In recent weeks two key House and Senate committees for health policy have hosted hearings addressing COVID-19 immunizations and the general local response to COVID-19. The U.S. House Ways and Means Subcommittee on Health held a hearing on February 26 titled “The Path Forward on COVID-19 Immunizations. Experienced experts, such as Dr. Clay Marsh, the West Virginia COVID-19 czar, and Dr. Ann Lewandowski, Executive Director of Wisconsin Immunization Neighborhood, testified at the hearing. The U.S. Senate Committee on Health, Education, Labor & Pensions (HELP) welcomed experience local leaders at its March 9 hearing titled “Examining Our COVID-19 Response: An Update from the Frontlines.” Umair A. Shah, the Secretary of Health for the State of Washington who previously served as Harris County Public Health Director, and Jerry Abraham, the director of Kedren Health Vaccines, a community health center in Los Angeles, testified at the Senate HELP hearing. Common themes addressed at the hearings included empowering local governments and organizations to use distribution strategies that fit the needs of their communities, improving equity in vaccine distribution, and building a stronger local health infrastructure.

Multiple representatives and witnesses described the disappointingly slow and inequitable roll out of vaccines, the ways distribution has improved in recent weeks, and the urgency to keep improving in the coming weeks. Marsh, who oversees West Virginia’s relatively successful vaccination administration, discussed the need to be diligent, structured, and consistent in organizing and delivering vaccines to localities while also encouraging local governments to be granted flexibility to administer vaccines in creative methods that fit the mold and makeup of their communities. Counties have already been employing many of these creative strategies to improve distribution, which include assisting federal agencies with the operation of mass vaccination sites and implementing vaccine management solutions that improve the administration process.

Improving equitable vaccine distribution was a central theme of the hearing. Multiple congressional representatives and witness illuminated how some vulnerable populations have died from COVID-19 at disproportionate rates yet have also received fewer vaccines at disproportionate rates. Lewandowski advocated for using mobile clinics to bring vaccines to targeted communities and increasing night and weekend appointments and clinics- a strategy many counties have implemented alongside more targeted methods, such as providing free transportation to vaccination sites. Abraham also described the success his community health center has had in reaching vulnerable populations, administering more than 50,000 vaccine doses as of the hearing. This success due in large part to the Federally Qualified Health Center program that begin last month, and was a win for counties who are instrumental in supporting more than 1,300 community health centers nationwide.

Additionally, rebuilding America’s overworked and exhausted public health infrastructure more broadly was a central topic. Shah described how the pandemic illustrated the shortcomings America’s public health infrastructure and emphasized the importance of funding public health and local health departments. HELP Chairwoman Patty Murray announced in her opening statement that she was reintroducing the Health Infrastructure Saves Lives Act that would allocate $4.5 billion to build and maintain the country’s public health infrastructure.

Counties operate and support core components of the local health care safety net, including over 1,900 local public health departments, nearly 1,000 public hospitals and critical access clinics, and more than 800 long-term care facilities and support legislation that provides necessary aid to for COVID-19 mitigation and vaccine distribution efforts at the local level. NACo also applauds the enactment of the American Rescue Plan, which provided billions in federal assistance for vaccine distribution, testing, and the public health workforce. The passage of this bill, and ongoing conversations by federal policymakers such as the ones had in these hearings are the necessary first steps to rebuilding the public health infrastructure and improving the local vaccine distribution capacity.

Additional Resources

• NACo’s COVID-19 Vaccine Distribution Toolkit
• Biden administration takes steps to improve equity in vaccine distribution & COVID response efforts
• NACo Brief: Vaccine Management Solutions