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Health Care

Why Is the Vaccine Backlog Increasing Again?

A worker performs a quality check in the packaging facility of Chinese vaccine maker Sinovac Biotech, developing an experimental coronavirus vaccine, during a government-organized media tour in Beijing, China, September 24, 2020. (Thomas Peter/Reuters)

Yesterday I noted that the pace of vaccinations started to slip earlier this week, and the number of in-transit or unused doses increased from about 12.2 million doses to 17.1 million doses between Monday and Wednesday. This morning, both the Bloomberg chart and the New York Times data show that out of 88.6 million doses, 66.4 million have been administered  — 75 percent, down from 84 percent Monday — with 22.2 million doses either in transit or sitting on shelves.

The instinctive explanation is bad weather disrupting shipments and canceling appointments, but the worst of the winter weather passed last week. Yesterday, 1.4 million doses were administered, but the rolling average of this week is about 300,000 fewer doses per day than last week, when the storms were hitting. We should be picking up the pace, but it looks like we’re administering doses significantly slower than manufacturers are delivering them. Manufacturers appear to be delivering significantly more than 1 million doses per day, and another 3 to 4 million doses of the single-shot Johnson & Johnson vaccine should be arriving next week.

For a while there, dramatically increasing the pace of vaccinations looked as if it was going to be an early Biden administration triumph. If it’s a supply problem, why is the number of unused doses increasing by a few million each day? And how can states and localities have a demand problem, with so many Americans eager to get it and growing irritated with a long wait for even the opportunity to try to book an appointment?

You’re still hearing stories of counties and localities not receiving as many doses as they expected. But it also seems like a lot of states, counties, and localities set up systems for appointments that just aren’t working for many people.

New Hampshire: “Many COVID vaccination registration and information websites at the federal, state and local levels violate disability rights laws, hindering the ability of blind people to sign up for a potentially life-saving vaccine, a Kaiser Health News investigation has found.”

California: “This week, 10 counties in the inland portions of Central and Southern California were slated to transition to the new vaccine distribution system helmed by Blue Shield — but limited communication, technical challenges and lack of transparency have resulted in delays for at least three counties. Meanwhile, the state is overhauling its equity program after young, healthy and wealthy residents in Los Angeles and San Francisco obtained vaccine access codes intended for vulnerable Californians.”

Massachusetts: “Overwhelmed by the rush of residents seeking to book one of the limited number of appointments, the state’s site crashed for more than two hours Thursday morning, eliciting a storm of frustration and criticism from residents and lawmakers alike, who said the administration should have been more prepared as it open vaccination eligibility to nearly 1 million additional residents.”

Pennsylvania: “Local pharmacies tell Channel 11 they’re frustrated and furious over the continued problems with the state’s COVID-19 vaccine rollout. Some owners said they don’t have any vaccine supply and don’t know when they will get more doses. Gov. Tom Wolf, however, guaranteed those doses are coming.”

Oregon: “Many Portland-area seniors ages 70 and older encountered a very slow-moving website and major glitches Monday as they tried unsuccessfully to schedule COVID-19 vaccination appointments at one of the area’s two mass vaccination sites. Some elderly residents reported that it took anywhere from a few minutes to more than a half hour for scheduling pages to load. And that when they got to those pages and clicked on available appointment times, they were told the appointments were already taken. That meant they would have to begin the time-consuming process of reloading pages and starting the booking process again.”

Ohio:  “The Federal Retail Pharmacy Partnership, instituted in early February, to provide direct government to pharmacy vaccinations stumbled out of the gate, at least here in northeast Ohio, as multiple appointments, scheduled at Rite Aid, had to be canceled.”

Rhode Island: “With Rhode Island’s COVID-19 vaccination rollout consistently ranking among the worst in the nation, Lieutenant Governor Daniel McKee earlier this week placed blame on Governor Gina Raimondo for the state’s lagging efforts. ‘Like most Rhode Islanders, I am not satisfied with the current administration’s progress on vaccine distribution, especially as we see our neighbors in Connecticut ranked among the top in the nation,’ said the lieutenant governor in a statement.”

South Carolina: “[Medical University of South Carolina] CEO Dr. Patrick Cawley described the process of receiving allocations as almost comical at this point because they don’t really know how many vaccine doses they’ll get until they open the box.”

Notice this does not appear to be a “red state problem” or a “blue state problem.” Crashed websites, jammed phone lines, complicated rules, and long waits occur in states with experienced governors and states with new governors.

We’re almost ten weeks into the vaccination process. Why are we still having these problems?


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