PROVIDENCE, R.I. (WPRI) – Harvard University is handing out grades to states based on COVID-19 vaccine rollout, and so far Rhode Island is failing across the board.

On Wednesday, the Harvard Kennedy School’s Belfer Center released a report card on Massachusetts’ vaccination effort compared with other states, giving the Bay State an “F” in three of four categories.

So Target 12 asked Harvard to run the numbers for Rhode Island — and the Ocean State did even worse, receiving an “F” in all four categories.

Rhode Island currently ranks in the bottom 10 states nationwide for coronavirus deaths per capita; vaccine doses administered; use of available doses; and speed of getting shots into arms. The school calculated each state’s per-capita metrics based on its adult population, excluding those under 18.

“[I]f we compare the states to 50 runners in a series of marathons, we can see who is leading — as well as who is bringing up the rear,” Graham Allison, the Harvard professor behind the rankings, explained in an article on the school’s website. By comparison, Connecticut got an “A” for vaccinations per capita, while West Virginia got an “A” on all three vaccination metrics.

Graphic created by Lisa Mandarini

But Rhode Island health officials are pushing back on the evaluation. They claim the state’s hyper-targeted approach to vaccinating the hardest-hit communities first is contributing to its unfavorable nationwide rankings – but isn’t necessarily a sign the strategy is failing.

“I’m not really sure it’s fair to grade people on that metric — it’s actually not what we are trying to do,” Dr. James McDonald, medical director at the R.I. Department of Health, told Target 12. “We are not trying to vaccinate as many people, just people, as quickly as possible.”

Rhode Island leaders’ approach has been to direct the limited supply of vaccine currently available to places where deaths, hospitalizations and infections are most concentrated, such as congregate-living facilities, densely populated neighborhoods and high-risk professions like health care.

“It’s really about protecting lives, keeping mortality as low as possible, and keeping people out of the hospital,” McDonald said.

The targeted approach, however, is slower than the one in neighboring Connecticut, which has opened more “mass-vaccination” sites where eligible residents can sign up and get inoculated on a first-come-first-served basis. In Massachusetts, the state is using facilities such as Gillette Stadium as mass-vaccination sites, and Rhode Island plans to open two next week.

As of Wednesday, Rhode Island had administered nearly 60% of the doses it had received from the federal government, the lowest rate across all states, according to data from the U.S. Centers for Disease Control and Prevention.

By comparison, Massachusetts had administered 65% of its doses, Connecticut had administered 69%, and other states were much higher, with Utah having used upwards of 95% of its doses.

At the same time, only about 25% of all vaccine doses administered in Rhode Island have gone into the arms of adults ages 60 and up, spurring frustration among older residents whose cohort accounts for the vast majority of COVID-19 deaths in Rhode Island and who are anxiously awaiting vaccines.

It’s too early to say definitively which strategy might prove the most effective in terms of successfully tamping down future deaths, hospitalizations and infections. Top health officials in Rhode Island say they are optimistic about the state’s coronavirus trends in recent weeks, despite the deaths of 426 people with the virus so far this year.

Health care workers, for instance, were the first group of people to receive vaccines, and weekly infections among that group have since tumbled about 70%, according to a Health Department presentation Thursday.

“Our strategy right now is working,” McDonald said Thursday.

McDonald also pointed to a decline in infections reported at nursing homes, where residents and staff were offered the vaccine next after hospital workers. He said reaching the most vulnerable populations first will help the state protect against future infection, especially amid the spread of highly contagious and possibly more deadly variants from the U.K. and South Africa.

“We know that a new COVID variant is going to come to Rhode Island. It’s inevitable,” McDonald told Target 12. “We need to drive down these infections and protect our high-risk people.”

How much the vaccines are directly contributing to the recent declines is tough to discern, as Rhode Island had already started to see decreases even before much of the vaccine had been administered. But there are signs that Rhode Island is seeing a more rapid decline in its targeted areas, and overall has fared better than other states so far in 2021.

For example, weekly infections in nursing homes have declined 58% since the start of the year, to about 105 cases last week, according to a Target 12 analysis of Health Department data. In Central Falls, where nearly half of the city’s 20,000 residents have received at least one dose of vaccine, the weekly infection rate has declined about 70% in 2021.

Statewide, weekly infections have declined 56% during that same time period.

Meanwhile, the number of COVID-19 patients currently in the hospital in Rhode Island has declined 47% to 238 people. In Massachusetts, hospitalizations fell 40% to 1,358 people, while in Connecticut the number only declined 27% to 770 people during that same time period, according state health agencies.

Nationwide, the COVID Tracking Project reports hospitalizations on average have declined 35% across all states since the New Year, while falling about 26% in the Northeast region.

McDonald said the overall trends in Rhode Island are encouraging and he’s optimistic that the state will be able to get shots into arms more efficiently in the coming weeks, especially once the mass-vaccination sites open.

Federal health officials, including Dr. Anthony Fauci, have indicated that COVID-19 vaccines should become more readily available to anyone who wants one by April. On Thursday, Fauci said at that point it could become “open season” for vaccines.

Asked what grade Harvard might give Rhode Island in 30 days, McDonald dismissed the rankings, saying “what people are focusing on is perhaps not the right thing.”

“Report cards are report cards,” he said. “I’m far more interested in protecting my Rhode Islanders than I am in satisfying someone’s report card.”

Eli Sherman (esherman@wpri.com) is a Target 12 investigative reporter for 12 News. Connect with him on Twitter and on Facebook.

Tim White (twhite@wpri.com) is Target 12 managing editor and chief investigative reporter and host of Newsmakers for 12 News. Connect with him on Twitter and Facebook.