Wednesday, October 20

Vaccination in the US is slower than initially planned

(CNN) — As the coronavirus pandemic continued to rise through the summer and fall, federal government officials repeatedly offered a ray of hope: enough doses of the vaccine to vaccinate 20 million Americans before the end of December.

However, after the first week of vaccine distribution and with only nine days to go before the self-imposed deadline is met, Operation Warp Speed ​​(OWS) is on track to fall far short of the 20 million injections. A tally by the Centers for Disease Control and Prevention (CDC) shows that approximately 9.5 million doses have been distributed as of Wednesday morning and just over a million people have been vaccinated, a number that is far from the goal that Operation Warp Speed ​​had originally set.

Officials with the Department of Health and Human Services (HHS) and the CDC say the agency’s counts are underestimating many vaccines due to data delays, but even taking into account the reporting delays, the America’s vaccination program appears to be taking longer than Warp Speed ​​officials projected.

When could we reach 20 million vaccinated in the US?

An initial hurdle: The Food and Drug Administration (FDA) two-day requirement to evaluate each shipment of the vaccine for quality control slowed distribution. The OWS told states to expect fewer doses for week two than originally planned. With the 20 million number seemingly farther out of reach, OWS officials acknowledged Monday that they may not make it until January.

“We still strongly believe that by the end of the year we will have allocated 20 million doses of vaccines to states that will be available,” said General Gustave Perna, director of operations for Operation Warp Speed ​​during Monday’s call. “We are sure that we will distribute the final part of that vaccine no later than the first week of January so that everyone has access.”

An HHS official said nearly 16 million doses have already been allocated for states and jurisdictions to order. However, as more doses of vaccines become available, Operation Warp Speed ​​and its health care and state partners will also need to be able to scale up the complicated distribution and logistics required to get vaccines from point A to point B. .

“It seems like reaching 20 million at the beginning of the year is ambitious,” said Dr. Marcus Plescia, medical director of the Association of State and Territory Health Officials.

Still, “people seem to be really excited about how vaccines are going,” added Plescia. “Everybody seems to feel like they are using the supply they have.”

Imperfect data on the vaccination process in the US

The vaccination effort is almost certainly moving forward faster than the CDC’s low numbers show. In addition to launching new vaccination programs, states are also grappling with new vaccination reporting tools, causing data delays. The latest figures also do not include most of the larger vaccination efforts that are starting this week in long-term care facilities.

CDC distribution data has only just begun to include Moderna’s vaccine, which was deployed this week to more than 3,500 locations, but CDC data does not yet include the number of Moderna vaccines administered. While the CDC plans to update the data regularly, the daily updates are not scheduled to begin until 2021.

Some states, like Michigan, are reporting their own data, but those statewide reports are also lagging.

The Michigan Department of Health and Human Services public information officer Lynn Sutfin noted that the state dashboard is not updated in real time and providers have up to 24 hours to upload administered doses to the vaccine registry.

Michael Pratt, communications director for Operation Warp Speed, praised the federal government’s progress thus far.

These doses are being distributed under state directives to the American people as quickly as they are available and releasable, and the rapid availability and distribution of as many doses – and 20 million doses are expected to have been allocated for distribution in just 18 days after the first vaccine was authorized for emergency use — it is a testament to the success of Operation Warp Speed, “Pratt said in a statement to CNN.

‘We haven’t started’ vaccination yet

States are readjusting to the reality that they will receive fewer doses of Pfizer’s covid-19 vaccine than initially promised in the coming weeks. And they also juggle to make sure every dose they receive is delivered on time.

While vaccines have been shipped to every state, in some areas vaccinations are just beginning. Dayton, Ohio Mayor Nan Whaley said on CNN Tuesday that her city had not yet begun administering vaccinations, although vaccinations began in Ohio on December 14.

“To date, we have not yet started vaccine distribution in Dayton,” Whaley said Tuesday. And he added that Christmas Eve will be the first day someone from Dayton receives the vaccine.

