If you ask New Jersey Gov. Phil Murphy why Covid-19 vaccinations are happening so slowly, he’ll say the answer is simple.
“The constraint is 100 percent right now supply from the feds,” Murphy, a Democrat, told a local TV station Thursday.
Ask the feds, and they’ll say they’ve distributed far more doses than the states have used, leaving vaccines on the shelf.
“Some states’ heavy-handed micromanagement of this process has stood in the way of vaccines reaching a broader swath of the vulnerable population more quickly,” Alex Azar, the U.S. secretary of health and human services, said at a Tuesday briefing, without singling out particular states.
And if you ask the vaccine makers, they’ll say the problem is not on their side, either.
“I don’t think that we have an issue of offering less vaccines than the countries frankly need. We have much more than they can use right now,” Pfizer CEO Albert Bourla told CNBC Tuesday.
One month into a vaccine rollout that has fallen short of everyone’s expectations, the blame-shifting over who’s at fault for the bottlenecks is multiplying and threatening to disrupt vaccinations even further. And that is frustrating public health experts who say that the Trump administration’s coronavirus vaccination team seems to be sleep-walking through its final days.
Several governors on Friday accused Azar of deceiving them about how many doses they could expect in the near future. Azar said Tuesday that the Trump administration was planning to release a strategic reserve of doses that it had been holding back for booster shots, but governors said they have since learned that there is no reserve because it was already released before this week.
“I am demanding answers from the Trump Administration,” Oregon Gov. Kate Brown, a Democrat, said Friday on Twitter.
“I am shocked and appalled that they have set an expectation on which they could not deliver, with such grave consequences,” she tweeted. “This is a deception on a national scale.”
The disappointing vaccine distribution, if it doesn’t improve, could be a major missed opportunity to save lives as the most recent wave of the pandemic tallies around 200,000 new cases per day. The coronavirus is causing as many as 4,000 deaths a day in the U.S.
“This needs to be a whole-of-government, whole-of-society approach, and instead what we’re seeing is a finger-pointing approach,” said Dr. Tom Frieden, a former director of the Centers for Disease Control and Prevention.
Frieden said in an interview that there’s so little basic information available about where the nation’s vaccine doses are and what’s coming that it’s difficult to know where the bottlenecks are. But he said Bourla’s comments about adequate supply were “nonsense,” and that Azar was hurting the situation.
“Secretary Azar’s comments have been unhelpful. They’ve been misleading and inaccurate and confusing,” said Frieden, CEO of the health nonprofit Resolve to Save Lives.
The nation’s halting start to administering Covid-19 vaccinations has suffered from multiple failures, including a lack of money before Congress appropriated more in December and minimal planning by many states and localities despite knowing for months that doses would be coming.
States are still lagging, as CDC data Friday showed that only 36 percent of doses distributed to states had been administered to people. But this week, as states ramped up the number of vaccination sites, the focus has begun to shift to the bottleneck in supply.
Oregon discovered the latest supply problem late Thursday when the state’s vaccine program manager went into the federal system for allocating vaccines to place an order and saw there were no additional doses, according to a person familiar with the state’s program who spoke on condition of anonymity. State officials then spoke by phone with federal officials and confirmed there would not be any additional doses for states to receive, the person said.
Patrick Allen, director of the Oregon Health Authority, sent a letter to the Trump administration seeking clarification on the federal government’s vaccine inventory. The letter was first reported by The Washington Post.
Several states including Oregon and New Jersey have been planning to expand eligibility for vaccinations to people aged 65 and older, on the expectation that there would be an uptick in supply and on the recommendation of Azar.
Philadelphia’s public health department said in a statement: “We are no longer expecting a surge of doses like Azar promised and we are not considering changing our prioritization scheme to allow for wider distribution. We have concerns that the number of doses that we will receive after January will be even less than the paltry amount we’re receiving now.”
Gov. Andrew Cuomo of New York, a Democrat, said Friday his state’s allocation from the federal government was set to drop from 300,000 doses this week to 250,000 doses next week.
Minnesota Gov. Tim Walz, a Democrat, accused federal health officials of “lying” about the existence of a federal stockpile.
Azar’s office did not immediately respond to a request for comment Friday. His days in government are limited, with President-elect Joe Biden having designated California Attorney General Xavier Becerra as his successor.
Dr. Marcus Plescia, chief medical officer of the Association of State and Territorial Health Officials, said his organization hadn’t gotten a clear answer on the federal government’s reserve of vaccine doses.
“We are getting mixed information on this,” he said. “But if there is no release of doses held in reserve, we are going to be challenged to increase to other groups beyond health care workers and LTCFs in the near future,” he said, referring to long-term care facilities.
Pfizer, which with its partner BioNTech is making one of the two vaccines approved in the U.S., announced this week that it was increasing its production forecast to 2 billion doses by the end of 2021, up from a previous forecast of 1.3 billion. The U.S. is due to receive 200 million doses by July 31 from Pfizer-BioNTech.
Asked about complaints from governors that there was a shortage of supply, Pfizer said in a statement Thursday that it was on track.
“Rest assured that Pfizer is working around the clock to manufacture and ready for release millions of doses each day and that volume continues to grow as our commercial ramp up progresses,” the company said.
Moderna, maker of the other U.S.-approved vaccine, early this month raised its production estimate from 500 million doses to 600 million doses for 2021. It said it’s continuing to add staff to build up to potentially 1 billion doses for 2021.
Still, some public health experts said they struggled to see any part of the vaccine supply chain that was working well.
“This is a complex system, and if you look at the data that we have so far, there are problems and bottlenecks and holdups all along the system,” said Bruce Y. Lee, a professor of public health and health policy at the City University of New York and executive director of the university’s PHICOR research team.
“Where is it being held up? Clearly, multiple places,” he said.
Lee said there needed to be more coordination by the federal government, including better tracking of where exactly doses are going unused, how to solve problems like shortages of syringes and people trained to administer vaccinations and clear guidance about what a vaccinator should do when they have leftover doses from opened vials.
“The federal government is the one entity with the resources and the independence and the authority to shore up problems in the supply chain,” he said.
Frieden, who served as CDC director under President Barack Obama, said he’s hopeful the incoming Biden administration will be more organized.
“If you give a vaccination program to people who’ve never run a vaccination program, don’t expect it to run smoothly,” he said. “CDC knows how to do this. CDC is the agency that should be leading this, but they’ve been sidelined.”