The deployment of the COVID vaccine is missing by millions of doses. Here’s why.



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The Trump administration has fallen behind on its original pledge to vaccinate 20 million Americans by the end of 2020, with fewer than 3 million people receiving COVID-19 vaccinations of the 14 million doses shipped. Local health 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 mistakes have also hampered the national effort. vaccination.

The first sign that the administration had over-promised came in late December, when authorities changed their promise – to vaccinate 20 million Americans by the end of the year to promise to “make vaccine doses available.” To 20 million. Senior adviser to the federal immunization effort known as Operation Warp Speed, Moncef Slaoui, admitted this month that “the toll of vaccinations – the shots – is occurring is slower than we think it is. pensions. “

“This number is lower than what we expected,” Slaoui admitted again during a briefing on Wednesday. He called on anyone who could “help us to further improve vaccine delivery to come to the table, roll up our sleeves and come and help us with specific ideas.”

The Department of Health and Social Services said Tuesday it has allocated 19.88 million doses of COVID-19 vaccine until the end of December. But attribution is not the same as administering doses. Allocated vaccines must always be shipped to destinations selected by states and, in some cases, redistributed by national and local health authorities before the health care providers administering the vaccines can begin preparing their first doses.

“We are distributing vaccines as quickly as they are available,” said Gustave Perna, the army general responsible for overseeing the logistics of vaccine distribution.

Although vaccine manufacturers and federal officials insist there were no major delays in producing or distributing the first 20 million doses, only 70 percent of the promised vaccines were shipped. Some suppliers have reported that they only started receiving their first shipments from state redistribution centers this week – days after they hoped to start vaccinations.

States received fewer doses of the vaccine than were originally allocated to them by the federal government. Earlier this month, Perna apologized for his “lack of communication” on vaccine allocations; he had revised the number of doses to be sent to certain states after receiving more information from Pfizer on what was available.

“It is disturbing and frustrating. We need precise and predictable numbers to plan and ensure success on the ground,” said Washington Governor Jay Inslee. at the time.

Washington officials said they were among dozens of states whose vaccine shipments have been cut – in their case by 40% – by federal officials, although this particular issue appears to have been resolved. Inslee later praised Perna for his “frankness” in explaining the problem, saying “There is no indication that further reductions are likely to occur. This is good news.”

Administration of 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 the vaccination figures were ” a day or two late “.

Vaccine suppliers have 72 hours to submit data on their vaccinations, which Dr Nancy Messonier, the CDC’s top COVID-19 vaccine official, said on Wednesday takes into account that “when they’re looking so quickly to get people vaccinated, it may take them a bit of time to be able to enter all the data. ”

It has not been easy for vaccine providers to navigate the prioritization levels defined in state and federal guidelines, balancing the demands of vaccine prioritization for healthcare workers with the pressure to administer vaccines quickly.

Vaccines have also been frustrated by the roll-out in long-term care facilities, after misunderstandings over consent requirements, has hampered the launch of vaccination programs by drugstore chains like CVS and Walgreens. Spokesmen for both companies said snafu consent had been straightened but declined to share specific figures on their vaccinations, which began nationwide last week.

But pharmacies have yet to start vaccinations in long-term care facilities in some jurisdictions, Messonier said, as some clinics hold on to doses until they have enough vaccine “for everyone in the world. the facility that wanted the vaccine. “

Giving the vaccine to people who are not on the highest priority list also delays reporting who is receiving the vaccines. Vaccine beneficiaries seeming to “cut the line” sparked outrage across the country, leading to protests by frontline healthcare workers at Stanford Medical Center and an investigation into some New York vaccine providers. New York Gov. Andrew Cuomo signed an executive order on Monday cracking down on vaccinators who do not follow the priority population process, fining violators up to $ 1 million and revoking all licenses, according to CBS New York .

Southern California hospital defended decision to vaccinate “non-frontline healthcare workers” after reporting that a Disney employee bragged that her connections got her a vaccine against COVID-19.

“Because the reconstituted Pfizer vaccine must be used within hours or be discarded, multiple doses were given to non-frontline health workers so that the valuable vaccine was not thrown away,” the spokesperson said. of Redlands Community Hospital Nikyah Thomas-Pfeiffer in a statement. .

While in Texas, officials urged vaccinators to “pivot” to administering doses to all “readily available and willing” residents, even though not all frontline health workers had been vaccinated.

“It has become clear that a significant portion of the vaccine in Texas may not yet be given. We know you have valid reasons as to why this has happened in some cases – but we also know that every day a vaccine is on the shelf is another. day that prolongs the pandemic, ”said Dr John Hellerstedt, Texas’s top health official, in a letter to clinics last week.

In Florida, local health departments are pleading for patience because telephone lines an accident and healthcare workers lining up overnight outside vaccination sites, competing with other residents demanding the vaccines.

“Empty pockets”

The rush to distribute millions of doses of vaccine comes after a year that had already exhausted public health budgets. “These health services are entering the vaccine distribution period with their pockets already empty. They have not received enough money from the additional funds from COVID,” said Tremmel Freeman.

The Trump administration boasted the $ 480 million given to local jurisdictions for influenza and COVID vaccinations in September and December, with Operation Warp Speed ​​providing syringes and other supplies to vaccinators across the country.

National and local health authorities will receive help from the recently passed COVID-19 relief bill, which has earmarked billions of dollars for vaccine development and distribution, although Tremmel Freeman said the money was not available. not yet reached frontline health providers trying to scale up their immunization. programs quickly.

“I haven’t seen any language that holds anyone accountable for making sure the money goes beyond the state level in the community to help with this effort either. We’ve seen this happen with testing. and the tracing, and let’s look at the disaster that happened there, ”added Tremmel Freeman.

The timing of the vaccine rollout also collided with the Christmas and New Years holidays, which put a strain on the workforce.

“There are two statutory holidays, there have been three major snowstorms, there is everyone working, you know, how to do the notification, how to make sure that we are administering it the right way”, Perna said on Wednesday.

The public now has a clearer view of how vaccine delivery unfolds: On Wednesday, the CDC unveiled a new virus delivery tracker that allows users to see how many doses have been dispensed and administered each day.



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