The Biden administration has spent its first week in office attempting to manually track down 20m vaccine doses in the pipeline between federal distribution and administration at clinic sites when a dose finally reaches a patient’s arm.
The Trump administration’s strategy pushed the response to the coronavirus pandemic to individual states and omitted pipeline tracking information between distribution and when the shot is actually administered, Biden administration officials told Politico.
The lack of data has now forced federal health department officials to spend hours on the phone tracking down vaccine shipments, the news website reported.
“Nobody had a complete picture,” Dr. Julie Morita, a member of the Biden transition team and executive vice-president of the Robert Wood Johnson Foundation, told Politico. “The plans that were being made were being made with the assumption that more information would be available and be revealed once they got into the White House.”
As of Saturday, January 30, 2021, 49 million doses of vaccine have been distributed by the federal government, but only 27 million administered by states, according to the US Centers for Disease Control and Prevention (CDC).
About two million of those doses are believed to be accounted for by a 72-hour lag in reported administration, Politico reported. That still leaves millions in the pipeline between delivery and patient. At least 16 states have used less than half the vaccine doses distributed to them, USA Today reported this week.
“Much of our work over the next week is going to make sure that we can tighten up the timelines to understand where in the pipeline the vaccine actually is and when exactly it is administered,” Dr. Rochelle Walensky, director of the CDC, told USA Today.
Among the problems in the rollout identified by the CDC’s advisory committee on immunization practices are the need to improve scheduling, increase staffing and define administration site workflows. States must also improve supply-demand mismatch.
In one example, a hospital in Arlington, Virginia, had to cancel 10,000 appointments after the state sent doses to county health departments. The state then directed patients to reschedule appointments through the county health department as they became available.
“It’s very disappointing,” Jeff Gorsky, a resident whose 3 February appointment was canceled, told NBC4 Washington. “We’re all stuck in the house, I rarely leave my house now, just to go grocery shopping. It would have freed me up.”
Similarly in Wisconsin, lawmakers quizzed the state’s health department on where 180,000 federally distributed vaccines that had yet to be administered were in the pipeline, according to a report from the right-leaning MacIver Institute.
A state health department official told lawmakers there was not enough vaccine to meet demand, but also that 50% of the doses had been set aside for a pharmacy partnership to vaccinate staff and residents of long-term care homes.
But adding to the confusion, a spokesperson for the Pharmacy Society of Wisconsin later said pharmacies had not received the doses from the health department, and still others were set aside for second shots despite federal guidance not to do so. “Some of [the vaccine] was being held back for second doses,” said Danielle Womack, a spokesperson for the Pharmacy Society of Wisconsin, the MacIver Institute reported. Wisconsin does not expect a vaccination scheduling website to go live until February, Wisconsin Public Radio reported.
If the Biden administration can’t get a handle on the rollout, inequities could also exacerbate racial health disparities between the populations worst impacted by Covid-19 and already behind in immunization.
An early look at the 17 states and two cities that have released racial breakdowns through 25 January found black people in all places are getting inoculated at levels below their share of the general population, in some cases significantly below.
“We’re going to see a widening and exacerbation of the racial health inequities that were here before the pandemic and worsened during the pandemic if our communities cannot access the vaccine,” said Dr Uché Blackstock, a New York emergency physician and CEO of Advancing Health Equity, an advocacy group that addresses bias and inequality.
That is true even though they constitute an oversize percentage of the nation’s health care workers, who were put at the front of the line for shots when the campaign began in mid-December.
For example, in North Carolina, black people make up 22% of the population and 26% of the health care workforce but only 11% of the vaccine recipients so far. White people, a category in which the state includes both Hispanic and non-Hispanic whites, are 68% of the population and 82% of those vaccinated.
The racial immunization gap is partly explained by higher levels of distrust of medical personnel by racial minorities who for centuries have been subject to abusive and discriminatory medical practices.
However, it is also a practical matter. In Florida, a plan to distribute Covid-19 vaccines through pharmacies with the supermarket chain Publix – which have been shown to cluster in affluent communities – left residents of Belle Glade 25 miles from the nearest vaccine center.
Most residents of the predominantly black community “walk everywhere they go”, said Mayor Steve Wilson. The state later provided a vaccine site for the community.
The CDC’s first report on early vaccine rollout is expected in February.