时代周刊:疫苗接种问题重重(1)（在线收听）

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IS THE U.S. BLOWING ITS BEST CHANCE AT MASS VACCINATION BEFORE THE VIRUS ASSERTS ITS DOMINANCE?

在新冠夺主之前，美国是否已经失去了大规模接种疫苗的最佳机会？

TWENTY MILLION. That was The number of Americans who were supposed to be vaccinated against COVID-19 by now. Instead, just under 5 million people have received a shot, and 17 million doses have been shipped to the states and other jurisdictions that are distributing them to hospitals, doctors and pharmacies. "There is a complete lack of federal leadership, and it's just horrifying," says Dr. Tom Frieden, a former director of the CDC. "We heard, 'It's our job as Operation Warp Speed to deliver vaccines to states. Then it's their job from there.' But that's not how public health works in the U.S."

2000万。这是目前应该接种COVID-19疫苗的美国人的人数。相反，只有不到500万人接种了疫苗，1700万剂疫苗被运往各州和其他司法管辖区，并被分发给医院、医生和药店。“联邦政府完全没有领导能力，这太可怕了。”前疾控中心主任汤姆·弗里登博士说。“我们听说‘我们的工作是向各州运送疫苗，之后就是他们的工作了。’但这不是美国公共卫生的运作方式。”

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As it is, state and local health departments are struggling to implement an unprecedented massvaccination program while also managing a surge in new COVID-19 cases—some 200,000 daily for many days in December and January—and record-breaking numbers of hospitalizations. Shrinking budgets have left some states scrambling to find the staff and expertise needed to stand up a complex system of receiving, storing, distributing, tracking and administering vaccine doses, not to mention educating the public about the shots and monitoring for side effects. "Early on, there was talk at the federal level that states don't need money, they are like pass-throughs for this stuff; it's going to be the health care systems that are going to do the vaccinating," says Kris Ehresmann, director of infectious diseases at Minnesota's department of health. "States and localities have a really, really big lift."

目前，州和地方卫生部门正努力实施一项前所未有的大规模疫苗接种计划，同时也在应对新冠肺炎新增病例激增(去年12月和今年1月的许多天里每天增加约20万例)和创纪录的住院人数。预算缩减使得一些州忙于寻找所需的人员和专业知识，以建立一个接收、储存、分发、跟踪和注射疫苗的复杂系统，更不用说教育公众关于疫苗注射和监测副作用了。“一开始，联邦层面上有传言说各州不需要钱，他们只是为这些东西转手，疫苗接种将由卫生保健系统来完成。明尼苏达州卫生部门传染病部主任克里斯·埃勒斯曼说。“各州和地方都有非常非常大的提升。”

Some of the shortfall may be a reporting lag as states learn new tracking systems, but there clearly are real problems. In Texas, data-entry issues led officials to overestimate the number of available doses, leaving unvaccinated many health care workers in the first group of eligible people who wanted the shot. Health officials in Lee County, Florida, decided to do without an online appointment system and offer limited vaccines on a first-come, first-served basis, which prompted elderly people to wait overnight, some up to seven hours, to get their shots.

一些短缺可能是由于各州学习新的跟踪系统造成的报告滞后，但显然存在真正的问题。在德克萨斯州，由于数据输入问题，官员们高估了可用的疫苗剂量，导致许多没有接种疫苗的卫生保健工作者成为第一批有资格接种疫苗的人。佛罗里达州李县的卫生官员决定不使用网上预约系统，以先到先得的方式提供有限的疫苗，这导致老年人为了接种疫苗需要通宵等候，有些人要等上7个小时。