The COVID-19 Vaccination Story: Public Health Expertise Is as Vital as Private-Sector Ingenuity

The COVID-19 pandemic response enlisted the efforts and resources of a multitude of federal, state, and local agencies, as well as private-sector entities that developed and manufactured vaccines, therapies, masks, and ventilators. A successful response to COVID-19 would not have been possible without both a whole-of-government effort and private-sector ingenuity. While the response was not always smooth, the public and private sectors came together to deliver more than 200 million vaccines, sparing more than 2.2 million lives, averting more than 17 million hospitalizations, and saving almost $1 trillion health care dollars. Yet, recent research has shown that public trust in public health during the COVID-19 response was not especially high, suggesting, perhaps, that its efforts were not well understood.

Vaccinating America: The Inside Story Behind the Race to Save Lives and End a Pandemic by Michael Fraser, PhD, MS, and Brent Ewig, MHS, provides an unparalleled perspective of the greatest public health undertaking in perhaps a generation. It is at once objective and thorough in addressing all sides of the vaccination effort while also providing the reader with a unique public health vantage point.

Both Fraser and Ewig have extensive experience working with state and local public health agencies and have devoted their careers to advancing the nation’s public health. Their knowledge and perspective come through strongly throughout the book.

Fraser is the current CEO of the Association of State and Territorial Health Officials (ASTHO). His organization represents and supports state health officers (SHOs) and their staffs across the country. SHOs are at the helm of state health agencies, which work to protect, promote, and advance public health every day. These agencies run myriad public health programs with the support of a dedicated, often undercompensated workforce.

When a disease outbreak on any scale occurs in their jurisdiction, SHOs bear the responsibility of advising the governors who appointed them, evaluating the epidemiology to understand the scope of the threat, and instituting policies to protect the public from that threat. This is typically done in close collaboration across state, local, and federal governments under an emergency response posture to facilitate rapid decision-making and implementation. SHOs operate in a realm that demands political and public accountability as they strive to do what is best for their citizens. Thus, they often bear the brunt of public backlash over public health measures and have even been subjected to death threats.

Ewig is both a former ASTHO staffer and the chief policy and government relations officer at the Association of Immunization Managers (AIM). AIM represents the leaders within state health agencies responsible for immunization programs. Most support for these programs comes to states through the Centers for Disease Control and Prevention (CDC) in the form of the Vaccines for Children program and Section 317 grant funding to support infrastructure and limited additional vaccine purchase. By and large, states provide little in the way of additional financial support to these programs, but it is these programs that bore the responsibility of ensuring that once COVID-19 vaccines reached their states’ borders they made it the “last mile” and into arms.

It is from their deep experience working with these state officials, along with 20 in-depth supplemental interviews with revered vaccine and public health experts, that Fraser and Ewig were able to tell an insider’s COVID-19 vaccination story. It is a story that the public would not otherwise hear but sorely needs to.