The Morning Jolt

Health Care

Twenty Million Vaccine Doses Are Missing

President Joe Biden talks with staff members manning a coronavirus vaccination site during a visit to Walter Reed National Military Medical Center in Bethesda, Md., January 29, 2021. (Kevin Lamarque/Reuters)

On the menu today: It’s the most mind-boggling figure, tucked deep in a Politico story on a Saturday: The Biden administration “is still trying to locate upwards of 20 million vaccine doses that have been sent to states.” Meanwhile, around the country, stories of vaccine doses being administered to hospital donors, boards of directors, and other wealthy not necessarily priority recipients start to pile up.

The Case of the Missing Twenty Million Vaccine Doses

On the campaign trail and before his inauguration, President Joe Biden and his team offered a consistent, bold, clear promise: They were ready to step into the executive branch of government and quickly increase the pace of vaccinations from coast to coast — even if the Trump administration had left a mess.

Then-candidate Joe Biden, June 30: “If I should have the honor of being elected president, on the day I’m sworn in, I’ll get right to work implementing all aspects of the response that remain undone. I’ll have more to say about my day one COVID-19 agenda in the weeks to come. But my response will begin well before I take the oath of office. It will start as soon as the election is decided.”

From the Biden campaign’s COVID plan: “Biden will be ready on Day One of his Administration to protect this country’s health and well-being.

November 18: “‘We will be ready on day one,’ Rick Bright, a member of President-elect Joe Biden’s COVID-19 advisory board, told CNN’s Alisyn Camerota on Wednesday, when she asked about what they would do if there was no plan from the Trump administration for vaccine distribution.”

President-elect Biden, December 8: “‘[My health-care team] going to be ready on Day One to spare not a single effort to get the pandemic under control, so we can get back to work, get back to our lives, and get back to our loved ones,’ Biden said at a press conference in Wilmington, Delaware. ‘They’ll lead the COVID-19 response across the government to accelerate testing, fix our supply chain, and distribute the vaccine.’”

President-elect Biden, January 14: “We’ll have to move heaven and earth to get more people vaccinated, to create more places for them to get vaccinated, to mobilize more medical teams to get shots in peoples’ arms.

Despite the promises, heaven and earth remain unmoved.

Politico, Saturday:

After a week on the job, Biden’s team is still trying to locate upwards of 20 million vaccine doses that have been sent to states — a mystery that has hampered plans to speed up the national vaccination effort. They’re searching for new ways to boost production of a vaccine stockpile that they’ve discovered is mostly empty. And they’re nervously eyeing a series of new Covid-19 strains that threaten to derail the response.”

Only a small percentage of those unaccounted for doses — roughly 2 million, two officials said — is due to lags in data reporting, the Biden team believes. That would mean the rest of the crucial supply is boxed away in warehouses, sitting idle in freezers or floating elsewhere in the complex distribution pipeline that runs from the administration to individual states.

Politico goes on to explain: “Instead, once the vaccine shipments are delivered to the states, responsibility for tracking them has been left up to states’ individual public health systems. The administration then only gets an update once the doses are actually administered and an official record is submitted.” A comment from an unnamed Biden adviser to the Financial Times echoes this assessment: “We inherited 57 different distribution strategies, some of which were working and some of which weren’t, and that’s what we had to work with,” the adviser said, referring to the plans adopted by the different states and territories.

Which states received vaccines and then have them sitting in a warehouse somewhere? We can’t be certain, but right now, the states with the smallest percentages of vaccines administered on the Bloomberg tracker are Rhode Island (52.6 percent), Kansas (53.6 percent), Alabama (53.6 percent), the District of Columbia, (54.2 percent), and Idaho and Massachusetts (tied at 54.6 percent). Notice there is no simple geographic or political connection among the states on the bottom of the list; you can’t dismiss this as a “Deep South” problem or blame it on red-state governors.

Some of those unused shots may be second doses that are being held for use on those who received the first dose. On the other hand, it’s hard to believe that all of the unused doses are in that category. We’re starting week seven of the vaccinations, so everyone who received the first shot in the first month or so should be getting their second shot soon. And for what it’s worth, the Biden administration doesn’t want states to sit on piles of unused vaccine to ensure the second-shot process will run smoothly:

They’ve also sought to persuade health providers to stop holding doses in reserve, a practice borne out of concerns people wouldn’t be able to get the second shot of their two-dose regimen — but one that’s no longer necessary and has only contributed to the confusion, according to two people with knowledge of the discussions.

On a call with White House officials Tuesday, Arkansas Republican Gov. Asa Hutchinson vented that some states are bearing the brunt of the blame for the uneven rollout because of those reserves — a nuance not reflected in the federal numbers, according to notes of the call obtained by POLITICO.

The complaint prompted a pledge from Centers for Disease Control and Prevention Director Rochelle Walensky to issue clearer guidance for how states should manage their allocated vaccines.

