The United States has entered a complicated phase of the COVID-19 vaccination effort as providers try to increase the number of people receiving the first vaccines, while ensuring that an increasing number of others receive second doses, just when millions of Americans are becoming eligible to receive vaccines.
The need to give each person two doses a few weeks apart greatly complicates the largest vaccination campaign ever carried out in the country. And the persistent uncertainty about the future supply of vaccines fuels the concern that some people will not be able to give the second injection in time.
In some cases, local health departments and providers have said they should temporarily restrict or even cancel appointments for the first few doses to ensure that there are enough second doses for people who need them.
Nola Rudolph said she had trouble making appointments for her 71-year-old father and 68-year-old mother, who live in rural New York. Every place she looked at a short distance away was reserved.
“Seeing that they were eligible, I was elated,” she said. “Seeing that they were in a dead zone, I went from very hopeful to desperate again.”
She managed to get a second dose for her father, but she still couldn’t find a place for her mother. “It’s like going in circles.”
Last month, the United States administered an average of 900,000 first doses a day, according to data from the Centers for Disease Control and Prevention analyzed by The Associated Press. Now, many of these people need a second dose, and the average number of Americans receiving a second dose reached its peak on Tuesday – 539,000 a day the week before.
The growing demand for second doses comes as the Biden administration is taking steps to increase the supply of doses.
White House COVID-19 coordinator Jeff Zients announced on Tuesday that states will see their dose allocation increase to 11 million a week starting next week, more than 2 million weekly doses since President Joe Biden took over.
Since the vaccine was authorized in late December, about 33 million people in the United States have received vaccines.
“It is really important and critical to recognize that there are still not enough doses for everyone,” said Dr. Nirav Shah, director of Maine’s Center for Disease Control and Prevention.
So far, about 10% of the US population has received at least one dose of the vaccine. About 3% received both doses, showed the AP analysis.
Across Los Angeles County, health officials say limited supplies mean that most vaccinations this week will be for second doses. In Napa County, the state, some appointments for the first doses were canceled last week to ensure there was enough for the second doses.
“We are getting a lot of questions from community members, asking, ‘Is my second dose in danger?’ And, at the moment, we do not have an answer because everything depends on the stock that arrives from the state ”, said Alfredo Pedroza, the city inspector.
Both COVID-19 vaccines distributed in the United States require two injections a few weeks apart to maximize protection. For Pfizer, doses should be three weeks apart. For Moderna, it’s four weeks. But, if necessary, the reinforcement will be postponed for up to six weeks, according to the CDC, which updated its guidance at the end of last month.
Local and state health officials now emphasize this extended deadline in public messages to ease concerns that people may not get their second injection in time.
Federal officials said they are confident that there will be enough doses to ensure that people receive the second injection.
Feeding concerns in some places, is the difficulty of reserving the second dose. Although many places schedule reinforcement when the first injection is given, others ask people to schedule it later because of logistical issues.
Tanny O’Haley is 64 and has Parkinson’s, but is not eligible for the COVID-19 vaccine in Los Angeles County, where she lives. He was able to take the first dose when he accompanied his 69-year-old wife for the vaccination because the site had a remaining vaccine.
O’Haley was unable to schedule his second dose, despite several calls to local authorities and the county health department. He plans to try again when he takes his wife to his second appointment on Wednesday.
“The whole experience was horrible,” said O’Haley.
In New Hampshire, authorities are abandoning the current scheduling system after thousands of people fought to reserve your reinforcements within the recommended time – with some receiving appointments for two months later. People will now have commitments for the second attempt when they make the first.
New Hampshire is one of several local jurisdictions that have applied to use the CDC’s Vaccine Administration Management System, or VAMS.
At the Las Vegas Convention Center in Nevada, another type of scheduling problem emerged last week, when the venue opened as a clinic dedicated only to second doses. When the consultations were made available online, people anxious for the first doses took up the vacancies.
“We had enough vaccine – we just need to control the crowd in some way,” said JoAnn Rupiper, of the Southern Nevada Health District.
People who booked a first dose on site had their appointments canceled, said Rupiper. To ensure that qualified people who have had trouble making appointments online have their second chances, the convention center is allowing visitors.
Despite scheduling confusion, health officials and providers say their main challenge remains limited supplies and variability in how many doses are distributed from week to week. Even with the increase in remittances announced by President Joe Biden’s administration, local officials and suppliers say they do not have enough doses to meet demand.
The shortage is one of the reasons why Dr. Anthony Fauci, the country’s leading infectious disease specialist, noted the potential value of the Johnson & Johnson one-shot vaccine, which recently filed for emergency use authorization. This photo is also less expensive to produce and easier to send.
Pedroza said the cancellations last week in Napa County, California, came after an increase in shipments a few weeks ago led the county to think it would continue to receive at least the same amount of doses. But the peak turned out to be unexpected luck, said Pedroza.
In Seattle, UW Medicine temporarily stopped making further appointments in late January due to limited stock, combined with the need to give others their second doses.
“If there were more offers, we would be happy to have more first dose appointments,” said Cynthia Dold, associate vice president of clinical operations at UW Medicine.
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Associated Press journalists Paul J. Weber in Texas, Nicky Forster in New York, Olga R. Rodriguez in San Francisco, Michelle R. Smith in Providence, Rhode Island and Holly Ramer in Concord, New Hampshire, contributed to this report.
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The Associated Press Department of Health and Science receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.