In Florida, less than a quarter of the delivered coronavirus vaccines were used, even as elderly people sat in lawn chairs all night waiting for their pictures. In Puerto Rico, vaccine shipping did not arrive last week until the workers who would have been administered for the Christmas holidays had left. In California, doctors are concerned about whether there will be enough hospital staff to administer vaccines and the likely declining number of COVID-19 patients.
The types of supply problems in clinics across the country have prompted the campaign to vaccinate the United States against COVID-19 far behind the record in their third week, raising fears about how as soon as the country is able to wipe out the epilepsy.
Federal officials said as far back as December that their goal was to have 20 million people getting their first sight by the end of 2020. More than 14 million doses of the Pfizer and Moderna vaccines have been dispensed with across the United States, federal officials said Wednesday. However, according to the Centers for Disease Control and Prevention, only 2.8 million people have received their first dose, although that number may be a bit low due to a weakness in reporting.
States vary widely in how many doses they have been given. South Dakota leads the country with more than 48% of its doses administered, followed by West Virginia at 38%. In comparison, Kansas has given less than 11%, and Georgia, less than 14%.
Concluding the challenges, federal officials say they do not fully understand the reason for the delay. But state health officials and hospital leaders across the country identified several factors. States have withheld doses for delivery to their nursing homes and other long-term care facilities, an effort that is just preparation and is expected to take several months. Nationwide, only 8% of doses dispensed for use in these facilities were given, with 2 million yet to be given.
The holiday season has meant that people are off work and clinics have reduced hours, slowing down the pace of vaccine administration. In Florida, demand for the vaccines declined over the Christmas holidays and is expected to rise again over the New Year, Gov. Ron DeSantis Wednesday.
And critically, public health experts say, federal officials have leaked many of the details of the final stage of the vaccine circulation process, such as registration and staffing, to oversee local health officials and hospitals.
In one notorious blunder, 42 people in Boone County, West Virginia, who were due to receive the coronavirus vaccine Wednesday instead were mistaken for experimental monoclonal antibody treatment.
“We brought in the people with the least resources and ability and asked them to do the hardest part of the vaccine – who really get the vaccines in people’s arms,” said Dr. Ashish Jha, dean of Brown University School of Public Health.
Federal and state officials have denied that they are to blame for the slow release. Officials behind Operation Warp Speed, the federal effort to speed up vaccinations, have said their job is to make vaccines available and send them out to the states. President Donald Trump said in a tweet Tuesday that it was “up to the States to distribute the vaccines once the Federal Government brought them to the designated areas. ”
“In the end, it looks like the buck won’t stop with anyone,” said Jha.
These problems are of particular concern now that a new, more contagious variable, first seen in Britain and horrific hospitals there, has reached U.S. officials in two states, Colorado and California, say they have found cases of the new variant, and none of the patients have recently traveled, suggesting that the variant is already spreading in U.S. communities.
The $ 900 billion relief package that Trump submitted to law Sunday will bring some relief to struggling state and local health departments. The bill will set aside more than $ 8 billion for vaccine circulation, in addition to the $ 340 million the CDC sent out to the states in installments in September and earlier December.
That funding release is welcome, if it is late, said Dr. Bob Wachter, a professor and chair of the department of medicine at the University of California, San Francisco.
“Why did that happen so far when we knew we had this problem two months ago?” he asked.
Michael Pratt, spokesman for Operation Warp Speed, said there will always be a gap between the number of doses dispensed, removed, ingested and reported.
“We are working to minimize these weaknesses,” Pratt said.
The task of administering thousands of vaccines is daunting to health departments that are already overweight by responding to the pandemic. In Montgomery County, Maryland, the health department has hired additional staff to help regulate vaccine distribution, said Travis Gayles, the county health officer.
“As we try to get vaccines out, we are also continuing the widespread response by supporting testing, contact detection, disease control and all these other aspects of COVID response, ”Gayles said.
Making matters worse, the county health department receives just a few days’ notice each week of the timing of vaccine shipping. When the latest batch arrived, Gayles’ team managed to contact people eligible for the vaccine and set up clinics to deliver the doses as soon as possible.
Overall, Maryland has given nearly 17% of its vaccine doses. In a view Wednesday on CBS, Gov. Larry Hogan influenced the slow process to cross-board challenges – from the federal government not issuing as many doses as originally expected, to a lack of procurement and financial support for local health sectors.
In Texas, Gov. Greg Abbott and top state health officials say vaccines are available in the state but are not being rolled out quickly to deal with an urgent surge of COVID-19 cases that is pushing hospital capacity to the breaking point.
“A good deal of vaccines could be distributed across Texas sitting on hospital shelves instead of being given to vulnerable Texans,” the governor tweeted Tuesday.
In California, Gov. Gavin Newsom on Wednesday urged people to be “humble” against such complex work and said the pace of vaccination would accelerate. California has administered 20% of the doses it received.
Hospitality among people receiving the vaccine can also be slow. Gov. said. Mike DeWine of Ohio told a news conference Wednesday that about 60% of nursing home workers offering the vaccine in the state had declined. In Florida, some hospital workers refused to be vaccinated, and these doses are now being prescribed for other vulnerable groups such as community health care workers and the elderly, but are not. that release has not started at all, said Justin Senior, chief executive officer for the Safety Net Hospital Alliance of Florida, a hospital consortium.
There are bright spots. Some states and hospitals are looking for ways to get the vaccines they receive quickly. West Virginia said Wednesday it was ready to deliver the first round of vaccine doses to residents and willing workers at all 214 state-of-the-art care facilities at the state – putting the state far ahead of it. most other states started vaccination at these facilities under a federal program with CVS and Walgreens.
In Los Angeles, Cedars-Sinai Medical Center, which employs about 20,000 people at several facilities, vaccinated about 800 people daily, said Dr. Jeff Smith, Cedars-Sinai chief operating officer. He said Cedars-Sinai planned to vaccinate all its employees who have opted out of the vaccine within two weeks.
But other communities are falling short of that quick snippet. Smith said the medical community is concerned about staff shortages when hospitals have to provide vaccines and treat COVID-19 patients.
In a news conference Wednesday, Operation Warp Speed officials said they expected the speed of deployment to accelerate significantly once pharmacies begin offering vaccines in their stores. The federal government has reached agreements with several pharmacy chains – including Costco, Walmart and CVS – to provide vaccines once they become more widely available. To date, 40,000 pharmacy places have enrolled in that program.
Most vaccines given nationwide to date have been given to health care workers in hospitals and clinics and to older adults in nursing homes. Gen. said. Gustave Perna, logistics director of Operation Warp Speed, said Wednesday that they were “two very challenging groups” for vaccination.
But public health officials have warned that reaching out to those original groups, who are largely vaccinated where they live or work, is a daunting task.
“This is the part where we should know where people are,” said Dr. Saad Omer, director of the Yale Institute for Global Health.
It may be more difficult, public health officials say, to vaccinate the next wave of people, which is likely to affect many more Americans as well as younger people with health problems. and frontline staff. New challenges include: How will these people be registered for their immunization meetings? How do they provide documentation that they have a health or work condition that makes them eligible for vaccination? And how do pharmacies make sure people show up and can do so safely?
“In the next step,” said Jha of Brown University, “we’re going to hit the same wall all of a sudden, we have to go out and start to see it. ”