Lessons learned: Why Michigan's approach lagged behind Minnesota's

Michigan bet big on mass vaccine events for COVID-19. It didn’t work out as hoped. Michigan focused COVID-19 vaccines on public health sites, not hospitals or doctors' offices. It lagged other states in vaccinating whites and Blacks. Aleszu Bajak

Michigan and Minnesota both had ample opportunities to push out vaccines through professional health care settings and into the arms of patients. They have essentially the same numbers of hospitals, rural clinics and doctors per capita.

But in the race to put shots in arms, Michigan lost. Its vaccination rate lagged Minnesota’s, exacerbating a late-pandemic spike in cases that killed 2,500 people. The vaccination gap between Minnesota and Michigan was particularly high for older people.

An analysis of data from both states – the only two to provide detailed and comparable vaccine records in response to records requests from USA TODAY – reveals key reasons Minnesota moved faster.

Minnesota supercharged its health care system, dispersing doses to a wide network of doctor's offices and hospitals across the state. Michigan, in an effort to equitably distribute vaccines to rich and poor alike, steered doses to public health departments that aimed to entice uninsured residents to mass vaccine events.

Not only did Michigan trail Minnesota’s overall vaccination rate through the end of March, it didn't do any better at vaccinating Black and Latino residents. 

Elizabeth Hertel, director of Michigan's Department of Health and Human Services, defended the state's approach when asked about its emphasis on local health departments over hospital systems and clinics.

The choice of who distributes the vaccine "was really a decision based on who is best equipped in certain regions to handle doing that," she said, adding that in some rural areas of the Michigan "there isn't a health system." ...

To be sure, Minnesota had some advantages unrelated to how it handled the vaccine supply. It historically has had a higher percentage of residents who receive flu vaccines, and the typical Minnesota household earns more than Michigan's. States pursued myriad vaccine strategies, and none got it perfect when it came to speedy or equitable distribution.

But decisions about where to channel vaccines in Michigan and Minnesota had important impacts, according to data and interviews with experts and health administrators. The states' divergent experiences in the crucial early months of vaccination offer lessons about what worked and what didn’t.  ...