One possibility that the Politico article didn’t mention is that the vaccines are being administered, just in a way that some people would rather not appear in official records. Unfortunately, there is mounting evidence that those distributing the vaccine are playing favorites, and in some cases, even stealing supplies.

The Vaccine Black Market?

There’s not quite a vaccine “black market” in the form of vaccination speakeasies or some shady guy on a street corner who says he can hook you up with the latest good stuff from Pfizer in exchange for cash. But there is an increasing number of anecdotes of medical personnel who have access and authority to distribute the vaccine helping out their friends, and hospitals bumping their donors to the front of the line.

In Santa Clara County, Calif.:

Santa Clara County officials are investigating the South Bay’s Good Samaritan Hospital after it offered Los Gatos teachers COVID-19 vaccinations in what the county has called a “problematic” series of events.

“Good Samaritan’s actions are problematic for multiple reasons,” wrote Dr. Marty Fenstersheib, the county’s testing and vaccine officer, in a Friday letter to the hospital obtained by this news organization. While the county will provide the hospital enough doses to complete vaccinations for those who have received the first, it will hold back “any additional doses unless and until Good Samaritan provides sufficient assurances it will follow state and county direction on vaccine eligibility and provides the county with a concrete plan through which Good Samaritan will do so.”

On Thursday morning, teachers in the Los Gatos Union School District received an email from Superintendent Paul Johnson informing them of an “exciting development”: The offer of vaccines via Good Samaritan, which Johnson framed as a thank-you after the district raised funds for 3,500 meals for frontline workers, including at Good Samaritan, at the start of the pandemic.

In New York City:

At NewYork-Presbyterian Morgan Stanley Children’s Hospital, one of the most highly regarded hospitals in New York City, a rumor spread last week that the line for the coronavirus vaccine on the ninth floor was unguarded and anyone could stealthily join and receive the shot.

Under the rules, the most exposed health care employees were supposed to go first, but soon those from lower-risk departments, including a few who spent much of the pandemic working from home, were getting vaccinated.

The lapse, which occurred within 48 hours of the first doses arriving in the city, incited anger among staff members — and an apology from the hospital.

And elsewhere in New York:

Garnet Health offered COVID-19 vaccination shots to community members who serve on boards for its two hospitals and fundraising arm, even though most appear to have been ineligible under a state priority system that restricted those doses to health care workers.

A spokesman for Garnet, which operates the former Orange Regional Medical Center in the Town of Wallkill and former Catskill Regional Medical Center in Harris, has confirmed that the health system made the vaccine available to its 16-member board of directors and the 25-member board for the Garnet Health Foundation, which raises money for hospital equipment and programs.

In Florida:

At least three South Florida hospital systems — Jackson Health, Mount Sinai Medical Center and Baptist Health — have already reached out and offered vaccines to some donors in advance of the general public, while in the process of dispensing vaccines to front-line employees, patients with chronic illnesses and other stakeholders connected to their health systems.

In carefully crafted statements, hospitals confirmed that donors were among those receiving the vaccine in advance of the general public — but they insist that those who received them were within the age group prioritized by Florida and the Herald found no evidence to the contrary.

The silver lining to these stories is that even wealthy hospital donors and lower-risk hospital workers need to get vaccinated. Those of us who have the “just start jabbing as many people as possible as quickly as possible” philosophy have to accept that this means vaccinating some non-priority people ahead of higher-risk groups. Every person vaccinated, regardless of age or health status, gets us one step closer to herd immunity. The problem is that we already feel like a society where wealth and connections can get you anything, and the “we’re all in this together” cliché about the pandemic was already insufferable in all of those celebrity sing-along videos.

For almost eleven months now, we’ve been saluting doctors and nurses and watching their TikTok dances — celebrating a group of people who prioritized care for others beyond making money and getting ahead. Hearing that some doctors and nurses could be breaking the rules on something as important and serious as vaccine distribution is particularly irksome.

And then there’s flat-out theft, seen elsewhere in Florida:

A Florida fire captain accused of stealing COVID-19 vaccines meant for first responders turned himself in Wednesday afternoon, sheriff’s officials said. Polk County Fire Rescue Captain Anthony Damiano, 55, faces a felony charge of falsifying an official record as a public servant and misdemeanor petit theft, according to a Polk County Sheriff’s Office news release.

Polk County Sheriff Grady Judd said at a news conference Tuesday that paramedic Joshua Colon, 31, was arrested Monday for covering up Damiano’s theft.

Polk County Fire Rescue had been delivering the coronavirus vaccines to first responders, and Colon, who had been honored as the county’s “paramedic of the year” earlier this month, was administering the shots, Judd said. Colon forged the vaccine screening and consent forms to help cover up the theft of three doses of the Moderna vaccine, Judd said.

You can’t explain 20 million missing doses through theft and off-the-books distribution driven by favoritism. But those factors might be small pieces of the puzzle.

ADDENDUM: For many years, I thought of John Weaver as the campaign consultant “who kept running guys named ‘John’ as the Republican candidate for people who can’t stand Republicans.

It turns out the truth was so, so, so much worse.

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