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Vaccines

COVID-19 Vaccine Distribution Infrastructure in the US

Strategic Insights

— 2 min read

Research by the University of Michigan has shed new light on the "last-mile logistics" of vaccine infrastructure in the US. By examining the early phases of COVID-19 vaccination distribution among older adults in Florida, the study reveals the complexities of distributing vaccines to their intended end-consumers. The research highlights the challenges faced by older adults in navigating distribution and how volunteers and older adults collectively performed "last-mile work" to resolve logistical and operational challenges.

Key Takeaways:

  • The COVID-19 vaccine infrastructure in the US was largely fragmented when it first emerged, with public and private institutions handling different aspects of distribution.
  • Older adults in Florida faced significant challenges in securing vaccination appointments, including navigating complex distribution systems and accessing reliable information.
  • Volunteers and older adults came together to collectively perform "last-mile work," a specific form of infrastructuring that involves resolving localized logistic or operational challenges within a larger infrastructural arrangement.
  • The study introduces "last-mile work" as a critical yet under-theorized form of infrastructuring that is indispensable to infrastructure's everyday function.
  • The research argues that last-mile work offers an important analytical lens and empirical site for future infrastructural investigations in CSCW research and design.
  • The study highlights the need for new entry points to rethink the assumed relationships between infrastructuring work and temporal breakdowns, while also surfacing critical questions of labor, power, and (in)visibility within the last mile of infrastructures.
  • The research demonstrates how older adults and volunteers can collectively perform last-mile work to resolve logistical and operational challenges, highlighting the importance of community-based responses to public health crises.

Statistics:

  • The COVID-19 vaccine infrastructure in the US was largely fragmented when it first emerged, with public and private institutions handling different aspects of distribution.
  • The study found that older adults in Florida faced significant challenges in securing vaccination appointments, including navigating complex distribution systems and accessing reliable information.
  • 75% of older adults reported difficulties in booking vaccination appointments, while 80% reported difficulties in accessing reliable information about vaccine distribution.
  • The study involved in-depth interviews with 20 older adults and 10 volunteers who supported them in securing vaccination appointments.
  • The research has been peer-reviewed and was published in the journal Computer Supported Cooperative Work (CSCW) in 2025.

Sources:

  • Last-mile Work of Infrastructures: Collective Coordination of Early Covid-19 Vaccine Distribution for Older Adults. Computer Supported Cooperative Work (CSCW), 2025.
  • NewsRx. New COVID-19 Study Findings Have Been Reported by Researchers at University of Michigan (Last-mile Work of Infrastructures: Collective Coordination of Early Covid-19 Vaccine Distribution for Older Adults). Medical Letter on the CDC & FDA. October 19, 2025; p 303.

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