How the U.S. Fumbled the Vaccination Roll-Out—and How to Fix Things
Nobody ever pretended that vaccinating 328 million Americans living in 50 states across 42,000 zip codes was going to be easy or quick. But all the same, there was plenty of hoopla and happy-talk back in December when the Pfizer-BioNTech and Moderna vaccines were authorized, with the U.S. promising to have the first 20 million people vaccinated by Jan. 1. When New Year’s Day arrived however, that figure was only 3.5 million—and every day since then has represented a serial disappointment, with the U.S. vaccine rollout turning into one of the worst examples of botched mobilization and clumsy logistics in recent memory.
In a deep dive into the problem, my colleagues W.J. Hennigan, Alice Park and Jamie Ducharme look at what went wrong (short answer: plenty) and what needs to be done to set things right (plenty again). The three spent the past few months observing, traveling and speaking with dozens of people involved in the development, distribution and administration of the coronavirus vaccine. A month into the operation it has now become clear that health experts, military logisticians and government authorities have often been at odds with one another over miscues, miscommunications and mistrust as they grappled with overcoming a tangle of logistical challenges in building an unprecedented health campaign from scratch.
A lack of federal leadership has resulted in state health departments scrambling to figure out solutions, creating a patchwork approach to allocating and administering allotted doses. Take Florida, for example, where state health officials decided to offer a number of vaccines through Eventbrite, a website primarily known for obtaining tickets to sports events, concerts and even monster-truck shows. In Lee County, in the state’s Gulf Coast, officials decided against building an appointment-based system, so senior residents instead had to spend more than seven hours, some overnight, in line, hoping to snag one of the limited vaccines available.
“It’s only now that the states are starting to realize the gravity of the situation and the volume required to vaccinate their populations,” says Dr. Peter Hotez, a vaccine scientist from Baylor College of Medicine in Texas. Across the U.S. that has meant vaccination numbers that trail those in many parts of the world. In Israel, for example, 32 out of every 100 people are vaccinated. In the United Arab Emirates, it’s 20. As for the U.S.? Fewer than five.
The good news is that some states are now picking up their pace dramatically. Reports Jamie: “Despite the rocky rollout, most sources I spoke with were encouraged by their progress—Michigan, for one example, is vaccinating six times more people per week than they were at the beginning of the campaign. That's a huge leap forward, but states and hospitals will need to work even harder to keep up the momentum as more people line up to get their shots.”
Localized success is not what’s needed to solve a national problem, of course. As the Biden Administration begins to implement its vaccination strategy, establishing federal leadership and a nation-wide approach to getting shots from factory to arms is going to be one of the biggest—and most daunting—challenges it faces.
While 28.4 million doses of the COVID-19 vaccine have been shipped to various U.S. states as of this morning, only about 14.3 million doses have been administered thus far, according to TIME's vaccine tracker—representing 4.3% of the overall U.S. population.
There are few entities in the world that know more about shipping stuff than the marketing goliath Amazon, and now the company is offering its services to President Joe Biden to assist in getting vaccines distributed throughout the U.S, reports the Associated Press . In a letter to the newly inaugurated president, Dick Clark, CEO of Amazon’s Worldwide Consumer division, wrote, “Our scale allows us to make a meaningful impact immediately in the fight against COVID-19, and we stand ready to assist you in this effort.” Amazon has already retained a third-party health care provider to vaccinate its 800,000 employees on-site in Amazon facilities when the shots become available to the general public.
In a case of just the wrong disaster at just the wrong time, a fire broke out today in one of the buildings of the Serum Institute of India—the world’s largest vaccine manufacturer—reports the New York Post. In a tweet, the company’s CEO promised no slowdown in output, despite the blaze, explaining that the vaccine is produced in multiple buildings within the complex. Serum Institute is producing 50 million doses of the Oxford-AstraZeneca vaccine per month, with a goal to manufacture 2.5 billion doses by the end of this year.
