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President Biden’s ambitious plan to improve the rollout of the US coronavirus vaccine has run into a problem.
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About 20 million vaccine doses are missing, according to Politico. The government has delivered them to states, but states have not delivered them to patients.
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The Trump administration could not keep track of where vaccine doses went and once they were delivered to states.
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President Biden has ambitious pandemic plans for his first few months in office: by mid-February, he plans to commission 100 federally-sponsored coronavirus vaccination centers. By the end of April he wants 100 million doses in the arms of Americans, for which an average of 1 million injections per day must be given.
But his administration already has a catch during the first 10 days in the White House: Some 20 million COVID-19 vaccine doses have not been taken into account – the federal government paid for them and delivered them to states, but there is no record that those doses have been distributed to patients.
Biden’s newly minted COVID response team has spent the past week trying to manually locate these millions of missing doses by calling officials and health care providers from various states, Politico reported Saturday.
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“I think they were really taken aback by that,” a Biden adviser told Politico. “It’s a mess.”
The previous government chose not to track vaccine doses through every step of the pipeline from federal to state to patient; Operation Warp Speed, the vaccine rollout program initiated by Donald Trump, prioritized dose distribution and did not require state updates of what happened to their doses until the injections were administered.
Fifty million doses have been distributed across the U.S. states as of Sunday, but only 31 million of those doses have been administered nationwide, according to the CDC.
To speed up vaccine roll-out in the country, Biden’s team needs to figure out what explains the big difference between distributed and administered doses – and what the delay is.
‘Nobody had a complete picture’
The Trump administration hoped to vaccinate 20 million people by the end of 2020, but fell short in part because it took no responsibility for overseeing the state-level vaccine rollout.
Many state health departments have said they lack funding and staff to administer mass vaccinations. In the past month, vaccine shortages have forced clinics in states like Virginia to cancel vaccine appointments.
Biden called the vaccine rollout under Trump “a dire failure.”
The Trump administration did not provide detailed data on how federal-to-state distribution worked to members of Biden’s transition team ahead of the January 20 inauguration.
Although the federal government has a vaccine distribution tracker called Tiberius, the transition team didn’t get access to this information until days before Biden took office, Politico reported. It then took some time for Biden’s COVID response team to discover that Tiberius only tracked how many doses states had received, and listed records indicating when and where doses were administered.
Every part of the process between those two steps – the distribution of vaccines to states and the vaccines thrown into the arms – was an untraced black box.
“No one had a complete picture,” Julie Morita, a member of the Biden transition team, told Politico. “The plans that were made were made on the assumption that more information would be available and revealed as soon as they entered the White House.”
‘There are places with vaccines that don’t use them yet’
State public health systems presumably keep track of where vaccine doses are stored, when they are shipped from state warehouses to clinics, and how many doses are where. But for now, the federal government has no idea what that tracking looks like and what distribution plan each state is following.
Biden’s advisers told Politico that the missing doses are scattered across states, but that the COVID response team shouldn’t track them all down or figure out why the vaccines aren’t being given immediately.
“Much of our work over the next week will allow us to tighten the timelines to understand where the vaccine is in the pipeline and when exactly it will be administered,” said Rochelle Walensky, the new director of the CDC. USA Today Thursday.
A delay in reporting is likely responsible for 10% of the missing doses, two officials told Politico. It takes up to three days for states to report that they’ve given an injection.
But the other 18 million doses still unlisted are in limbo – stored in freezers and warehouses, held in reserve in clinics or on the road – across the country.
Some states, concerned about impending vaccine shortages, are keeping hundreds of thousands of doses in reserve, so citizens who have received their first doses are guaranteed to receive a second dose after the required three or four week interval.
The Biden administration hopes that greater transparency about when and how many doses will be shipped to states in the next three weeks will encourage government officials to stop holding doses in reserve.
“We know there are places in the country without enough vaccine, and at the same time, there are places with vaccines that aren’t using them yet,” Andy Slavitt, senior adviser on the COVID response team, told USA Today. “This is a natural challenge that states are facing.”
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Originally published