Why the COVID-19 Vaccine Rollout Is So Slow

The distribution of vaccines has gotten off to a slower-than-expected start, with millions of doses distributed to states but sitting unused in freezers.

Only about 5 million Americans have received their initial COVID-19 vaccine. Irfan Khan/Getty Images
  • Millions of doses of the coronavirus vaccine have been distributed to states but are sitting unused in freezers.
  • Two coronavirus vaccines have been approved for emergency use in the United States by the Food and Drug Administration.
  • The first priority group for vaccination included healthcare workers, and residents and staff of long-term care facilities such as nursing homes.

With two coronavirus vaccines approved for emergency use in the United States, federal and state agencies are scrambling to vaccinate as many people as quickly as possible.

However, the distribution of vaccines has gotten off to a slower-than-expected start, with millions of doses distributed to states but sitting unused in freezers.

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases (NIAID), acknowledged in early January that the country is falling behind in its vaccination efforts.

“Clearly, no excuses. We should have gotten 20 distributed, and 20 into the arms of people — by 20, I mean 20 million,” he told the Economic Club of Washington Jan. 6.

Other federal health officials say the pace should pick up soon, but state and local agencies are still facing an uphill battle to reach their vaccination goals.

Vaccine rollout by the numbers

Two coronavirus vaccines have been approved for emergency use by the Food and Drug Administration (FDA):

  • Moderna-NIAID
  • Pfizer-BioNTech

Both vaccines require 2 doses given several weeks apart for full protection.

As of Jan. 6, here’s where the country’s coronavirus vaccine rollout stands, according to data from the Centers for Disease Control and Prevention (CDC):

  • Over 21.4 million: Total number of doses distributed
  • Over 5.9 million: Total number of people who’ve received at least 1 dose

To put this in perspective, by the day before, Israel had vaccinated over 19 percent of its population, about 10 times the rate of the United States.

Some states are doing better than others, including blue states like Connecticut and Colorado, as well as red states like North Dakota and West Virginia.

Mississippi, Alabama, and Georgia have the slowest vaccination rates, according to CDC data.

The CDC’s first priority group for vaccination included healthcare workers, and residents and staff of long-term care facilities such as nursing homes. Vaccination in this high-risk group has also been slow to ramp up:

  • Over 3.7 million: Total number of doses distributed
  • Over 603,000: Total number of people who’ve received at least 1 dose

Rolling out the vaccine quickly took on a new sense of urgency with the detection in December of a more contagious variant of the virus in the United Kingdom. That variant is now in Colorado, California, Florida, and other states.

So far, the new variant doesn’t appear to cause more severe disease, but its increased transmissibility will make it harder to keep the virus from spreading.

The United States is currently in the middle of a midwinter surge — with over 21.5 million cases and over 364,000 deaths — so the country needs to vaccinate as many people as quickly as possible.

Vaccine rollout issues and concerns

Vaccinating tens of millions of people in the United States in a short period of time is a massive undertaking, especially given the country’s disjointed healthcare system and underfunded public health systems.

The rollout of the vaccine has already hit several snags, including slowdowns due to the Christmas and New Year’s holidays, and winter storms.

Hospitals have also been facing huge numbers of COVID-19 cases and hospitalizations in recent weeks, which has affected their vaccination campaigns.

On Jan. 5, over 130,000 people were currently hospitalized with COVID-19, according to The COVID Tracking Project. This number has been rising since October.

Technical challenges

The Moderna-NIAID and Pfizer-BioNTech vaccines are based on an mRNA platform that’s never been used in an approved vaccine before.

So these vaccines involve new distribution, storage, and administration protocols that distribution sites need to get up to speed on.

Storage is a particular challenge in some places. Both vaccines need to be stored in a freezer until being thawed prior to use.

The Moderna-NIAID vaccine can be stored in a standard freezer. But the Pfizer-BioNTech vaccine requires ultracold storage in a specialized freezer, which limits the sites that can distribute this vaccine.

A wide range of technical issues have also slowed the rollout, from freezer failures, to a shortage of staff to administer the vaccine, to people being mistakenly given an experimental coronavirus treatment instead of the vaccine.

Other administrative issues have cropped up. One hospital didn’t know which vaccine it would be receiving until the shipment arrived, which delayed its vaccination of healthcare workers.

And in Florida, older adults faced long lines to receive the vaccine, with some people camping out overnight.

Lack of federal involvement

States had been calling on Congress for months to provide more support for state vaccination efforts, but it wasn’t until late December that federal lawmakers approved the billions needed.

The Department of Health and Human Services also announced Jan. 6 that it would be providing additional funding to help states get vaccine doses into people’s arms.

However, this funding could take weeks to reach the states, when they should have been preparing for vaccine distribution months ago.

The federal government has also left much of the planning and coordination to overburdened state and local agencies.

When faced with criticism for the slow rollout, President Donald Trump responded with his administration’s typical hands-off approach to the pandemic.

“The Federal Government has distributed the vaccines to the states,” he said on Twitter. “Now it is up to the states to administer. Get moving!”

These types of problems, though, have plagued the country throughout the pandemic, from ongoing shortages of personal protective equipment for healthcare workers to a botched federal distribution of the antiviral medicine remdesivir.

Priority groups

Some experts have raised concerns that states are sticking too tightly to the CDC’s guidelines for who should be prioritized to receive the vaccines, and leaving vaccine doses unused.

While vaccinating those at greatest risk from COVID-19 is essential, some locations don’t have enough demand in those high-priority groups to use all the doses they’ve been allocated.

Nancy Messonnier, who heads the CDC’s immunization center, urged distribution sites in a live-streamed interview Jan. 5 to move quickly to the next priority group if the demand isn’t there among those first in line.

“I really hope that articulating these phases … isn’t leading to unnecessary barriers,” she said. “Don’t leave vaccine in the fridge. Don’t leave vaccine in the vial.”

This story originally appeared on: Healthline.com - Author:Shawn Radcliffe