As states across the country scale efforts to administer Covid-19 vaccines, obtaining information about who received the vaccine is almost as scary as the distribution itself.
With thousands receiving their second doses this week – and many officials debating whether to expand groups eligible for vaccination – blind spots are emerging: some states have not yet released vaccination updates and the numbers released by the Centers for Disease Control and Prevention vary dramatically from those released by state health departments.
Furthermore, the CDC has been slow to show the numbers for the second dose, and an agency spokesman said that a percentage of those who received the second dose were initially mixed with the numbers for the first dose, increasing dose counts in some States.
Most states have yet to release demographic data on who is receiving the vaccines, such as race, age and location – vital information in a pandemic that has disproportionately affected communities of color. Racial data in the medical examiner’s record led to a WBEZ report in Chicago, which revealed that 70 percent of the city’s coronavirus deaths were black.
In the early months of the pandemic, obtaining data on where the outbreaks were occurring and who was dying from the virus was slow, difficult and often incomplete. The lack of information hid problems such as nursing homes and meat-packing factories in those early weeks. At that time, the federal government was unable to track outbreaks in schools and there were delays in monitoring positive cases by race. The federal government was slow to disclose this information and left the effort largely to the states, obscuring the total severity of the pandemic.
Almost a year later, history is already repeating itself, as the data on the launch is full of gaps, contradictions and delays.
“I will say that there is no state that has an ideal information system now in terms of the real-time public health information we need,” said Howard Koh, professor at Harvard University’s TH Chan School of Public Health.
Koh, a former assistant secretary for health and human services, made the comments during a news conference last week about the vaccine’s launch.
“Unfortunately, we’ve already seen that with the slow launch of testing and all the confusion about testing,” said Koh.
The logistics of vaccinating an entire country were bound to be difficult. Experts warned for months that, even when vaccines arrived, it was equally important to establish a structure to distribute vaccines.
Health professionals and nursing home residents were the first to be vaccinated, but states are under increasing pressure to expand distribution instead of leaving vaccines in freezers.
“Each dose of vaccine that stays in a tank instead of on an arm can mean another life lost,” said Health and Human Services Secretary Alex Azar on Tuesday.
When the vaccine was launched in mid-December, only a patchwork of states posted updates online, while others relied on the news. It took another two weeks for the CDC to release data at the state level, which revealed that the country was far short of its vaccine implantation goals.
Publishing data, often an arid topic left to lawmakers and demographers, has become a powerful tool during the pandemic, informing governors, mayors and public health officials when it is safe to resume meals at indoor restaurants or reopen schools.
But states like Missouri and Connecticut have yet to release data updates online. And some of the most populous states are still slow to release data online. California has not yet released daily vaccination data online. The state gave CDC figures showing first doses at about 2,500 per 100,000 people, lagging behind the national average of 3,600. These numbers can take several days, because states have up to 72 hours to report vaccination numbers to the CDC.
However, Los Angeles County is reporting data, as is New York City, which published vaccination data online before the state. And states with smaller populations, like Idaho and South Dakota, were the first to publish data online.
According to an NBC News analysis of vaccination data, South Dakota has been consistently among the top three states in administering initial vaccinations since the launch began, with more than 6,100 vaccines per capita on Thursday. West Virginia had the highest number, with about 6,600 per capita.
Kansas, Illinois and Arkansas just released their data reports this week, a month after the vaccine was launched.
Many state panels, like Illinois, show vaccines by county, but not by race or age. States like Tennessee are reporting race. And while county-level dose data is useful, it lacks the precision that can come from smaller geographic areas, such as postal codes. A person’s postal code can be used to determine the racial and economic makeup of a neighborhood, without violating their privacy with a full address.
“Most people don’t think about it until times like this, Koh said. “We need the best possible information from a population point of view – by community, by neighborhood, by race, ethnicity, and we need this in real time. It has to be reliable, and we just don’t have these robust systems now. “
The delay in CDC’s three-day reports creates discrepancies compared to information released by state health departments. Even taking into account the delay, some of the vaccination totals released by the CDC were still wrong by the thousands.
A CDC spokesman said the first dose numbers were initially wrong because they included some numbers for the second dose, which were corrected in a new data release on Thursday.
This release was the first time that the CDC released the status of the second doses in the country, about 10 days after some states began to release these numbers.
It is also the first complete picture of how far the country is from collective immunity. Even so, the CDC has not yet released data on race, age or location within states. Without this, it is difficult to say whether the poorest and minority communities and those with limited health care had equal access to vaccines. The CDC said it will expand the data in the future.
More robust data reporting can help to identify these inequalities. Florida is one of the few states that publish data on location of residence. A Wall Street Journal report found that out-of-state residents and foreigners with second homes migrated to Florida once age eligibility was expanded.
Many state implementation plans were based on addressing vulnerable populations and essential workers, but as some of these plans are adjusted, they may not have the time or luxury to obtain data before doses.
Dr Peter Hotez, dean of the Baylor College of Medicine specializing in vaccine administration, said that, in an ideal scenario, states would have the ability to collect timely data on vaccinations broken down by demographics of those being vaccinated, such as age and race. But he said he is not sure if this is realistic without sacrificing delivery speed.
“I think this is very important and useful, as long as it is not a barrier to vaccination,” said Hotez.
“We learned over the course of 2020 that we didn’t do well with complicated things,” he said. “We have to make it easier, or it won’t be done.”
After treating the pandemic by the United States last year, he said: “We have to do everything possible to make it easy, not demanding and robust”.
Hotez said he generally believes the figures that states are reporting are accurate, although he said some delays are still likely.
“I have no reason to doubt the veracity of the numbers. The numbers are terrible, ”he said. “These are not the Communist Party’s five-year plans exaggerating the wheat harvest.”
FIX (January 15, 2021, 5:30 pm Eastern time): An earlier version of the graph in this article incorrectly stated that Arizona does not have a Covid-19 vaccine data panel. The state has one. The graph has been corrected.