“We are not a big city that gets these resources quickly. We’ve talked about this, (about) how testing was very slow in communities like Dayton and across the country, and I’m concerned that vaccine delivery is slow as well, “he added.

Although every state has data on how many people get vaccinated, only 23 states have publicly released that information, according to a survey by Johns Hopkins University.

The CDC and state numbers are not a real-time reflection of vaccinations in the territory. However, they raise questions about how states are ensuring that their entire supply is used efficiently. The time lag between the doses received and the doses delivered begins to become even more overwhelming when you consider that each state will receive more doses of Pfizer and first-round doses of Moderna this week. In many cases, the first week dose delivery has not yet been fully delivered.

The difference between vaccines received and administered in the US

In Michigan, where the COVID-19 vaccine dashboard shows only 26,737 doses of the 84,000 shipped to the state last week have been administered, Sutfin said delayed shipments and delayed data updates explain the difference.

“While Michigan received more than 84,000 doses last week, they were not all received on the same day. The vaccine is delivered daily to local hospitals and health departments across the state. As they understand more about operations and clinical flow, we expect the time from receipt to administration to decrease, ”Sutfin told CNN.

Sutfin also noted that the process of unpacking, inventorying, thawing and coordinating each vaccine dose “takes some time, so it is expected that at any time there will be a difference between the vaccines received and the doses administered.”

The situation in Florida

In Florida, as of Tuesday night 68,133 people had received the covid-19 vaccine. The state initially received 179,400 doses of Pfizer.

Florida Hospital Association President and CEO Mary Mayhew told CNN that reconfiguring the clinical space to maintain social distancing and assigning staff to administer the vaccine explains why the initial number of people vaccinated does not match. with the supply of available vaccines.

“I am confident that hospitals are deploying critical resources efficiently and effectively to support urgent vaccine delivery to front-line healthcare personnel,” Mayhew said when asked if she was concerned about the difference. “Hospitals are working in collaboration with other community health care partners to support the timely distribution of vaccines.”

Decentralized structure

Although states oversee the vaccine distribution process, many state health departments or governor’s offices have left the actual administration of vaccines to the hospitals, long-term care facilities, and pharmacies that will receive shipments according to the programmed. This decentralized structure could cause some delays in learning about where the weaknesses are in the process.

Mississippi health official Dr. Thomas Dobbs explained during a news conference Tuesday that it was not the state’s job to make sure vaccines were effectively injected once they were assigned to long-term care facilities.

“They haven’t started vaccinating,” Dobbs said of long-term care facilities, “but we’ve released enough allowance for them to start, so they’re in the process of putting it together. And you know, that’s something that is out of our control. But you know, within the next two weeks they will start it up.

‘It’s a little frustrating’

Dr. Ashish Jha, dean of the School of Public Health at Brown University, said he is not surprised by some of the initial problems with the vaccine’s deployment.

“It’s a bit frustrating because it’s not that we didn’t know the vaccines were coming,” she told CNN’s Kate Bolduan on Monday.

It’s going to slow down a little bit. Again, better planning would have made us move faster, but here we are and we get these vaccines as quickly as possible to the right people, ”he said.

Dr. Georges Benjamin, executive director of the American Public Health Association, is more optimistic about the rollout, saying it has been “reasonably well” so far. He hopes that the incoming Biden administration is thinking about how to bring accurate figures to states to set expectations for Americans about when life can return to normal.

“We are not interested in having these multiple estimates of when it will reach the rest of the population because I don’t think good planning can be done that way,” Benjamin told CNN. “I hope the new administration is thinking about the messages, so that people do not have any illusions about getting vaccinated.”

That said, vaccines were developed in record time without the normal “bureaucratic pace,” Benjamin said. He believes this process has given Americans a new vision of what the vaccine development process looks like.

“The American public is getting a good idea of ​​the vaccination process that they have never had before. And I think that people should pay close attention to this, when people talk about what public health does, this is an example of what we do, “Benjamin said.

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