In just a few days, the United States is unlikely to meet its goal of vaccinating 20 million Americans by the end of the year as the nation launches a historic US campaign to vaccinate hundreds of millions of people against the coronavirus in mid-next year.
Two Covid-19 vaccines from Pfizer-BioNTech and Moderna have now received emergency clearance from the Food and Drug Administration, paving the way for the first handful of frontline healthcare workers and vulnerable long-term carers to be vaccinated against the virus.
The Trump administration’s vaccination program, Operation Warp Speed, called for 40 million doses of vaccines to be provided between the two companies by the end of the year, which would have been enough for about 20 million people, as each drug requires two vaccinations at different intervals.
By Tuesday, however, it appeared to be falling far short of that target: the Centers for Disease Control and Prevention said a little over 11.4 million doses had been given since December 13, but only about 2.1 million had been given were. The CDC found a number of reasons for the significant difference in the number of distributed doses that remained to be administered.
Part of the problem is a delay in data reporting, the agency said, while other issues are with how jurisdictions manage their assignments. The federal government’s partnership with large pharmacy chains such as CVS and Walgreens, which are tasked with vaccinating long-term care residents, is still pending, according to the CDC.
But even if it counts too little, the United States is still “below where we want to be,” said White House coronavirus advisor Dr. Anthony Fauci, opposite CNN’s “New Day” on Tuesday.
“I think when we get into January we will see an increase in momentum,” said Fauci, adding that he hopes the pressure will be enough to “catch up to the planned pace, which we have over a month or so.” Had spoken a month ago two. “
Still, just a few months ago, the federal government’s forecast of how many doses would be available was much higher than the eventual 40 million threshold. In October, during a keynote address at a Goldman Sachs virtual event, Secretary for Health and Human Services Alex Azar said that up to 100 million doses could be available. An HHS spokesperson was not immediately available for a request for comment.
There were also notable hurdles along the way. President Donald Trump’s Covid-19 vaccine tsar Moncef Slaoui admitted to reporters last week that the 20 million target “is unlikely to be met” and the surge in vaccinations is “slower than we expected”.
U.S. Army General Gustave Perna, who oversees the logistics for Operation Warp Speed, made repeated apologies shortly after the Pfizer vaccine was first distributed after some state officials reported that the dose allocation had been cut, and it was not made clear who was to blame.
“The mistake I made is not really understanding – again my responsibility – what steps are needed to make sure the vaccine is releasable,” Perna said at a press conference.
In a statement to CNBC, Pfizer stated that each batch of their vaccines must receive “Certificates of Analysis” at least 48 hours prior to distribution under the company’s emergency approval from the FDA. While it was not clear whether the certificates were the reason for the discrepancy between the numbers Perna originally gave to the states, those estimates were trimmed because the cans were not available for release.
“We were too ambitious with our first rollout,” said Dr. Leana Wen, former Baltimore health commissioner. “Here’s what happened. Here’s what we’re going to do to fix it. We should hear that.”
It just gets harder from here
The slower-than-expected initial rollout affects this early on as “this should be the easy part,” Wen said.
Because doses of approved vaccines are so scarce, the federal government encouraged states to initially only vaccinate health care workers and long-term care residents, meaning hospitals and pharmacies that have partnered with long-term care facilities are responsible for administering shots .
If the government gives a wider segment of the population the chance to get the shot, vaccine doses will have to be given outside of hospitals and nursing homes, which could create more challenges, said Wen, emergency doctor and public health professor at George Washington University.
“When we talk about people in the community who come to places like pharmacies, doctor’s offices … that’s the hard part,” Wen said in a telephone interview.
True number probably “much higher”
State and local officials expected some early hiccups, which is partly why the government decided to start with healthcare workers, said Dr. Marcus Plescia, Chief Medical Officer of the Association of State and Territorial Health Officials, in a telephone interview.
“There are kinks that need fixing and this has probably been a good population to work on,” he said, adding that prep is a quick process. “It was just quick preparation for this launch, and states and locals are getting a lot of the information they need at the last minute.”
So far, however, Plescia has added that he has not heard of a “great snafus” and that he expects the pace of vaccinations to really pick up in January. Plescia said he believes the actual number of doses given is also “significantly higher” than the number published by the CDC.
That’s because the CDC likely relies on state vaccine records that are way out of date, he said. The quality of government registers varies from country to country, but “I wouldn’t call even the best IT systems of the 21st century,” he said. The Christmas and New Year holidays are also likely to affect hospitals’ ability to vaccinate their staff.
“We are in the middle of one of the biggest national holidays of the year and everyone has had a pretty difficult year. I think people are really taking time out,” he said. “That will certainly slow down demand.”
For example, the Riverside Health System in Virginia began vaccinating its frontline health workers on December 16, but decided to limit the number of appointments in the first few days, Riverside chief pharmacy officer Cindy Williams previously told CNBC in a telephone interview. This would allow the health system to determine how much demand there would be and get a sense of how their strategy would work, she said.
“We found that we were far more efficient than we expected,” said Williams, adding that in some cases, Riverside Health has tripled the number of appointments in a given period. Williams said they would not hold appointments on Christmas Eve and Christmas Day and planned to resume vaccinations on Monday.
“We’re speeding things up pretty quickly and we’re also finding that the team members were very willing to sign up for the clinics,” said Williams.
Some good news
States and local jurisdictions got some good news this week after Trump signed the coronavirus support and government funding package on Sunday: $ 8.75 billion in additional funding for their vaccine distribution programs.
The money, which meets the demands of the national organizations, would help pay additional staff for vaccination clinics, sufficient resources for the safe storage of cans at extremely low temperatures, needles and other critical supplies, and increased communication efforts to convince people, among other things the safety of the drugs.
The financing has been a long time coming. For months, state and local health departments have been asking Congress to allocate more than $ 8 billion in additional funding to carry out its vaccine distribution plans, which were finalized in October and presented to the CDC.
“This money is late,” said Adriane Casalotti, director of government and public affairs for the National Association of County and City Health Officials.
“This should have been done in spring and summer so people can do some of the build before the vaccines are available. Now they are trying to do the build while vaccines are available,” Casalotti said.