The Trump administration fell far behind in its initial pledge to vaccinate 20 million Americans by the end of 2020, with less than 3 million people receiving COVID-19 vaccinations out of the 14 million doses that were sent. Local health care providers responsible for the last mile of vaccine delivery are understaffed and exhausted by the ongoing battle against the pandemic, and limited resources, prioritization plans and errors have also hampered the vaccination effort across the country.
The first sign that the government had promised too much came in late December, when officials modified their promise – to vaccinate 20 million Americans by the end of the year to promise to “make vaccine doses available” to 20 million. The chief adviser to the federal vaccination effort known as Operation Warp Speed, Moncef Slaoui, admitted this month that “the termination of immunizations – gunshots – is happening more slowly than we thought it would be”.
“That number is less than we expected,” Slaoui acknowledged again at a news conference on Wednesday. He challenged anyone who can “help us improve the vaccine administration even further by coming to the table, rolling up our sleeves and coming to help us with specific ideas.”
The Department of Health and Human Services said Tuesday allocated 19.88 million doses of the COVID-19 vaccine by the end of December. But the distribution is not the same as administering the doses. The allocated vaccines must still be sent to destinations chosen by the states and, in some cases, redistributed by state and local health authorities before the health professionals who are applying the vaccines can start preparing their first doses.
“We are distributing vaccines as quickly as possible,” said Gustave Perna, the army general in charge of overseeing the logistics of vaccine distribution.
Although both vaccine manufacturers and federal authorities insist that there were no major delays in the production or distribution of the first 20 million doses, only 70% of the promised vaccines were shipped. Some providers reported that they only started receiving their first shipments from state redistribution centers this week – days after waiting to start vaccination.
States have received fewer doses of vaccine than initially allocated by the federal government. Earlier this month, Perna apologized for his “failure to communicate” about vaccine distribution; he had revised the number of doses to be sent to some states after receiving more information from Pfizer about what was available.
“This is disturbing and frustrating. We need accurate and predictable numbers to plan and ensure local success,” said Washington Governor Jay Inslee at the time.
Washington officials said they were among dozens of states whose vaccine shipments have been reduced – in their case by 40% – by federal authorities, although this specific issue appears to have been resolved. Inslee later praised Perna for his “candor” in explaining the problem, saying “there is no indication that further reductions may occur. This is good news.”
Administering the vaccine
Data from the Centers for Disease Control and Prevention showed that as of Thursday, only 2,794,588 people had received their first dose of the COVID-19 vaccine from Moderna or Pfizer-BioNTech, although the CDC warned that immunization numbers were “a day or two late”.
Vaccine providers have 72 hours to send data in their vaccinations, that Dr. Nancy Messonier, the main employee of the CDC’s COVID-19 vaccine, said on Wednesday that she takes into account “that when they are looking to vaccinate people so quickly, it may take a little time to be able to enter all the data. ”
It has not been easy for vaccine providers to navigate the prioritization layers established in state and federal guidelines, balancing the demands to prioritize vaccines for healthcare professionals and the pressure to administer injections quickly.
Vaccinators have was also frustrated with implantation in long-term care facilities, after misunderstandings about the consent requirements, hindered the launch of vaccination programs by pharmacy chains such as CVS and Walgreens. Spokesmen for both companies said the consent confusion had been corrected, but declined to release specific numbers about their vaccines, which started across the country last week.
But pharmacies have not yet started vaccinating at long-term care institutions in some jurisdictions, said Messonier, because some clinics are holding doses until they have enough vaccine “for everyone at the institution who wanted the vaccine”.
Administering the vaccine to people who are not on the priority list is also delaying reporting who is getting the vaccines. Vaccine recipients looking like “cutting the line” were met with outrage across the country, resulting in protests from frontline health professionals at Stanford Medical Center and an investigation into some vaccine providers. On Monday, New York Governor Andrew Cuomo signed an executive order cracking down on vaccinators who are not following the priority population process, fining offenders up to $ 1 million and revoking all licenses, according to CBS New York.
In Southern California, a hospital defended its decision to vaccinate “health care workers outside the frontline” after reports that a Disney employee bragged that his connections gave him a COVID-19 vaccine.
“Since the reconstituted Pfizer vaccine should be used within a few hours or discarded, multiple doses were administered to health professionals outside the front line so that the valuable vaccine was not thrown away,” said Redlands Community Hospital spokesman Nikyah Thomas-Pfeiffer, in a statement.
While in Texas, authorities urged vaccinators to “pivot” the administration of doses to any residents “readily available and willing”, even though not all frontline health workers have been vaccinated.
“It was clear that a significant part of the vaccine in Texas may not be administered yet. We know that you have valid reasons to explain why this happened in some cases – but we also know that every day that a vaccine is on the shelf is another day that prolongs the pandemic, “said Dr. John Hellerstedt, Texas’s chief health officer, in a letter to clinics last week.
In Florida, local health departments are begging for patience while telephone lines The accident and health professionals line up at night outside vaccination sites, competing with other residents who call for vaccines.
“Empty pockets”
The struggle to distribute millions of doses of vaccines comes after a year that had already stretched public health budgets. “These health departments are entering the vaccine distribution period with empty pockets. They did not receive enough money from the original supplementary funds from COVID, ”said Tremmel Freeman.
The Trump administration has praised the $ 480 million given to local jurisdictions for flu and COVID vaccinations in September and December, with Operation Warp Speed providing syringes and other supplies to vaccinators across the country.
State and local health officials will receive help from the recently approved COVID-19 relief bill, which has earmarked billions for vaccine development and distribution, although Tremmel Freeman said the money has not yet reached health providers who are trying increase your immunization programs quickly.
“I have not seen any language that holds anyone accountable for ensuring that the money goes beyond the state level to deeply assist the community in this effort as well. We have seen this happen with testing and tracking, and we look at the disaster that occurred there,” added Tremmel Freeman .
The timing of the vaccine’s launch also collided with the Christmas and New Year holidays, which exhausted labor.
“There are two holidays, there have been three major snowstorms, everyone is working, you know, how to make the notification, how to make sure we are managing it right,” Perna said on Wednesday.
The public now has a clearer view of how the vaccine is being distributed: on Wednesday, the CDC unveiled a new virus distribution tracker that allows users to see how many doses have been distributed and administered each day.