As States Expand Access to Vaccines, Supply Isn't Keeping Up

Racing to ramp up Covid-19 vaccinations, states have opened mass inoculation sites and expanded eligibility. But a big problem remains: The supply isn’t increasing fast enough.

The United States, facing a growing threat from more contagious and possibly deadlier virus variants, is gradually administering more doses every day, now up to an average of about 1.67 million, according to a New York Times database.

But states are also steadily widening access beyond the most vulnerable groups, frontline health care workers and nursing home staff and residents. Now, some state officials say they are ready to administer thousands more shots every day — if they can get them.

Last week, California announced that it would soon become one of just a handful of states to expand vaccine access to people of any age with underlying health issues or severe disabilities. But it has already used 72 percent of its doses and has shortages in some areas.

The mass vaccination site at Dodger Stadium shut over the weekend because Los Angeles had exhausted its supply, Mayor Eric Garcetti said. He said the city received just 16,000 doses last week — roughly a day’s worth.

“When vaccines do get to Los Angeles, we know how to administer them,” Mr. Garcetti told reporters. “We have a great infrastructure set up, of amazing people, and we will give them to folks efficiently and safely. But the problem is, we still aren’t receiving enough doses soon enough.”

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Officials in Georgia say constrained supply is getting in the way of opening up eligibility. When the Atlanta Board of Education called on Gov. Brian Kemp earlier this month to start allowing teachers to be vaccinated, the governor said the state was not getting enough doses for residents who were already eligible.

Many districts around Atlanta, he said, had stopped scheduling new vaccine appointments because federal deliveries were falling so far short of the demand.

Experts say expanding eligibility requires a delicate balance of prioritizing those most at risk and ensuring no dose goes to waste.

“I don’t think anyone would want to be the person to receive the vaccine at the expense of someone else who is higher risk,” said Dr. Sarita Shah, an epidemiologist at Emory University in Atlanta.

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    Dr. Michael Osterholm, the director of the Center for Infectious Disease Research and Policy at the University of Minnesota, said expanding lists too quickly could backfire. “People are going to be angry when they are promised a second dose and don’t get it on time,” he said.

    Some experts, like Dr. Robert Murphy, the director of Northwestern’s Institute for Global Health, have called for more flexibility for places that have already vaccinated their most vulnerable residents.

    “I think the dangerous thing is some places are too regimented with the current rules,” Dr. Murphy said. “If you’ve got an extra 50 vials, that’s 500 doses, and nobody is coming, and this thing is going to expire in a matter of days or weeks — give it out.”

    New York State has used 90 percent of its initial doses, Gov. Andrew Cuomo said on Saturday, but is forging ahead to expand eligibility to anyone with underlying health issues. He, too, said his state could be vaccinating faster if it had more doses.

    On Sunday, the first day that appointment sign-ups opened for New Yorkers with chronic health conditions, tens of thousands flooded websites and many were left waiting for openings.

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