Covid-19 vaccine’s slow U.S. rollout could portend more problems

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Covid-19 vaccine’s slow U.S. rollout could portend more problems


Three weeks into the most ambitious vaccination campaign in modern U.S. history, far fewer people are being protected against Covid-19 as the process moves more slowly than officials had projected and has been beset by confusion and disorganization in many states.

As a result, the federal government came nowhere close to vaccinating 20 million people by the end of 2020, as it had promised.

Of the more than 12 million doses of vaccines from Moderna Inc.
MRNA,
-5.99%

  and Pfizer Inc
PFE,
+0.19%

with BioNTech SE
BNTX,
-2.88%

  that have been shipped, only 2.8 million have been administered, according to federal figures.

The shortfall is due in part to a lag in reporting data using new tools, government officials and health experts said, but as the federal government has left it to states to determine what to do with the vaccines it ships to them, and with some states pushing decision-making to local health departments and hospitals, the process has gone far from smoothly.

People in Florida are waiting in hours-long lines to get shots on a first-come, first-served basis. Some West Virginians got a Covid-19 treatment instead of vaccines. A medical practice in Texas had only two workers sign up to take the shots. While some states received fewer doses than they expected and some hospitals got their first ones this week, other health care providers have more doses than they know what to do with and are scrambling to find enough syringes to use them.

“Hospitals aren’t vaccinating everyone at the flip of a light switch,” said Claire Hannan, executive director of the Association of Immunization Managers, which represents state immunization officials. “There may have been an expectation from Operation Warp Speed or others that we’d give everyone the vaccine overnight.…It was a logistics equation for them. If you’ve been in vaccines for a long time, you know that’s the easy part. Getting it into actual arms is the hard part.”

So far, vaccines have mostly gone to health care workers and residents of long-term care facilities, in line with guidelines from the Centers for Disease Control and Prevention. Essential workers like bus drivers or grocery clerks, plus older adults, are expected to be vaccinated next in 2021 as supplies increase and as more vaccination sites come online. The slow rate of vaccinations so far has raised questions about whether those groups will start getting shots this winter and the rest of Americans in the spring, as initially projected.

Moncef Slaoui, chief adviser for Operation Warp Speed, the U.S. government’s coronavirus response program, and other federal officials said they hope the pace will increase. “We agree that that number is lower than what we hoped for,” he said at a news briefing Wednesday. “We know that it should be better, and we’re working hard to make it better.”

Public health officials and states say uptake is lagging for several reasons, beginning with holiday seasons that have kept staff of hospitals and nursing homes away from work. They also note they are facing high percentages of people, including some health care workers, who are skeptical of taking the shots.

Hospitals and other sites are staggering appointments to avoid pulling too many workers from caring for patients amid a nationwide surge in Covid-19 cases, officials say. Administration of the vaccines also takes more time than a typical flu shot, particularly since they are being done socially distant, and may be preceded by a Covid-19 test.

In addition, people who receive vaccines are being monitored for at least 15 minutes in case of allergic reactions. At least 11 allergic reactions to Covid vaccines have been reported, according to the CDC. No serious safety concerns have been found, in line with findings from the clinical trials.

The federal government is sending vaccines to states based on their populations, and it has provided guidelines, but no rules, about how they should be distributed. State and local jurisdictions have been asking the federal government for more funding to support vaccine distribution than the $340 million disbursed so far. The economic stimulus package recently signed into law by President Trump contains an additional $8 billion.

Different state policies have led to confusion and shipment delays for hospitals, said Michael Wascovich, vice president of field pharmacy services for Premier Inc., a group purchasing organization whose members include 4,100 hospitals, 80% of which received doses.

“Every state is doing what they want to do,” he said. “You could be in Philadelphia and it’s completely different across the river if you’re in Trenton or Camden.”

Many states are following CDC guidelines to start with front-line medical workers and people in long-term care facilities, but not all. Florida Gov. Ron DeSantis on Dec. 23 extended eligibility to people aged 65 and older.

Now, some public health officials are concerned the country may not be ready for the next phase of vaccination, expected to include essential workers such as grocery store clerks or first-responders.

The U.S. health system and its stretched local health departments weren’t prepared for the volume to vaccinate an entire country in a few months, according to Ms. Hannan, the director of the immunization association.

An expanded version of this story appears on WSJ.com.



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