A welcome arrival, issues aside
COVID-19 vaccine push in state runs into snags
1,025,423.
That’s the number of New Yorkers who, as of Friday, had received at least one dose of COVID-19 vaccine, according to figures released daily by the state.
It does not include staff or residents of long-term care facilities, as the federal government is overseeing those vaccinations and has not yet released state-by- state data on the effort. More importantly, however, as the nation battles its deadliest phase of the pandemic yet, it comes nowhere near touching the 7 million high-risk New Yorkers who are currently eligible for vaccination.
“The period we’re in now is a footrace between the vaccine and how many people you can get vaccinated, which is becoming more and more a question of how fast can you produce the vaccine and how quickly is the infection spreading,” Gov. Andrew M. Cuomo said this week.
While infections are starting to level off in New York, hospitalizations and deaths remain high and a new, more contagious version of the virus has officials worried declining infection rates could shoot up again before enough people are vaccinated — overwhelming the state’s already-stressed hospital system.
The problem is a simple one of supply and demand. There’s too few doses to accommodate the massive demand for vaccines in a pandemic that has now touched nearly every nation on the globe.
The inauguration of President Joseph R. Biden on Wednesday buoyed hopes that a new administration could speed up the vaccination rollout and smooth out the chaotic state-by-state approach undertaken thus far. But the journey to anything like herd immunity will depend largely on ramping up production of existing Moderna and Pfizerbiontech vaccines and approving new ones.
I believe brighter days are ahead with the new administration at the helm and we will continue to do everything within our power to get shots in arms as quickly and fairly as possible.”
— Gov. Andrew M. Cuomo
Navigating a confusing rollout
The vaccine rollout in New York has been chaotic from the start.
First came the announcement that hospitals would serve as regional distribution hubs for the vaccine — a development that left many county leaders befuddled as their local health departments had been planning mass vaccination campaigns for well over a decade.
Cuomo said it made sense to designate hospitals as hubs, since the first people eligible for the vaccine were health care workers. But other developments have also left counties — and the general public — confused.
On Jan. 11, the same day that New York opened eligibility to some essential workers and people age 75 and older, the state launched a hotline and web portal to help people sign up to receive a vaccine at mass-vaccination sites opening statewide.
Available appointments were snatched up almost immediately, and many people reported problems getting through to the line. Some waited on hold for hours only to have the line cut off. Others — assuming they would need to schedule two appointments, one for their first dose and one for their second — ate up slots intended for first-dose appointments only and could not figure out how to cancel them after the state clarified that providers would actually be scheduling second doses.
The next day, Cuomo announced that New York would actually be expanding eligibility to people age 65 and older — a move that hadn’t been expected for weeks if not months. It immediately expanded the pool of eligible New Yorkers from 4 million to 7 million. Cuomo said he was following a new and sudden change in guidance from the U.S. Centers for Disease Control and Prevention.
“Nurses and doctors who still haven’t been vaccinated, and there are hundreds of thousands who haven’t been vaccinated, are now in the category of 7 million,” he said. “So the policy and the intelligence of the federal system eludes me. But we will do the best we can. But this is a — I happen to be Christian — loaves and fishes situation…300,000 dosages per week, and 7 million people who desperately want the vaccine quickly.”
County health departments have begun to schedule their own vaccine clinics, but those too have been marked by confusion and chaos.
Albany County Health Commissioner Elizabeth Whalen last week said her department had to cancel some 700 appointments that had been made, mostly by teachers, using an unauthorized scheduling link. The state Office of Information Technology Services reported a similar issue to the state inspector general, after an unpublished link for
state-run vaccination sites was shared without authorization on social media.
“We’re working with the state on how to ensure this doesn’t happen, because the last thing we need is confusion within these systems,” Whalen said.
On Jan. 15, county health departments were informed of another last-minute change. In an effort to distribute vaccines evenly across eligible populations, the state asked them to focus their vaccination efforts on essential workers, while pharmacies would handle people 65 and above, and hospitals would handle health care workers.
Many had already spent time identifying and compiling lists of eligible older adults in their communities, and some had already scheduled clinics for them.
Meanwhile, this past week, a dip in anticipated vaccine doses caused several vaccine providers to cancel already-scheduled appointments. New York City alone had to reschedule 23,000 appointments because of the shortage, and Cuomo warned Thursday that the state would be out of vaccine by Friday.
What now?
Whether the vaccination rollout improves under Biden’s administration remains to be seen, but many hope it will.
Biden, who took office Wednesday, has pledged a “full scale, wartime” response to COVID-19, with a goal of administering 100 million shots in his first 100 days. He has also vowed to take a centralized, federal approach to the response in stark contrast to his predecessor, who encouraged a state-by-state approach.
“I believe brighter days are ahead with the new administration at the helm and we will continue to do everything within our power to get shots in arms as quickly and fairly as possible,” Cuomo said Wednesday.
But even if Biden invokes the Korean War-era Defense Production Act to speed up vaccine production, experts say it will do little to increase supply in the short-term as ramping up manufacturing capacity takes time and resources.
“The brutal truth is it’s going to take months before we can get the majority of Americans vaccinated,” Biden said Thursday.
In the meantime, states are trying to speed up the period from distribution to shots in arms.
As of Friday, fewer than half of the nearly 40 million doses distributed nationwide had actually been administered,
CDC data show. Some of those are second doses in reserve for future appointments, but
many are not.
In New York, 97 percent of nearly 1.2 million doses received had been administered as of Thursday, according to the state’s vaccine tracker. The rate was lower in the Capital Region, where 87 percent of 78,550 doses received had been administered.
The Biden administration has pledged to clearly inform state officials about how much vaccine they will get in a given week. That should ease concerns of providers who were wary of scheduling appointments for vaccines they weren’t sure they were going to get.
Meanwhile, a vaccine developed by Johnson & Johnson is expected to significantly speed up vaccination efforts if approved by the Food and Drug Administration as it involves only one dose and can be stored at normal refrigeration temperatures. Clinical trial results are expected by the end of the month, and FDA approval is anticipated in March.
Clinical trial results for other vaccines currently in development by Astrazeneca and Noravax are expected in March or April.