Johnson & Johnson’s Covid single dose vaccine should be the catalyst for the country’s return to normal. Instead, it is generating confusion and accusations between the states and the Biden government about why millions of doses are not used.
Almost three weeks after the Food and Drug Administration authorized the injections, no one seems to be able to explain why vaccinations are delayed. Some states are believed to be intentionally withholding fire, while others say it takes time to inoculate populations like those living at home.
Over the past two weeks, senior Biden government officials have met privately to try to determine what happened. Two senior government officials believe that states are conserving their J&J supplies until there is enough to reach underserved communities and specific groups, such as teachers or the disabled. But several state officials say they are using what they can get as soon as they can.
What is clear is that about 2.3 million of the 4.3 million doses of the vaccine administered have already been administered. Between 140,000 and 200,000 doses reached people in the last few days, according to the Centers for Disease Control.
The rugged launch of J&J highlights the challenges the White House still faces in ensuring timely and stable administration of Covid-19 vaccines, with President Joe Biden looking at July 4 as the “Independence Day” of the virus. Because it takes just two weeks to achieve immunity with the J&J injection – compared to five or six weeks for Pfizer and Moderna two-dose vaccines, respectively – the absence of enough “one and done” vaccinations has a ripple effect, delaying the general pace of the launch.
Biden government officials have repeatedly warned that the initial deployment of J&J would be difficult, as there was only a limited stock of shots available in the first few weeks. Problems can also be compounded by delays in reporting. But they expect distribution to decline when more vaccine is available later this month.
“You cannot distribute the vaccine equitably if there are not enough doses to distribute it,” said a senior health official.
The White House did not immediately respond to a request for comment.
As states have the final say on how their quotas are distributed, some are using the J&J vaccine in populations that are more difficult to reach for a second chance visit. Others are putting speed in relation to the patrimony and sending the shots in a wide way.
“It may be a little slower to launch because everyone is trying to decide how to best use this particular vaccine,” said Marcus Plescia, the medical director of the Association of Territorial and State Health Officers.
West Virginia is initially using the J&J injection to inoculate its homeless and homeless population, as well as those with intellectual and developmental disabilities who live in congregated environments. Next week, health officials predict they will use the entire first shipment of 15,500 J&J vaccines, and vaccine appointments are already scheduled, according to West Virginia’s Covid-19 czar, Clay Marsh.
“I think people are learning to do this in the best way,” said Marsh. “We are just trying to build this structure, the logistics, the processes so that we can more effectively and efficiently take advantage of the advantages of this new opportunity.”
Pennsylvania is using 107,600 doses of J&J to vaccinate teachers and other school staff in an effort to bring children back to classrooms. As of Friday, nearly 83,900 injections have been administered, according to a health department spokesman.
Maryland has deployed its vaccines in a variety of settings, such as health departments, hospitals and two mass vaccination sites.
“We want to make sure that we’re always being flexible and giving people as many options as possible, so we wanted to go into as many environments as we could,” said Bryan Mroz, assistant secretary of health for the state.
Earlier this month, scientists and public health experts warned against recommending J&J injection for specific groups, concerned with the perception that the injection is “different” from others. The White House coronavirus coordinator, Jeff Zients, even alerted states that the White House could intervene with “technical assistance” if he knew that the states were doing this. The J&J injection has been shown in trials to be less effective than Pfizer or Moderna, but provides strong protection against hospitalization and death.
“I think the federal government tried to provide some leadership on this – this is useful,” said Plescia. “But, as we have seen, states are attentive and respectful of federal guidelines, but they do what works for them.”
Meanwhile, governors are sensitive to the way vaccination data is displayed. In weekly private calls to the White House, they pressured Biden government officials to find out how many doses the federal government is responsible for administering, concerned with public monitoring of the CDC that holds states responsible for doses that are not under their control.
The CDC will provide additional reports that show vaccination data in states through federal and state channels, according to a senior government official.
The official emphasized that the agency focused on the number of Americans who were vaccinated as a whole, “which is relevant to controlling the disease,” and not on the channel through which the injection was administered. States have access to this information through a system called Tiberius.
It is unclear how many doses of the Johnson & Johnson vaccine have been administered by federal vaccine locations, retail pharmacies and federally qualified health centers, which the states do not control. On March 10, some 50,000 doses of J&J were sent to California, Texas and Florida for administration at federal locations administered by the Federal Emergency Management Agency, according to a spokesman. Another 23,000 were in transit at the time, the official said. FEMA has not responded to additional requests for comment on how many more doses of the vaccine have been administered in the past two weeks and how many have been administered overall.
Weekly allocations for the J&J vaccine have also changed in the past few days, according to reports from several internal senior leadership briefings obtained by POLITICO. Earlier this month, the government allocated 3.9 million doses to the states, a federal program that channels doses to retail pharmacies, safety net providers and pilot vaccination sites administered by FEMA. Since that time, doses have been extended sporadically.
The administration initially said they could not receive more doses of the vaccine until the end of March. Then, according to a briefing dated March 11, the government said it plans to distribute another 400,000 doses across the country in the following week. Another briefing dated March 15 said the government had actually increased the total allocation to 600,000. It is still unclear exactly how many doses of J&J have undergone quality control and are awaiting shipment.
Despite increasing numbers of allocation in the past two weeks, the vaccination rate has remained low.