WASHINGTON – States have delayed the availability of hundreds of thousands of vaccine doses, even as the coronavirus outbreaks intensify. A sign that the country is moving with its supply screw և now faces more acute challenges կապված due to demand, staff և hard-to-reach vaccinations. population:
The deciding question in the first few weeks of vaccine distribution was why states spend so much time managing doses from the federal government. The most influential in the four months of the four months is the number of states waiting to order all their rations based on their adult population և that week.
When Michigan Governor Gretchen Whitmer asked White House officials last week if they were considering sending more doses of the vaccine to her state amid a deadly wave, the state did not order the 360,000 doses available at the time, puzzled by federal officials advising to work instead. with experts to make sure Michigan supplies are efficiently deployed.
But Michigan was not the only state to drop the dose on storage shelves. At some point in the past week, 13 states had more than 100,000 doses each, according to a federal official familiar with the numbers who, like others, spoke on condition of anonymity because of the sensitivity of the issue. Indiana withdrew only 90% of the available doses for the state, leaving 306,000 on the shelves. Texas ordered 95% of its stake, leaving 673,000 doses temporarily unchanged.
The delays were observed within the federal government, where officials discussed whether performance indicators, including how quickly states order, use their vaccines, deliver them to vulnerable groups, should be part of the distribution decisions, according to the three individuals. who are familiar with the issue. Any new approach, however, had to be signed by the White House, which was in pain to avoid punishing some states, while encouraging others, including directing additional doses to virus hotspots.
“The fair, equitable distribution of the vaccine is based on the adult population across states, races and territories,” Whitef Ziens, coordinator of the White House Coronavirus Working Group, told a briefing on Friday. “It simply came to our notice then. And we will continue to do so. The virus is unpredictable. “We do not know where the next escalation will take place.”
Experts say that four months after the immunization campaign, with more transmissible versions of the virus across the country, states should no longer encounter blockages that prevent them from accessing all of their vaccine allocations.
“States և their health care providers must now have the capacity to deliver the vaccines available to them every week,” said Alejon L. Schwartz, Yale University Health Policy Assistant անդամ Member of the Connecticut Vaccine Advisory Committee. “Vaccine doses should not be left on the table during this time.”
State են officials offered various explanations for not ordering all of their allocations each week. Many noted the difficulty of matching the first and second doses. “We do not always order all second doses as they may not be needed this week because the first doses were used,” said Leach Satfin, a spokesman for the Michigan Department of Health and Human Services.
Others pointed to declining demand, staffing challenges, and poor communication between state and local officials. Muhannad Hamami, director of the Wayne County Health Department in Michigan, said the abrupt rejection of Moderna County’s dose meant it could not operate one of its clinics, which is typically capable of delivering 2,000 doses a day to people in Detroit.
Indiana Health Department spokeswoman Sarah Verskhur said the unrelated doses were “intended for business, higher education, and local health departments that are planning to start vaccinations in the coming days.” Chris Van Deussen, a spokesman for the Texas Department of Public Health, said last week the state’s balance sheet would be phased out by Friday, before second dose orders could be placed. But at the end of the week, there were 145,000 doses left.
In North Carolina, which ended last week with 426,000 unsatisfied doses, state health officials did not respond to requests for comment. Residents of all 16 և states were allowed to film on Wednesday. Lisa Macon Harrison, director of public health at Granville-Vance in the northern part of the state, said orders fell because of a spring break last week.
“Last week was a spring break for many communities, with teachers, students and nurses planning a short break,” he said. “School nurses were not available in some places [to administer shots]”The staff levels across the country were going to look a little different.”
Michael Fraser, executive director of the Association of Public Health Officers, said some countries that do not order their full allocation are in soft demand and are developing new strategies to increase interest in filming. He insisted it was too early to redistribute doses across states.
