As Governors Lead on Vaccine Distribution, White Paper Identifies Key Challenges and Promising Practices

As Governors prepare to embark on the largest vaccination campaign in history to ensure that a safe and effective COVID-19 vaccine is available for hundreds of millions of Americans, the National Governors Association released a report with input from two other organizations that analyzes state and territorial vaccination plans to support ongoing planning efforts.

Governors of states and territories, working in close collaboration with local partners, will have responsibility for the “last mile” of COVID-19 vaccine distribution, which will include receiving vaccine allocations from the federal government, managing the systems for ordering, distributing and monitoring, and supporting the administration of vaccines in a wide variety of health care and community settings. To meet this challenge head on, states will need timely coordination with federal and local partners on evolving issues, as well as sufficient federal funding to carry out the work. 

The National Governors Association, with input from the Duke-Margolis Center for Health Policy and the COVID Collaborative, analyzed all publicly available state and territorial COVID-19 vaccination plans. Citing specific examples of gubernatorial leadership from across the country, the report spotlights common themes, strategies and critical issues across state and territorial plans, such as equity, data infrastructure, effective public communication strategies, and determinations for allocation to critical populations and phasing of vaccine delivery across population groups.

“In a rapidly changing information environment, with many remaining unknowns regarding vaccine availability, efficacy across populations, handling requirements, and potential demand for the vaccine, states will need to be flexible and adaptive in adjusting their strategies and tactics in responding to challenges,” the report notes. “Ensuring strong mechanisms for input, partner coordination, and communication can help ensure that states can course correct to shift resources or efficiently target populations.”

The report notes that federal funding is needed to conduct key activities including building data systems, supporting mass vaccination clinics, meeting cold-chain requirements, procuring supplies, and hiring additional workforce, among other needs. To date, states have received $200 million from the federal government to assist with COVID-19 vaccination, with an additional $140 million forthcoming. In addition to funding, states are awaiting critical federal guidance and support for addressing challenges related to data reporting, provider enrollment and training, vaccine storage and management and communications.

To read the report, click here.