Pace of giving vaccine shots is slower than expected

In Florida, less than onequarter of delivered coronavirus vaccines have been used, even as older people sat in lawn chairs all night waiting for their shots. In Puerto Rico, last week’s vaccine shipments did not arrive until the workers who would have administered them had left for the Christmas holiday. In California, doctors are worried about whether there will be enough hospital staff members to both administer vaccines and tend to the swelling number of COVID-19 patients.

These sorts of logistical problems in clinics across the country have put the campaign to vaccinate the United States against COVID-19 far behind schedule in its third week, raising fears about how quickly the country will be able to tame the epidemic.

Federal officials said as recently as earlier in December that their goal was to have 20million people get their first shot by the end of 2020. More than 14 million doses of the Pfizer and Moderna vaccines had been sent out across the United States, federal officials said Wednesday. But, according to the Centers for Disease Control and Prevention, just 2.8 million people have received their first dose, although that number may be somewhat low because of lags in reporting.

States vary widely in how many of the doses they have received have been given out. South Dakota leads the country with more than 48% of its doses given, followed by West Virginia at 38%. By contrast, Kansas has given out less than 11% of its doses, and Georgia, less than 14%.

Compounding the challenges, federal officials say they do not fully understand the cause of the delays. But state health officials and hospital leaders throughout the country pointed to several factors. States have held back doses to be given out to their nursing homes and other long-term-care facilities, an effort that is just gearing up and expected to take several months. Across the country, just 8% of the doses distributed for use in these facilities have been administered, with 2 million yet to be given.

The holiday season has meant that people are off work and clinics have reduced hours, slowing the pace of vaccine administration. In Florida, for example, the demand for the vaccines dipped over the Christmas holiday and is expected to dip again over New Year’s, Gov. Ron DeSantis said Wednesday.

And critically, publichealth experts say, federal officials have left many of the details of the final stage of the vaccine-distribution process, such as scheduling and staffing, to overstretched local health officials and hospitals.

“We’ve taken the people with the least amount of resources and capacity and asked them to do the hardest part of the vaccination— which is actually getting the vaccines administered into people’s arms,” said Dr. Ashish Jha, dean of Brown University’s School of Public Health.

Federal and state officials have denied they are to blame for the slow rollout. Officials behind Operation Warp Speed, the federal effort to fast-track vaccines, have said that their job was to ensure that vaccines are made available and get shipped out to the states. President Donald Trump said in a tweet Tuesday that it was

“up to the States to distribute the vaccines once brought to the designated areas by the

Federal Government.”

The $900 billion relief package that Trump signed into law Sunday will bring some relief to struggling state and local health departments. The bill sets aside more than $8 billion for vaccine distribution, on top of the $340 million that the CDC sent out to the states in installments in September and earlier in December.

That infusion of money is welcome, if late, said Dr. Bob Wachter, a professor and chair of the department of medicine at the University of California, San Francisco.

“Why did that take until now when we knew we were going to have this problem twomonths ago?” he asked.

Michael Pratt, a spokesperson for Operation Warp Speed, said that there will always be lags between the number of doses that have been allocated, shipped, injected and reported.

“We’re working to make those lags as small as possible,” Pratt said.

There are bright spots. Some states and hospitals are finding ways to speedily administer the vaccines they have received. West Virginia said Wednesday that it had finished giving the first round of vaccine doses to willing residents and workers at all of the state’s 214 longterm care facilities — putting the state far ahead of most other states that began vaccinating at these facilities under a federal program with CVS and Walgreens.

In Los Angeles, CedarsSinai Medical Center was vaccinating about 800 people a day, said Dr. Jeff Smith, Cedars-Sinai’s chief operating officer.

In a news conference Wednesday, Operation Warp Speed officials said they expected the pace of the rollout to accelerate significantly once pharmacies begin offering vaccines in their stores.