By Matt Field, March 18, 2021
Health workers in Mecklenberg County, North Carolina, process a delivery of COVID-19 vaccines. Credit: Mecklenberg County. CC BY-NC 2.0
As an assistant secretary of defense during the Clinton administration, Graham Allison helped secure nuclear missiles from Ukraine after the fall of the Soviet Union. Later he wrote a book about whether the United States and China would fall into what he called the “Thucydides’s Trap” and end up fighting a war. He’s also written other books about decision-making during the Cuban missile crisis and nuclear terrorism. Now the long-time Harvard professor has a new project that is seemingly unrelated to the topics of weapons of mass destruction and international power dynamics: Getting US states to up their vaccination game.
After a rocky start, the COVID-19 vaccination campaign in the United States appears to be gaining steam. Daily vaccination numbers are steadily rising and President Joe Biden last week directed states to make all adults eligible for shots by May 1. But as with almost every public health intervention officials have tried during the pandemic, the vaccination campaign hasn’t always been going smoothly. “One day, I got up and was pissed about how stupid it was, how it made no sense,” Allison said. Appointment websites crashed, states complained about supplies, and the government lost track of vaccine doses. Allison wanted accountability.
He and a colleague Hugo Yen put together a method for copying data from the Centers for Disease Control and Prevention into an excel spreadsheet so that people could grade states on their vaccination performance. Their protocol allows anyone to rank the states by COVID-19 deaths per capita, vaccinations administered per capita, the percentage of vaccine supplies used, and the number of months left until eligible residents are vaccinated.
Allison and Yen first put together an analysis for Massachusetts, where Allison has been a professor at Harvard University for five decades and Yen is a research assistant. After the state scored three Fs and a D in a report the pair released on Feb. 9, the local headlines were not flattering. “Harvard Professor Gives Massachusetts an ‘F’ for its vaccine rollout,” read ABC’s. “Harvard analysis gives Massachusetts failing grades on report card for vaccine rollout,” Boston.com said “Obviously this excited the governor,” Allison said of the state’s early grades.
People from other states began calling Allison about creating their own report cards. “I’m not in the business of consulting about report cards for coronavirus. With my excellent assistant Hugo Yen, [we] created a citizen’s guide, saying this is not that hard for you, in your own state or your own news outlet, to do this.”
The report card doesn’t grade countries on their responses to the pandemic; the United States, with more than 29 million coronavirus infections and 537,000 deaths ranks first among the worst performers in combatting the virus. While the Trump administration spent much of the pandemic focused inward, taking steps to pull out of the World Health Organization, for example, and generally not staking out a leading international position on COVID-19, other countries like China, Russia, and Israel have seized on providing pandemic supplies and vaccines as a way to foster alliances. In the great power competition that Allison is so famous for analyzing, the United States seemed to be forfeiting the game.
That’s partly what inspired Allison to create the report card.
“I think the whole process of our country dealing with COVID, and the response has been a series of colossal failures. And I think that’s had a big impact on our consciousness, on our morale, and our standing in the world,” Allison said. “So this comes out of my traditional interests.”
The pandemic trends are finally looking better in the United States, and the once shaky vaccine rollout is gaining momentum. The Centers for Disease Control and Prevention says more than 15 percent of the population over 18 years old is fully vaccinated while nearly 30 percent has received at least one dose. According to Bloomberg’s vaccine tracker, on March 15, the average number of daily vaccinations was 2.4 million, compared to 1.6 million a month earlier.
Whether Allison and Yen’s assessment made a difference or not, Massachusetts, too, has jumped up in the rankings of state vaccination performance. The F student, Allison said, is now scoring a B.
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Yes, this is interesting and good information. I am especially curious about vaccine supplies for smaller, more rural populations in the US. My wife and I are 67 and 68, quick to register for vaccine in SW Montana, but had extended stay in Coastal Oregon in another rural, low population county. We could not get a higher priority before leaving Montana, so left late January for Oregon where we were called for shot in Montana when we were in Oregon. Registered in Oregon ASAP, and still no availability of vaccine for anyone under eighty yet. In Montana, twenty year olds are being vaccinated.