City must increase investment into public education and communication campaigns to increase uptake, especially by enlisting community leaders, trusted agents, and other influencers to relay messaging about the safety and efficacy of the vaccine. Additionally, the City should immediately and widely publicize information on who is eligible, where to receive vaccinations, and how to register people in advance (per the first recommendation above). With case and death tolls continuing to mount, our health systems becoming increasingly stretched thin, and a long winter ahead, the City must be in constant communication with residents about how the vaccines are being rolled out and when different categories of New Yorkers are eligible to register for waiting lists, walk-ins, or make appointments to get vaccinated. 

Of course, I recognize that the City’s response depends on a consistent supply of vaccine from the federal government, the ability to expand the reach of our rollout to new categories of New Yorkers, and the cooperation of private partners. As the epicenter of the crisis, New York deserves all the help it can get. However, it is our obligation to do everything in our capacity to ensure the City’s role in the vaccine distribution is swift, equitable and organized. I urge you to consider these suggestions and hope they will be incorporated into the City’s plan. 

Sincerely, 

Scott M. Stringer 

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