The Day

Unused vaccines pile up across U.S. as some regions resist

- By ANNA EDNEY and DREW ARMSTRONG

Many U.S. states and cities have a growing surplus of coronaviru­s vaccines, a sign that in some places demand is slowing before a large percentage of the population has been inoculated, according to an analysis by Bloomberg News.

The data indicates that as many as 1 in 3 doses is unused in some states. Appointmen­ts for shots often go untaken, with few people signing up.

Bloomberg analyzed state and U.S. data from Monday, providing a snapshot of vaccine use before Johnson & Johnson shelved millions of shots pending federal health officials’ investigat­ion into extremely rare cases of blood clots. That pause probably will cause the number of unused shots to fluctuate, but will not change much in the comparison­s of states.

Demand remains strong. In the U.S., 37% of people have gotten at least one dose, and the country is one of the world leaders in vaccinatio­ns. But even some states that are doing well are struggling with stubborn pockets where uptake is low.

In Virginia, for instance, 83% of vaccines supplied to the state have been used — but the number of people getting shots differs sharply from city to city. That difference is especially stark in Charlottes­ville and Lynchburg, separated by an hour’s drive on U.S. 29 past vineyards and open farmland.

“Virginia is sort of a microcosm of the country,” said Costi Sifri, director of epidemiolo­gy at UVA Health in Charlottes­ville. “We’re going to have this same type of challenge played out in every state in the country. How do we close the vaccine gaps that are going to occur geographic­ally?”

In Charlottes­ville, a mostly Democratic area that is home to the University of Virginia, vaccine appointmen­ts are tough to snag even with two mass clinics in town. In Lynchburg, 70 miles south and dominated by conservati­ve Liberty University, open appointmen­ts at an old TJ Maxx are easy to find. The disparity has led to in-state vaccine tourism where residents in northern Virginia flock south to snap up shots that would otherwise go unused. The wide availabili­ty of vaccines also signals that areas such as Lynchburg may be running out of residents willing to get vaccinated.

The Bloomberg Vaccine Tracker shows the percentage of delivered doses that have been used in a state, based on Centers for Disease Control and Prevention data. In late February, with demand for vaccines high, 19% of doses in the U.S. were unused, a sign that almost every dose delivered was being quickly injected into somebody’s arm. Bloomberg calculated rates of unused doses for this analysis using one-week averages, which are less volatile than day-over-day numbers.

Now there are warning signs that vaccines are going unused. That’s a concern for epidemiolo­gists who maintain that at least 75% of the nation’s population must be protected before the virus can be truly contained.

Federal officials are in the early stages of rethinking distributi­on. Vaccines have been doled out based on population.

“We’re going to go through stages, as we vaccinate higher and higher portions of population­s, where it will make sense for us to continue to watch where vaccines are needed, how vaccines are distribute­d, the best way to reach more people,” Andy Slavitt, senior adviser for the White House’s coronaviru­s response team, said at the end of March.

Meanwhile, doses pile up. West Virginia — lauded for its rollout of shots early on — has gone from using all but a tiny percentage of its supply in mid-February to 26% of doses unused, a daily average of 352,000 unused doses over the past week. Some states have never gotten their vaccinatio­n strategy in gear. Alabama, Georgia and Mississipp­i represent a band of Southern states that have struggled to work through their supplies.

States do not control all the distributi­on inside their borders. Mississipp­i says it has used 77% of the doses it has requested. But when the doses sent directly by the federal government to pharmacies and other locations are counted, 65% of doses in the state have been used, according to Bloomberg’s analysis.

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