Some states expressed disappointment at the launch, acknowledging their own problems, but also seeking more federal resources amid concerns about the burden they now have to put vaccines in patients’ arms. In several cases, local confusion on the ground has created its own delays, not to mention dangerous and costly mistakes.
Without a federal mandate on how to administer the vaccine, it is up to the states to decide who will receive the vaccine and when, creating a mess of rules that vary widely across the country. While some states focus exclusively on health workers, others have started vaccinating the elderly and other frontline workers as well.
West Virginia Governor Jim Justice announced that people over 80 were eligible to receive the vaccine on Wednesday, while the Tennessee Department of Health said it would start administering the vaccine to residents 75 and older, daycare teachers and staff.
Texas has distributed only a third of the vaccines it has received so far, according to figures released on the state’s vaccine panel. And in Ohio, Republican Governor Mike DeWine said he is not satisfied with the number of vaccines that have been administered in his state, as well as with the adherence of those in priority groups that choose to receive the vaccine.
Several states have also said that it has been difficult to plan the launch of a vaccine when their Trump administration supply numbers are constantly changing and they are only receiving information about vaccine supply on a weekly basis.
“There is no federal organization, no federal deployment, there is no coordination between the federal government and state governments,” Pennsylvania Deputy Governor John Fetterman, a Democrat, told CNN “Newsroom” on Thursday.
Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said on Thursday on NBC’s “Today” program that the federal government can still help states increase vaccine distribution without controlling all steps. “Instead of intervening and taking over, I think it might be better to give more resources and work with them, together with them,” said Fauci, who also advises President-elect Joe Biden. “In other words, I am not saying that we are taking over, we are going to do your job, but saying that we are really going to help you do your job, particularly by giving you many more resources.”
States are realizing, however, that they are not receiving a huge increase in funding from the federal government for the time being, after the last stimulus bill passed in Congress without billions of dollars in state and local aid that Republicans have opposed.
Trump administration officials insist that a delay in states’ vaccination reports is a reason for the low numbers, but they recognized this week that even with the delay, the numbers are behind and the federal government needs to be doing a better job of dealing with with bottlenecks.
“We know it should be better and we are working hard to make it better,” Moncef Slaoui, chief scientific adviser to Operation Warp Speed, told a news conference on Wednesday.
According to a Republican state official, a major problem resulted from the fact that states are responsible for all logistical decisions to send the vaccine to suppliers as soon as they receive shipments from the federal government, especially the so-called “last mile” from vaccine travels before it is given to individuals.
Another difficulty has been the complicated storage and transport needs of vaccines, because many suppliers do not have the tools needed to handle storage requirements. This official also noted that many medical facilities also had to provide training on how to handle and administer the vaccine.
An HHS spokesman defended the administration’s work with the states, tweeting that the “CDC issued $ 340 million to influenza / COVID vaccination jurisdictions in September. The CDC issued another $ 140 million to jurisdictions for influenza vaccinations. COVID vaccinations in December “
A senior Trump administration official emphasized that states that don’t report more quickly are contributing to the delay, something that Operation Warp Speed operations director Gustave Perna said will “increase” as reports become more routine. But unlike Trump, other government officials acknowledged that there are shortcomings and room for improvement.
“We would have liked to see everything go well and have 20 million doses in people today at the end of 2020, which was the projection. This obviously did not happen. And that is disappointing, ”said Fauci on Thursday.
‘Not translating’
The United States has granted emergency clearance for two vaccines so far, from Pfizer and Moderna, with others potentially coming online in the U.S. next year, which would help speed up the deadline for people to be vaccinated.
Both vaccines require two doses: the Pfizer vaccine requires a second dose 21 days later and the Modern vaccine 28 days later. Currently, these second doses have been withheld by the federal government, so they will be available and administered when they are needed to deliver the second doses.
But Fauci suggested on Thursday that distributing the first doses to more people is “under consideration” to help increase the number of people who can be vaccinated, although this opens up the risk that manufacturing problems may prevent people from receiving the vaccine. second injection.
“I still think that if done correctly, you can take a single dose, reserve doses for the second dose and still get the job done,” said Fauci on Today, “but there is a lot of discussion about whether or not you want to spread the initial vaccination by vaccinating. more people in the first round. “
Dr. Leana Wen, a CNN medical analyst and former Baltimore health commissioner, said the federal government should have built and funded infrastructure to distribute the vaccine months ago, while they were still in development and increasing production.
“What went wrong in this process? We need to have real-time tracking to see where the delay is,” said Wen in CNN’s “newsroom” on Thursday. “We need to have a lot more resources dedicated to distribution and not just scientific development, because otherwise, Operation Warp Speed for science is clearly not translating to warp speed for distribution.”
Problems with delays in vaccine delivery are not universal across the country. Some state officials say they are satisfied with the system so far.
“We knew it was a complicated process. We were surprised at how easy it is going,” a state employee in the Southeast told CNN.
But those sentiments emphasize division within states, with several state health officials saying they still need more funding.
“State health departments are stretched to the max fighting Covid, doing tests. The county and the location are in the same boat,” a Northeast state official told CNN. “It’s not just the scale of the vaccine’s operation, but putting it on top of what the states are already dealing with.”