Lessons From the First Year of COVID-19 Vaccination, and What’s Next

December 14, 2021

Statement attributable to: Michael Fraser, Claire Hannan, and Brent Ewig

ARLINGTON, VA—Dec. 14 marks one year since the first COVID-19 vaccine was administered to an American outside of a clinical trial. Since then, the U.S. public health system and its partners have administered almost 500 million COVID shots. This is an historic achievement worthy of celebration.

We are grateful to the thousands of public health professionals, health care providers, pharmacy workers, and many others who have been working nonstop to deliver and administer vaccine to every corner of our nation. These public servants and private sector partners have truly been sprinting a marathon. We owe them a debt of gratitude.

Tragically, one year into our national vaccination campaign close to 200,000 Americans have died since these safe and effective vaccines became widely available. The last year has been difficult, and we have learned several lessons.

Convenience matters.

Public health agencies have enrolled tens of thousands of providers to make COVID vaccines accessible. This includes enrolling thousands of retail pharmacies that just a few years ago were not in the business of vaccine distribution. We have seen tremendous creativity in setting up mass vaccination, pop-up, mobile clinics, and incentives all with the goal of encouraging vaccination nationwide.

Our systems to track vaccine safety and vaccinated individuals has improved. States have updated how they manage inventory to avoid waste, prioritize vaccine to the most vulnerable, and provide real-time vaccine uptake information to the public. Early on in the vaccine campaign, states enrolled and educated providers in record time. And while cumbersome at the start in some areas, states and pharmacy partners now have well developed systems for scheduling of appointments and obtaining vaccine verification.

Making the vaccine completely free has reduced financial barriers. This convenience is imperative as we still need to reach tens of millions of unvaccinated Americans. The expanded capacity should be sustained and enhanced for both future pandemic preparedness and to facilitate higher levels of routine vaccination in the future.

Humility matters.

As great as our advances have been, there is still much we don’t know about this virus - even as scientists are working around the clock. We are seeing science evolve in real time. This means recommendations and guidelines will change based on new evidence. We recognize this can be frustrating to the public, and it’s on us as public health professionals to communicate as clearly as possible. Perhaps one of the biggest lessons is that the virus is the enemy – not each other. We must and will be united to defeat it.

Global action matters.

As we’ve seen with the emergence of variants, none of us is safe until all of us are safe. Inequity in global vaccine distribution is morally indefensible: we can take care of the needs of our nation and share vaccine with the world. We are proud that the U.S. has donated more vaccine than any other country, but there is so much more to do as global partners.

Trust matters.

Most people seek information on vaccines from people they trust, including their doctors and their peer groups. Because the science confirming the vaccine’s safety and effectiveness is so clear, this explains why the vast majority of Americans have chosen to be protected against severe illness and death caused by COVID. But we also know millions remain hesitant or outright opposed to vaccination. Misinformation and disinformation abounds, especially on social media. And we know trust in public health authorities and the media is frayed.

The fact is vaccination has been the norm in America for decades – indeed prior to COVID, most childhood vaccination rates were above 90%; almost all members of the military complied with the range of vaccine requirements; and most health care providers followed flu vaccine requirements because they know it keeps both them and their patients safe. If we can turn down the temperature on vaccine debates, return to these norms, and cut through the temptation to favor ideology over evidence, we can finish the job of vaccinating most Americans and get better control of this virus.

It has been a long twelve months for all of us, but we have made great strides. Let’s celebrate these wins with an eye toward getting the rest of the country, and the world, vaccinated as soon as possible.


Claire Hannan has served as the executive director of the Association of Immunization Managers (AIM) since 2004. She holds a master's degree in Public Health from the Johns Hopkins Bloomberg School of Public Health. Michael Fraser has served as the Association of State & Territorial Health Officials (ASHTO) chief executive officer since August 2016. He received his doctorate and master's degrees in sociology from the University of Massachusetts at Amherst and a Master's of Science in Management from the Eli Broad School of Management at Michigan State University. Brent Ewig is a public health consultant with over two decades of experience working for leading public health associations. He holds a Master of Health Sciences in Health Policy degree from the Johns Hopkins Bloomberg School of Public Health.

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