The Morning Jolt

Health Care

Why Are 6 Million Vaccine Doses Being Held Back?

A Walmart pharmacist draws a dose into a syringe from a Moderna coronavirus vaccine in West Haven, Conn., February 17, 2021. (Mike Segar/Reuters)

Ted Cruz screwed up by heading out on a family vacation as the weather in Texas took a severe turn for the worse, but as usual, our ADD media grew obsessed with the gaffe; the top eight items on Memeorandum this morning are all about Cruz and Cancun, and Politico has four items on the Texas senator, although they at least have the good sense to put them in the middle of the page. Arguably the largest logistical effort in the United States since World War Two is going on all around us, with God knows how many lives hanging in the balance, and it just doesn’t interest the national political media nearly as much as the Cruz family’s text messages to friends.

The 6 Million Vaccine Doses Being Held Back Unnecessarily

This newsletter has been (healthily) obsessing over the gap between the number of vaccine doses distributed to states and the number going into arms, observing that the eight-figure separation between those figures cannot be explained by mere snafus in reporting data. Today the numbers on the Bloomberg chart show 14.3 million doses shipped but not administered, while the New York Times numbers show 15.7 million doses — a slight increase from Wednesday’s 15.54 million doses.

This morning, the New York Times offers a bit more of an answer, revealing that indeed, states and a federal program designed to prioritize nursing homes and long-term care facilities have let a significant number of doses collect dust on shelves:

Millions of doses wound up trapped in logistical limbo, either set aside for nursing homes that did not need them or stockpiled while Americans clamored in vain for their first doses. Now a national effort is underway to pry those doses loose — and, with luck, give a significant boost to the national vaccination ramp-up.

In New York, Gov. Andrew M. Cuomo has pushed the Biden administration to allow him to claw back 100,000 excess doses that were allocated to the federal program for long-term-care facilities. In Michigan, Dr. Joneigh S. Khaldun, the chief medical executive, is raiding nursing home doses that she said had been locked in a “piggy bank” controlled by CVS and Walgreens, the two pharmacy chains in charge of the federal initiative.

And in Virginia, Dr. Danny Avula, the state’s vaccine coordinator, said he has been “wheeling and dealing like on a trading floor” to free up tens of thousands of doses for the general population.

Dr. Avula, a 42-year-old pediatrician and preventive medicine physician, came to the job in early January to find multitudes of Virginians languishing on vaccination waiting lists and less than half of the state’s vaccine allotment actually making it into arms.

. . . Federal officials estimate that as many as six million vaccine doses are still being unnecessarily stowed away. Freeing them up could increase the number of doses used by more than 10 percent — significantly stepping up the pace of the nation’s inoculation program at a time when speed is of the essence to save lives, curb disease and head off more contagious variants of the virus.

Deep in that article, referring to Virginia, “A flood of public requests for data gave the state a chance to create a new incentive not to hoard.”

Governments perform better when the public — often, but not always, represented by the media — ask tough questions, demand to see the data, compare it to the numbers in other places, and call officials and departments out for poor performance. This is the truth, whether the state government is headed by a Democrat or a Republican. Cheerleading media institutions cannot hold the government accountable — and we all know the habits people pick up when they know no one is going to hold them accountable.

It’s good to see a more widespread recognition that the slow pace of administering delivered doses was not just a matter of mundane delays in reporting data. But there are still some odd discrepancies. The Washington Post’s coverage of the nation’s capital expanding the eligibility for the vaccine starting March 1, states

residents who have conditions such as cancer, diabetes or kidney or liver disease can seek a vaccine through their doctor or through the city’s public registration system. Doses remain in short supply, and this new group of patients — representing more than a quarter of adults in the city — will compete for appointments with seniors and an increasingly large pool of eligible essential workers.

But do doses really remain in short supply? The District of Columbia ranks near the bottom in terms of how much of their allocated vaccines have been administered, at 67 percent. Manufacturers delivered the city 193,300 doses and the city’s health institutions have administered 130,437 of them. Where are those other 62,000 doses? What’s the holdup?

Rhode Island is now allowing residents 65 and older to book appointments for vaccine shots at one of two state-run mass clinics. Manufacturers have sent the Nutmeg State 234,500 doses so far, and they’ve administered 159,931 . . . leaving more than 74,000 doses somewhere in the supply chain.

But the state currently ranking dead last in percentage of doses administered is Alabama. That state’s numbers recently improved — “Alabama gave out 149,201 doses of vaccine last week, 35,918 more doses than it gave the week before” — but now bad weather is forcing the cancelation of appointments and delaying shipments. Manufacturers sent Alabama 1,032,175 doses so far, and they’ve administered 672,038 . . . leaving more than 360,000 doses somewhere in the supply chain.

If every state had similar percentages of administered doses, we could accept that these are unavoidable universal problems. But somehow North Dakota — no stranger to bad weather! — has administered 105 percent of their allocated doses by getting more doses out of each vial.

Nonetheless, cold, ice, and snow across much of the country is slowing down the pace of vaccinations a bit. From February 10 to 14, the U.S. recorded at least 1.7 million doses administered a day and hit 2 million per day twice. But Monday, the country only administered 820,000 doses, Tuesday 1.5 million, Wednesday 1.3 million, and yesterday 1.7 million again.

California may be known for good weather, but that doesn’t matter much when the vaccines have to get shipped in from the middle of the country:

Thousands of COVID-19 vaccine appointments scheduled Friday at sites run by the city of Los Angeles will have to be postponed after shipments of doses were delayed by the severe winter weather that’s wreaking havoc across the country.

About 12,500 people will have their appointments delayed, and those affected should be notified by text, email or phone, according to a city statement.

“Severe weather across the country has disrupted travel and shipping nationwide, including delaying the delivery of our vaccines,” Mayor Eric Garcetti said. “Our city is ready to administer COVID-19 vaccines swiftly, safely and equitably, and as soon as doses arrive in Los Angeles, we will get them into people’s arms immediately.”

City officials said two shipments have been held up because of the inclement weather: 26,000 doses, previously set to arrive Tuesday, are still in Kentucky, and 37,000 more, set to be used next week, are in Tennessee.

There’s a lot of good news on the pandemic front, as Kyle Smith and Isaac Schorr observe.

And as for fears that the vaccines won’t be as effective against the South African variant, Pfizer’s scientists contend a lot of people are inaccurately interpreting “less effective” to mean “not effective.”

A laboratory study released on Wednesday suggested that the “South African” virus variant may reduce protective antibodies elicited by the Pfizer/BioNTech vaccine by two-thirds, but it is not clear how much that reduces the shot’s effectiveness against this version of the pathogen.

Phil Dormitzer, one of Pfizer’s top viral vaccine scientists and a co-author of the study, said in an interview he believes the current vaccine is highly likely to still protect against the concerning variant first discovered in SA.

“A level of neutralising antibodies that may be on the order of between a third and a half the level of neutralising antibodies you see against the original virus does not mean you have only a third to half of the protection level, you may well have full protection,” he said.

University of Texas Medical Branch professor and study co-author Pei-Yong Shi said he also believes the lessened immune response observed is likely to be significantly above where it needs to be to provide protection.

Pfizer is already at work on developing a booster shot designed to ward off the South African variant.

ADDENDUM: Yesterday, I recalled the not-so-accurate, not-so-insightful mid-1990s comparisons of Rush Limbaugh and Howard Stern:


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