Operation Warp Speed (OWS) -the program that spurred the creation of the COVID-19 vaccine– has been one of Trump Administration’s and the American private health sector’s great victories. They’ve worked together and achieved the feat of having a coronavirus vaccine in record time for the country. But there is one challenge that, for the moment, is not meeting expectations: the massive vaccination process in the United States.
There are many criticisms about the organization of the vaccination process, mainly concerning communication between the federal and state governments. The administrations of the different states of the union claim that if they do not have clear information on how many doses they are going to have and when they will receive them, the organization and logistics become more complex.
Despite that, Bloomberg noted that vaccination in the United States began on December 14 with healthcare workers, and so far (January 26) some 22.73 million vaccines have been administered of the 41.42 million that have been distributed for a total of 54.9 percent. 19.25 million people have received at least one dose of vaccine, and 3.35 million have received both doses.
In the last week, an average of 1.16 million doses were administered per day and on Monday, January 25, the number of vaccinees increased to almost 1.5 million.
What does this mean? That the pace of administration has picked up, the states and their health systems started quite slowly in December and, as the days went by, they improved the vaccination process.
This, which can be good, now also means a problem in the immediate future, as there are inoculation centers that are running out of vaccine and this frustrates health authorities because they have to cancel appointments until they receive the doses.
“Health authorities are frustrated because the available doses are not being used while the virus is killing thousands of people every day. Many vaccination appointments have been canceled,” reads an article in The New York Times.
For example, by Saturday, January 23rd, the Houston hospital system looked in danger of running out of doses and, as a result, had to cancel appointments. “All of a sudden, vaccine distribution stopped,” said Dr. Esmaeil Porsa. “It’s disconcerting and frustrating because I keep hearing that there are high percentages of vaccines that have been distributed, but not administered.”
According to the Times statistics, Texas is one of the states with the best percentage of doses given (57%) relative to the number of doses received (3,070,825). Some 1,763,299 doses of vaccine have been administered so far.
In that sense, the data is quite clear: the states that received fewer doses have had more effective logistics to make better use of the vaccines distributed.
For example, West Virginia, whose governor is Republican Jim Justice, has used 83% of the doses received (243,100). In percentage terms, it is the best performing state, but also one of the states that received the fewest doses.
According to The New York Times, of the 50 states, 43 and Washington, D. C., “have begun vaccinating the elderly. Many of those states initially offered the vaccines only to medical workers and nursing home guests. And at least 39 states and Washington, D.C., have expanded their occupation-based vaccination programs to include some non-medical workers, such as police officers, teachers, grocery store clerks or others at risk of being exposed to the virus on the job.”
“The sudden expansion of vaccine eligibility has caused problems as states tried to increase capacity and people tried to figure out how to sign up for appointments.”
Communication needs to be improved
The vaccination process caught the country in a governmental transition. Therefore, communication between the states and the federal government has not been the best in this first month of vaccination.
“Health officials are desperate for the federal government to clarify vaccine shipments, saying they need accurate numbers to plan weeks in advance,” reads an article in The Hill. “Instead, the numbers have come in only one week at a time and have not been consistent.”
Joe Biden’s administration has said it will work to improve communication, but has not shown a concrete plan to simplify and clarify distribution, raising concerns as coronavirus cases and deaths increase daily.
Beyond the fact that only slightly more than 50% of the distributed doses have been administered, “experts say those numbers do not paint a complete picture, and do not necessarily mean the vaccines are unused.”
“I know there is a perception that the vaccine has not been distributed quickly enough, but that is not the case,” said Mississippi state health official Thomas Dobbs.
“Most of the doses we’ve given to the health systems to distribute, and they’re really starting to distribute them. I think we’re going to run out of vaccine soon, and there will be people who say, ‘Now it’s my turn. Why can’t I participate,'” Dobbs said.
The increase in eligibility, which a priori was a measure to prevent doses from going unused, now represents a problem because demand has increased and supply has not.
“States have made adjustments. They’re opening up [eligibility] to more people. But, you know, their allocation is not increasing, so that’s why you’re seeing states asking for more doses,” said Claire Hannan, executive director of the Association of Immunization Managers.
For this reason, criticism fell on Trump’s Administration, as its officials recommended that they open up eligibility for the vaccination process, but the supply did not increase. The Biden Administration has not said, as yet, how they can increase distribution.
Biden, who recently said he could do nothing to change the trajectory of the virus, promised that 100 million people would be vaccinated in his first 100 days.
Given that the states and their health systems have improved the vaccination process, passing the one million doses administered per day mark, the reality is that Biden can meet his challenge if he improves the distribution processes and delivery to the states. The question is how?
There are those who have wondered about a supposed federal vaccine stockpile, but the reality is that no such thing exists. “There is no significant vaccine stockpile to speak of. For the most part, vaccines are being shipped each week as they are manufactured. (The exception is a small emergency stockpile that the Biden administration has said will continue),” says The Times.
The stockpile doses were already intended for booster shots for people who had received the vaccine, not to supply states with more vaccine.
To improve this situation, the outgoing Trump administration, in the voice of Alex M. Azar, outgoing secretary of Health and Human Services, said the government will switch to a new model: “instead of maintaining a stockpile of booster vaccines, each weekly shipment from manufacturers will include doses for new people, as well as second doses for those who should receive their booster vaccines. President Biden echoed this policy in announcing his vaccine plan last week.”
Azar was the one who generated confusion regarding the dose stockpile by giving a miscommunication about the distribution of doses. He said the federal government would release a stockpile and states believed it was an influx of vaccine on the way to vaccinate more people and not those who had already been given the first dose.
Priority: people with a vaccine
As vaccines are being shipped as they are manufactured, the priority now will be to administer the second dose to people who have already been inoculated for the first time.
“Federal officials have previously said they were working with states to track who has received a vaccine, and when they should receive their booster shots, which is three weeks later for Pfizer’s vaccine and four weeks later for Moderna’s,” the Times reads.
This mission will require, above all, an effective partnership between the federal government and all the states.
Will the vaccination process in the United States continue normally?
There are concerns that certain centers in the country ran out of doses momentarily and had to cancel appointments. This should not be a concern because it is unlikely that vaccines will be in short supply in the US.
“At least three other vaccines are in late-stage clinical trials, and the success of any one of them could mean millions more doses for U.S. residents by this spring,” the Times reports.
According to the New York media outlet’s “conservative” estimates, there should be enough vaccine for the entire country by this summer.
For example, if none of the other three vaccines (Johnson & Johnson, AstraZeneca and Novavax) are licensed, the U.S. has signed agreements with Pfizer and Moderna for a total of 400 million doses to be supplied by the summer, enough for 200 million people.
“This is pretty close to the U.S. population of 260 million adults (the vaccines are not yet approved for children, although studies are ongoing).”
So, sooner rather than later, Biden will have to implement from the Federal Government a plan effective enough to improve vaccine distribution and increase the pace of the vaccination process.
For the time being, although there are criticisms and concerns, the reality is that the United States is currently the country with the most people vaccinated and with a vaccination rate that is increasing day by day. And this was achieved in the midst of the transition of power.