But ordering a second dose delay could push the United States to delay firing, as Britain and Israel have done, to mitigate logistical challenges and to provide some protection to more people. Uncertainties as to how much the first-dose doses offer, and how much of those benefits, are also at the heart of the debate over whether the federal government should move the vaccine to hotspots. Some argue that immunity will not strike fast enough to contain outbreaks, making mitigation strategies a better bet.
“The downside is that if the wave happens now, we know that even if you have a single dose of son onson և john onson, immunity doesn’t really last for two or four weeks, and for Pfizer և Moderna you have more than five or six weeks. Schedule, ”said Anuj Mehta, a Denver pulmonologist who chaired the Colorado Vaccine Advisory Group. “And it will do nothing to help the channel.”
Keith Inglish, chair of the Department of Pediatrics and Human Development at Michigan State University, disagreed with the delay, noting that “a few weeks after the first dose” there was a sharp decline in symptoms.
As important as overdoses are, he said, is the effective distribution of doses that the state already has. And where rapid vaccination may be most beneficial is in areas near outbreaks, such as Washington state, where officials are watching closely for record growth in British Columbia as the US-Canada border remains closed to unnecessary travel.
Secretary of State for Health Umayr Shah said the state of Washington was not yet receiving enough supplies to target certain areas of the state, and that such an approach could undermine continued efforts to vaccinate more seniors. According to him, the path of the virus is unpredictable, the population-based approach remains the fairest both in the republic and in the states.
Pressure on the federal government to reconsider its strategy has increased as immunization availability expands across the country, but new infections are concentrated in several states, including Michigan, New York, New Jersey, Florida and Pennsylvania. The average number of new seven-day infections in Michigan rose from 1,503 on March 7 to 7,226 on Thursday, according to The Washington Post.
Last week, the White House responded to Whitmer on Thursday by President Biden, who called him and said the federal government was ready to send additional vaccines to his state to help use its supply, according to an administration official who knew. the conversation. As for the proposal to move vaccines in the state, Whitmer told reporters on Friday. “It simply came to our notice then. The problem is, when you look at the map, the whole country is a hot spot. ”
Early on, officials considered, but did not pursue, the “local prevalence / prevalence of COVID-19” as a factor in the provision of vaccines, according to a federally approved area’s memorandum issued last year by the National Association of Urban Health Officials. Responsible for the health sector involved in the consultations. Some senior officials at the Centers for Disease Control and Prevention were initially skeptical of a highly consensual approach, according to two officials, one of whom said the resolution had been reduced to large urban areas where people gather for health care even if they lived elsewhere.
Federal officials believe that one of the reasons states leave vaccines on the shelves is to order personnel who cannot lay down their weapons immediately, or because of limited capacity to control them or increased demand. Sending unused doses quickly will reduce the vaccination effectiveness of states in the closely monitored table, which has not been used to determine allocations, but may nevertheless include government officials who have provoked public reactions to federal partners, according to people familiar with the debate.
Kansas Health Minister Lee Norman said his state had ordered all of its doses, but that some of his colleagues had discussed not doing so during a recent call from state health officials.
Days before leaving office in January, Trump administration officials unveiled an incentive system that would reward states with extra shots if they used their supplies quickly. The Biden administration scrapped the approach, instead retaining a population-based formula, although it gradually diverted more vaccines to retail pharmacies, community health centers, and mass vaccination sites across the federal territory. These sites are being selected in part because they are likely to serve colored communities that have a proportionate impact on the epidemic, administration officials say.
Extended allocations to pharmacies are also politically charged, as they are seen as a reduction in the share of doses available to governors who claim increased voter allocations. However, over-the-counter dosages have generally been more effective.
In a recent call, Zi Yen told governors that states handled an average of about 80 percent of their doses, while pharmacies performed slightly better at 84 percent, according to a transcript of a Washington Post interview. There have been large fluctuations among the states, says Var yen, with the top 10 states averaging about 90 percent and the bottom 10 providing about 71 percent of their doses.
– – –
This report was contributed by Jacqueline Duprin of the Washington Post Post Lena H. The student: