Here’s why vaccine delivery is taking longer than expected

In Florida, less than a quarter of delivered coronavirus vaccines have been used, even as the elderly sat in lawn chairs all night waiting for their vaccines. In Puerto Rico, last week’s vaccine shipments did not arrive until the workers who allegedly administered them left for the Christmas holidays. In California, doctors are worried about whether there will be enough hospital staff to both administer vaccines and care for the growing number of patients with Covid -19.

These types of logistical issues at clinics across the country have far delayed the United States’ vaccination campaign against Covid -19 in its third week, raising concerns about how quickly the country will be able to tame the epidemic.

Federal officials said as late as December their goal was for 20 million people to receive their first vaccine by the end of 2020. More than 14 million doses of Pfizer and Moderna vaccines had been sent to states. United, at the federal level. officials said Wednesday. But, according to the Centers for Disease Control and Prevention, only 2.8 million people received their first dose, although that number may be somewhat low due to delays in reporting.

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States vary widely in the number of doses they have received. South Dakota leads the country with more than 48% of its doses administered, followed by West Virginia with 38%. In contrast, Kansas distributed less than 11% of its doses and Georgia less than 14%.

To compound the difficulties, federal officials say they do not fully understand the cause of the delays. But public health officials and hospital officials across the country have pointed to several factors. States have withheld dose distribution to their nursing homes and other long-term care facilities, an effort that is only just beginning and is expected to take several months. Nationwide, only 8% of the doses distributed for use in these facilities have been administered, and 2 million remain to be administered.

The holiday season means people are on vacation and clinics have cut hours, slowing the pace of vaccine administration. In Florida, for example, demand for vaccines fell over the Christmas holidays and is expected to drop again over the New Year, Gov. Ron DeSantis said on Wednesday.

And critically, public health experts say, federal officials have left many details of the final phase of the vaccine distribution process, such as planning and staffing, to local health officials and hospitals. overloaded.

“We took the people with the least resources and abilities and asked them to do the hardest part of immunization – which is actually giving the vaccines into people’s arms,” said Dr Ashish Jha. , Dean of Brown University’s School. of public health.

Federal and state officials have denied being responsible for the slow deployment. Officials on Operation Warp Speed, the federal effort to speed up vaccines, said their job was to ensure vaccines were available and shipped to states. President Donald Trump said in a tweet on Tuesday that it was up to “states to distribute vaccines once brought to areas designated by the federal government.”

“In the end, the responsibility seems to end with no one,” Jha said.

These issues are of particular concern now that a new, more contagious variant, first spotted in Britain and in scores of hospitals, has arrived in the United States. Officials in two states, Colorado and California, say having discovered cases of the new variant, and none of the patients had recently traveled, suggesting that the variant is already spreading in American communities.

The $ 900 billion relief package Trump enacted on Sunday will bring some relief to ailing state and local health services. The bill sets aside more than $ 8 billion for vaccine distribution, in addition to the $ 340 million the CDC sent to states in installments in September and earlier in December.

This infusion of silver is welcome, even if it is late, said Dr. Bob Wachter, professor and director of the department of medicine at the University of California at San Francisco.

“Why has it taken until now when we knew we were going to have this problem two months ago?” He asked.

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The task of administering thousands of vaccines is daunting for health services that have already been overburdened by the pandemic response. In Montgomery County, Maryland, the local health department has recruited additional staff to help manage vaccine distribution, said Travis Gayles, the county’s health official.

“As we try to roll out vaccinations, we are also continuing the pandemic response by supporting testing, contact tracing, disease control and all these other aspects of the Covid response,” Gayles said.

To complicate matters, the county health department only receives a few days’ notice each week when its vaccines are to be dispatched. When the last batch arrived, the Gayles team scrambled to reach out to those eligible for the vaccine and set up clinics to distribute the doses as quickly as possible.

Overall, Maryland administered nearly 17% of its vaccine doses. In a Wednesday appearance on CBS, Gov. Larry Hogan attributed the slowness of the process to challenges at all levels – from the federal government not delivering as many doses as initially expected, to the lack of logistical and financial support for them. local health services.

In Texas, Gov. Greg Abbott and senior state health officials say vaccines are available in the state but not being distributed quickly enough to cope with a critical increase in growing Covid-19 cases the capacity of hospitals at the breaking point.

“A significant chunk of vaccines distributed across Texas could be 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” in the face of such a complex task and said the pace of vaccination would pick up. California administered 20% of the doses it received.

Reluctance among those to whom the vaccine has been offered can also slow deployment. Ohio Governor Mike DeWine told a press conference on Wednesday that about 60% of nursing home staff had offered the vaccine in the state refused it. In Florida, some hospital staff have offered the vaccine and these doses are now reserved for other vulnerable groups like community health workers and the elderly, but that rollout hasn’t quite started, a said Justin Senior, CEO of the Safety Net Hospital Alliance of Florida, a hospital consortium.

There are bright spots. Some states and hospitals are finding ways to quickly administer the vaccines they have received. West Virginia said on Wednesday it had completed giving the first round of vaccine doses to residents and consenting workers at all of the state’s 214 long-term care facilities – placing the state far ahead of the Most of the other states that have started vaccination in these facilities are federally. program with CVS and Walgreens.

In Los Angeles, Cedars-Sinai Medical Center, which employs some 20,000 people at multiple facilities, immunizes about 800 people a day, said Dr Jeff Smith, chief operating officer of Cedars-Sinai. He said Cedars-Sinai expected to vaccinate all of its staff who have opted for the vaccine within a few weeks.

But other communities fall short of this quick clip. Smith said the medical community was concerned about the staff shortage when hospitals must both administer vaccines and treat Covid-19 patients.

In a press conference on Wednesday, Operation Warp Speed ​​officials said they expected the pace of the deployment to accelerate dramatically once pharmacies start offering vaccines in their stores. stores. The federal government has made deals with a number of drugstore chains – including Costco, Walmart and CVS – to administer vaccines once they become more widely available. So far, 40,000 pharmacies have signed up for this program.