Covid vaccine update: the US will not reach the 20 million dose target by the end of the year

Photographer: Eva Marie Uzcategui / Bloomberg

The United States is vaccinating an average of just 200,000 people a day against Covid-19, and many states have used only a small percentage of the remittances sent to them this month.

Data collected in the states and the United States Department of Health and Human Services show that, although Operation Warp Speed ​​has distributed millions of doses, some states have been slow to place them in people’s arms. The country will almost certainly not reach the Trump administration’s goal of 20 million vaccinations by the end of the year, according to an analysis by Bloomberg News.

The latest CDC count on Monday showed that despite the distribution of 11.45 million doses by Moderna Inc., and Pfizer Inc. and BioNTech SE, only 2.13 million people received injections. This represents about 20% of the initial allocations. Oregon used only 15.3% of its supply, Ohio 14.3% and Maryland 10.9%.

Authorities blame a delicate vaccine with complex storage requirements, uncertainty about the delivery of doses and strain at local health agencies that already face historic challenges.

“We would like to have better absorption,” said Steve Kelso, a spokesman for the Kent County Health Department in Michigan, where the state used 18.5% of its doses. “We can stick more needles in our arms.”

How much of their allocations are states using?

The analysis shows variations in the speed of functioning of the states through the vaccine

Source: state panels and public comments, US government data

More than 330,000 Americans died from the pandemic and tens of thousands more are expected to succumb in the coming months, making the vaccine’s launch even more critical. But Moncef Slaoui, chief scientific adviser to Operation Warp Speed, said last week that the goal of vaccinating 20 million people by the end of the year is unlikely to be achieved.

In recent weeks, countries around the world have launched vaccination campaigns in a global race to end the pandemic. Some are far surpassing the US: Israel, whose size and population are similar to New Jersey, administered injections to an average of 60,000 people a day in its first week. If the United States were moving at the same speed, it would be doing 2.2 million inoculations daily – ten times the current rate.

A spokesman for the Department of Health and Human Services said on Tuesday that the figures reported did not reflect the most recent situation.

“We are closely monitoring the data reported by jurisdictions on vaccine administration and are excited about the work they have done so far during the holidays,” said Michael Pratt. “There is an expected lag between the shots entering the guns and the data being reported.”

President Donald Trump reiterated on Tuesday night in a tweet that “it is up to the states to distribute the vaccines”.

But President-elect Joe Biden said in a previous speech that “the effort to distribute the vaccine is not progressing as it should” and that he “would move heaven and earth to take us in the right direction”.

Biden said his government would reach 100 million doses in its first 100 days if Congress provides funds. “If it continues to move as it is now, it will take years, not months, to vaccinate the American people,” he said.

Muddle Michigan

Bloomberg News analyzed the first three allocations to states, including two weeks of photos from Pfizer and one from Moderna. In some cases, the totals allocated are higher than the states claim to have received. The number of doses sent aligns with what the CDC says has been distributed, allowing for consistent state-to-state comparisons.

Michigan used less than 1 in 5 of its 455,900 doses allocated as of December 21, according to Bloomberg’s analysis.

“The lack of certainty about vaccine allocations, the timing when these doses arrive and the process of scheduling thousands of employees for vaccination made it all challenging,” said John Karasinski, a spokesman for the Michigan Health & Hospital Association.

Kent County, which encompasses Grand Rapids, formed a group of health departments, hospitals and pharmacies with the goal of vaccinating about 2,200 people in the first phase, which targets health professionals. So far, only about 575 vaccinations have been made.

Kelso, the spokesman, said some employees did not want to deprive a real frontline worker of a vaccine. Holidays may be slowing things down. And some people are still concerned about security, even some health department employees.

“A lot of people don’t want to be the first child on the block,” said Kelso.

Other groups are having more success. The Sparrow Health System vaccinated about a quarter of its employees, pharmacy director Todd Belding said in an interview. Michigan’s central hospital system is administering about 2,000 doses a week, almost as much as its state allocation, he said.

The phased launch is slower than if vaccines were available to all participants, such as the flu vaccine. Some delay is intentional: hospitals do not want to vaccinate entire departments at once, in case side effects drive employees away. But Sparrow is also coordinating with authorities to target populations such as prison medical staff and independent health professionals. Identifying and reaching these groups takes time, a challenge that will persist when vaccines reach grocery workers and teachers.

“This prioritization added a certain level of complexity,” said Belding.

Other states are moving more slowly. As of December 28, Maryland had worked with only 10.9% of its 191,075 doses from the first three weekly distributions, according to Bloomberg’s analysis.

In Montgomery County, the head of public health Travis Gayles said he is preparing to face obstacles such as a lack of personnel. Years of budget cuts have hampered municipalities’ ability to create effective responses to the virus from scratch – at one point, Montgomery was registering cases of viruses by fax – and these cuts can also hamper the vaccine’s distribution.

“With Covid now, it definitely shows a bright light on the impact of these budgetary decisions,” said Gayles.

In New York, officials are guarding vaccination sites and putting “light pressure on them,” said Larry Schwartz, a member of Governor Andrew Cuomo’s Covid-19 Task Force. A portion of the state’s allocation goes to pharmacies that the federal government will inoculate residents and nursing home employees, and it may have taken some time to prepare, said Schwartz.

“Like everything that is completely new, there is always a short period of acceleration,” he said.

Ashish Jha, dean of the Brown University School of Public Health, said the Trump administration’s dependence on states has undermined the response. The Warp Speed ​​program has had admirable success in helping to develop and distribute a vaccine, he said, “but at that point it is encountering an obstacle.”

“We are going to set up field hospitals and tents everywhere and get the National Guard to do that,” said Jha in a telephone interview. “That last mile had very little investment. I think this is going to be a big problem. ”

Private institutions are facing difficulties, even those with relatively good performance. In Virginia, which generally used about 15% of its initial allocation, Sentara Healthcare administered about 60% of its doses, said Jordan Asher, chief medical officer of the 12 hospital system. The internal goal was to distribute this in three weeks, and Asher said that Sentara was a little ahead of schedule.