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More than a dozen states are now reporting that the federal government has reduced its allocation of COVID-19 vaccines, raising questions about the Trump administration’s planning for the distribution effort.
Immunization and medical supply chain experts TPM contacted expressed dismay and confusion at the situation.
States from California to Maine said their vaccine allocations had been reduced while Pfizer, the manufacturer, said it had “millions of additional doses in our warehouse, but so far we haven’t received no shipping instructions for additional doses. “
To Bruce Y. Lee, a professor of health policy at CUNY who helped model the deployment of the H1N1 vaccine, this suggests a logistical problem.
“When vaccines are produced and they stay in the warehouse, it means something has gone wrong with the supply chain,” Lee said. “That it wasn’t coordinated.”
He added that the reduction in vaccine shipments, in some cases by 30% and in some cases by much more, comes amid concerns about “what’s the plan with the supply chain and the delivery system, and this was not very clear.
Officials for Operation Warp Speed and the CDC informed states of the reduction in vaccine shipments during a call Wednesday, blaming the problem on manufacturing issues at Pfizer. HHS Secretary Alex Azar did the same in an interview Thursday morning.
Pfizer has denied this, saying it has yet to receive any orders on where to send the doses it has.
“It’s very difficult to plan when you have no idea what you are getting, or you have an idea that is wrong,” Claire Hannan, director of the Immunization Action Coalition, told TPM.
Mark Capofari, former director of global logistics at Merck, said the supply chain for an effort like national vaccine distribution was extremely complex, and added that it was not clear whether the Trump administration had[ed] the number of patients they can fully immunize from the start. “
The Trump administration has tried to account for the problem by telling states that they are simply incorrect. According to an HHS spokesperson at TPM, “Operation Warp’s speed allocation numbers locked with states have not been changed or adjusted.”
The spokesperson added that Operation Warp Speed provides official allocation numbers to states for the coming week and that no further numbers should be relied on.
But Hannan said HHS effectively sets the “official” allocation number to the final amount in the shipping queue a few hours before doses arrive.
“I think it’s really hard to hear HHS come out and say it’s incorrect, that their allowances haven’t been cut,” Hannan said. “And then hear them say it’s a planning estimate, and don’t count on it until he’s actually in the queue to place the order.”
“If we do that, if we wait for something to be in the queue to order, then there is no planning at all,” Hannan added, claiming that it dramatically cuts the time that states have to order. plan to distribute the dose allowances they receive.
Logistical problems are compounded by the continued lack of federal funding or support for those who actually inject the vaccine at the state and local levels.
The mystery of where the vaccine doses went and why they were not shipped remains. Operation Warp Speed works with FedEx and UPS to distribute Pfizer doses; neither company has provided an explanation as to what might be happening.
FedEx referred TPM to the government, and said it was working “to transport the vaccines in accordance with their allocation and distribution plans. It is not for us to decide who will get the vaccines.
UPS said three vaccine packages on Thursday were delayed, but are expected to be delivered by the end of the day.
HHS Assistant Secretary for Health Adm. Brett Giroir said in a statement Friday that the government was withholding doses for the second dose of the two-dose vaccines.
Nobody leaves #Vaccines against covid sit in a warehouse! We need to reserve doses for the 2.9 million vaccinated this week to ENSURE they are supplied in 21 days. There is also a 500k emergency reserve. Expect 7.9 million vaccines to be shipped in the next few weeks (Pfizer and Moderna).
– ADM Brett P. Giroir (@HHS_ASH) December 18, 2020
Hannan said Giroir’s figures would only represent a portion, but not all, of the doses withheld.
“Mathematically, there are more doses that have to be taken into account,” Hannan said. Operation Warp Speed has pledged to deliver 20 million doses by 2021.
“If they’re withholding doses, how did they find that exact number? And how does that fit in with the production schedule? Lee asked.
Lee added that it was not clear to him why the Trump administration would coordinate the second dosage nationwide after delegating the rest of local distribution policy to state and local authorities.
“You can’t have it both ways: if you have to coordinate when people come back for the second move from the national level, you have to decide how you are going to distribute from the national level,” he added. .
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