Disclosing, Explaining, and Learning from a Bad Week

by Noam Bramson | Jan 10, 2021

This is a New Rochelle story, but it’s necessary to begin with some broader context.  Bear with me.

As America’s painful COVID experience nears its one-year anniversary, our thoughts and actions increasingly focus on the vaccine.  How quickly can it be manufactured?  How will it be distributed?  How can we address and overcome doubts about its safety and efficacy?  When will this nightmare finally be over?

The issue of sequencing — who gets the vaccine first, second, third, and fourth — is especially complicated, logistically and morally, given the present mismatch between demand and supply.  So it’s no wonder that vaccine distribution protocols, which fall under state jurisdiction, have been intensely debated.  It’s also no wonder that vaccination rates among different hospitals have been carefully scrutinized, with urgency to get the vaccine into people’s arms as quickly as possible.

Up to now, New York has limited vaccine distribution mainly to health care workers in what the State calls Phase 1a.  This week, New York will expand to Phase 1b, including teachers, first responders, and people over 75 years of age.  There’s more here.

I don’t feel qualified to have a personal opinion about the right vaccination policy, but I do believe that uniformity and consistency are vital to avoid a free-for-fall.  Therefore, I see it as my responsibility to explain, uphold, and implement State directives, in partnership with local and regional health providers.

That’s the backdrop for this past week’s events in New Rochelle.

On Wednesday around midday, I received a call from Montefiore New Rochelle hospital with important news: the hospital had just been directed by State health authorities to expand vaccine distribution to the entire municipal and school district workforce.  Knowing that Montefiore’s prior vaccine delivery numbers had been low, and that the State was eager to get the vaccine out the door, the hospital’s invitation seemed entirely plausible, and I did not think to confirm it with State colleagues.  In retrospect, that was a mistake.

I immediately informed the City Manager, so that our employees across all departments could be mobilized in an orderly fashion, and I contacted the School District leadership, so that they could coordinate with the hospital on a parallel track.

The City administration established a vaccination schedule, and municipal employees began lining up for their vaccines by Wednesday late afternoon, with the goal of completing the City workforce over the next 48 hours or so.  The School District established its own schedule.

Next day, the wheels came off.

On Thursday evening, I received upsetting word from both hospital and State officials.  Montefiore’s invitation had been an error; the hospital had misinterpreted the State’s guidance and was not yet authorized to issue phase 1b vaccines, let alone to vaccinate the whole municipal workforce, which includes categories of employees outside 1b.  The vaccination process needed to be halted right away.  This was especially traumatic for the School District, which has a larger workforce than the City, including hundreds of teachers who would now be disappointed.  A mess.

For me, this difficult week also has a dimension of personal regret involving my own vaccine.  Although Montefiore’s invitation encompassed elected officials, I had originally intended to decline my own vaccination and wait for a future phase.  Around midday Thursday, however, the City Manager informed me, with surprise and distress, that many municipal employees were refusing to take the vaccine.  Here in our own City family was the vaccine hesitancy that experts fear could imperil efforts to achieve herd immunity.  A serious problem.

I was persuaded that receiving my own vaccine would demonstrate confidence in the vaccine’s safety and efficacy, and set a good example for colleagues.  So I agreed to get my injection Thursday mid-afternoon, and then returned to City Hall, where the City Manager and I sent an email to the entire workforce, affirming the vaccine’s importance and urging colleagues to do the right thing and follow our lead.  In the moment, I was trying to act responsibly, but now I certainly regret my participation and can’t shake a feeling of shame that I received a vaccination to which I was not properly entitled.

I am satisfied that everyone in this whole episode was operating in good faith and sincerely trying to do the right thing under great pressure.  But, as someone with a visceral aversion to “cutting the line” (in fact, while I was waiting for my vaccine at Montefiore, a friendly nurse literally invited me to cut the line, I declined), I find this chain of mistakes professionally frustrating and personally embarrassing.  And I suppose this blog post is my attempt to fully disclose what happened, learn from the experience, and move on.

Seeing the challenges firsthand will only reinforce my determination to ensure that our community is provided with information and access to the vaccine as quickly as supplies and State authorization permit, especially with imminent entry into phase 1b, which is really the beginning of mass vaccinations.  As we look ahead to recovery from this incredibly difficult year, there is no more important responsibility.  Onward.