By Ellie Kaufman, Annie Grayer, Sara Murray and Andrea Kane | CNN
As the coronavirus pandemic continued to worsen throughout the summer and fall, federal government officials repeatedly offered a ray of hope: enough vaccine doses to vaccinate 20 million Americans by the end of December.
But after the first week of vaccine distribution and with only nine days left to meet their self-imposed deadline, Operation Warp Speed is on track to fall far short of 20 million armed shots.
One count, from the U.S. Centers for Disease Control and Prevention, shows that on Monday morning about 11.4 million doses were distributed and about 2.1 million administered – not even close to Warp’s originally stated goal Speed.
Officials at US Health and Human Services and the CDC say the agency’s numbers undervalue many vaccinations due to data delays, but even considering delays, the US vaccination program appears to be taking longer than the Warp Speed officials predicted.
An early hurdle: A two-day requirement by the U.S. Food and Drug Administration to review each shipment of vaccines for quality control slowed distribution. States were told by OWS to expect fewer doses in week two than originally planned. With the number appearing to be farther from reach of 20 million, OWS officials acknowledged last Monday that they may not get there until January.
“We still have a strong sense that we will have allocated 20 million vaccine doses to the states by the end of the year,” General Gustave Perna, Chief Operating Officer of Operation Warp Speed, said in the Dec. 21 call. “We are confident that we will distribute the last part of that vaccine by the first week of January at the latest, so that everyone has access to it.”
An HHS official said nearly 16 million doses have already been allocated to states and jurisdictions to order. But as more vaccine doses are available, both Operation Warp Speed and the state and healthcare partners receiving the vaccine will also need to be able to scale up the complicated distribution and logistics needed to get vaccines from point A to point. B to get.
“It seems ambitious to get to 20 million by the beginning of the year,” said Dr. Marcus Plescia, chief medical officer of the Association of State and Territorial Health Officials.
Still, “people seem to be very encouraged about how the vaccinations are going,” Plescia added. “Everyone seems to feel that they are using whatever supplies they have.”
Imperfect data
The vaccination effort is almost certainly going faster than the low numbers the CDC data reveals. In addition to launching new vaccination programs, states are also grappling with new vaccination reporting tools, delaying data. The latest figures also don’t include most of the larger vaccination efforts underway in long-term care settings this week.
CDC distribution data has just begun to include the Moderna vaccine, which has been rolled out to more than 3,500 locations. While the CDC plans to update the data regularly, the daily updates won’t begin until 2021. Some states, such as Michigan, report their own data, but that state-level reporting is also lagging behind.
Lynn Sutfin, an official with the Michigan Department of Health and Human Services, pointed out that the state’s dashboard is not updated in real time and providers have up to 24 hours to upload their administered doses into the vaccine registry.
Michael Pratt, Operation Warp Speed’s chief of communications, praised the federal government’s progress so far.
“These doses are distributed to the American people at the direction of the states as soon as they are available and released, and the rapid availability and distribution of that many doses – with 20 million doses expected to be allocated for distribution just 18 days after the first. . vaccine received emergency use approval – this is testament to the success of Operation Warp Speed, ”Pratt said in a statement to CNN.
‘We still haven’t started’
On top of states that are reconsidering the reality that they will receive fewer doses of Pfizer’s Covid-19 vaccine than initially promised in the coming weeks, they are juggling how to make sure every dose they receive is delivered on time.
While vaccines have been sent to every state, in some areas, vaccinations are only just getting started. Mayor Nan Whaley in Dayton, Ohio, told CNN on Tuesday that her city had not yet begun administering vaccines, although the vaccinations began in Ohio on Dec. 14.
“To date, we still haven’t started distributing vaccines in Dayton,” Whaley said Tuesday, adding that Christmas Eve is the first day someone from Dayton receives the vaccine.
“We are not a big city getting these assets quickly. We’ve talked about how testing has been very slow in communities like Dayton and across the country, and I’m afraid vaccine distribution will be slow too, ”she added.
While all states have data on the number of people getting vaccinated, only 23 states have released that information publicly, according to a study from Johns Hopkins University.
CDC and state figures are not a real-time reflection of the vaccinations taking place on the ground, but they raise questions about how states are ensuring their entire supply is used efficiently. The time lapse between the doses received and the doses administered begins to become even more daunting when one considers that every state will receive more doses of Pfizer and first round doses of Moderna last week; in many cases, the first week’s doses have not yet been fully administered.
In Michigan, the state’s Covid-19 vaccine dashboard on Dec. 28 shows that only 37,660 doses of the vaccine were delivered out of the 231,075 doses sent to the state. Sutfin said the delay in shipments and the delay in data updates explains the discrepancy.
While Michigan received more than 84,000 doses last week, not all were received the same day. Vaccine is delivered daily to hospitals and local health departments across the state. As they understand more about surgery and clinic flow, we expect the time from receipt to administration to decrease, ”Sutfin told CNN.
Sutfin also outlined that the process for unpacking, inventorying, thawing and coordinating each dose of vaccine “takes time, so it is expected that there will be a difference at any time between the vaccine received and the doses administered.”
In Florida, 118,764 people have received the Covid-19 vaccine as of Monday morning. The state initially received 179,400 doses from Pfizer.
Mary Mayhew, president and CEO of the Florida Hospital Association, told CNN that reconfiguring the clinical space in a socially detached way and allocating staff to administer vaccines explain why the initial number of people vaccinated does not match the available vaccine.
“I am convinced that hospitals are efficiently and effectively deploying essential resources to support the urgent delivery of vaccines to primary care health workers,” Mayhew said when asked if she was concerned about the discrepancy. “Hospitals are working with other community healthcare partners to support timely distribution of the vaccines.”
While states oversee the vaccine distribution process, many national health departments or government offices have left the actual administration of the vaccine to the specific hospital, long-term care facility, or pharmacy that would receive the shipment. This decentralized structure can cause some delay in learning if there are weaknesses in the process.
Dr. Mississippi health officer Thomas Dobbs explained in a press conference on Tuesday that it was not the job of the state to ensure that vaccines actually got into people’s arms once they were assigned to long-term care facilities.
“They haven’t started vaccinating yet,” Dobbs said, referring to long-term care facilities, “but we’ve allocated enough to get started, so they’re in the process of setting up that institution. And you know, that’s something we have no control over. But you know, in a few weeks they’ll get that rolling. ”
‘It’s a bit frustrating’
Dr. Ashish Jha, Dean of the Brown University School of Public Health, said he is not surprised at some of the early problems with the vaccine rollout.
“It’s a bit frustrating because it’s not like we didn’t know vaccines were coming,” he told CNN’s Kate Bolduan on Monday.
“It’s going to be a little slower – again, better planning would have gotten us faster, but here we are and let’s get these vaccines to the right people as soon as possible,” he said.
Dr. Georges Benjamin, executive director of the American Public Health Association, is more optimistic about the rollout, saying so far it has gone “pretty well.” He hopes the upcoming Biden administration will think about how to get accurate numbers to states to raise expectations for Americans about when life can return to normal.
“It’s not in our interest to have these multiple estimates of when it will reach the rest of the population, because I don’t think you can plan properly that way,” Benjamin told CNN. “I hope the new government will sit down and reflect on the coverage so people don’t hope they get vaccinated.”
That said, the vaccines were developed in record time without the normal “bureaucratic pace,” Benjamin said. He believes this process has given Americans new exposure to what the vaccine development process is like.
“The American public is getting a good idea of the vaccination process that they’ve never had, and I think people should pay a lot of attention to this. When people talk about what public health is doing, this is an example of what we are doing,” said Benjamin.