Yesterday, Russia applied to the European Union to register its Sputnik V for use on the continent, reports The Moscow Times. The vaccine, which Russia claims is 90% effective, has already been registered for use in multiple countries, including Belarus, Bolivia, Venezuela and Algeria, but the EU is adopting a go-slow approach. The European Medicines Agency, which oversees approval, said in a statement yesterday it is not expediting its review process for the vaccine.
TODAY'S CORONAVIRUS OUTLOOK
The Global Situation
More than 96.8 million people around the world had been diagnosed with COVID-19 as of 1 p.m. E.T. today, and more than 2 million people have died. On Jan. 20, there were 689,683 new cases and 17,403 new deaths confirmed globally.
Here's how the world as a whole is currently trending:
Here's where daily cases have risen or fallen over the last 14 days, shown in confirmed cases per 100,000 residents:
And here is every country with over 1.5 million confirmed cases:
Things have gone from very bad to much worse in the U.K., with the country seeing a record 1,826 COVID-19 deaths yesterday, passing the previous high set only the day before. That’s despite a new lockdown that began on Jan.5, which Prime Minister Boris Johnson said may have resulted in some flattening of the number of cases and deaths but conceded that “they are not flattening very fast,” in an interview with Sky News yesterday. The E.U. has now agreed to cut all transport links with the U.K. and ban the entry of U.K. residents.
Tourism is a vital sector of the Sri Lankan economy, accounting for roughly 5% of its gross domestic product, and in a nod to that, the country announced today that it is reopening its doors to foreign visitors after slamming them shut in March, reports the Associated Press. Tourists are required to produce three negative COVID-19 tests—one 72 hours before their departure for Sri Lanka, one upon arrival and one seven days later. They are also confined to a bubble in 14 designated tourism zones.
Canadian government officials were none too happy yesterday to learn that the promised doses of the Pfizer-BioNTech vaccine that were supposed to be delivered next week from a Belgian manufacturing plant would not be forthcoming, due to production problems, according to CNN. Referring to Pfizer executives, Ontario Premier Doug Ford groused, “We’ve got to be on these guys like a blanket. I’d be outside that guy’s house. Every time he moved I’d be saying, ‘Where’s our vaccines?’” Compounding Canadian frustration: there is a Pfizer plant just across the border in Kalamazoo, Mich., but the departed Trump administration banned exportation of vaccines and President Biden has not yet acted to affirm or overturn that policy.
The Situation in the U.S.
The U.S. had recorded more than 24.4 million coronavirus cases as of 1 p.m. E.T. today. More than 406,000 people have died. On Jan. 20, there were 178,255 new cases and 4,229 new deaths confirmed in the U.S.
Here's how the country as a whole is currently trending:
And here's where daily cases have risen or fallen over the last 14 days, shown in confirmed cases per 100,000 residents.
President Joe Biden’s promise to administer 100 million vaccines in the first 100 days of his administration hit its first speed bump on day one when, as CNN reports , the incoming COVID-19 team found that the outgoing Trump administration had left no vaccine distribution plan in place at all on which the new administration could build. "There is nothing for us to rework. We are going to have to build everything from scratch," said one source. The new Administration had tried in the run-up to the inauguration not to be overly critical of the Trump administration’s planning, but one frustrated official nonetheless referred to it as “further affirmation of complete incompetence.”
In addition to all of the plans President Biden had previously outlined to combat the pandemic in its $1.9 trillion proposal to Congress, the White House today released a new, streamlined, seven-point program to curb the spread of the virus. The plan includes: fixing the PPE problem “for good;” providing “clear, consistent, evidence-based guidance;” improving vaccine distribution; protecting older and high-risk Americans; reestablishing the U.S. Global Health Security and Biodefense Unit to anticipate future pandemics; providing “regular, reliable and free” testing; and imposing a national mask mandate. This afternoon, the President held a press event at which he signed 10 executive orders covering other COVID-related matters, including strengthening the vaccine supply chain, improving data collection and reporting, and ensuring COVID health equity in underserved communities.
The new administration is moving fast to leverage the international credibility of Dr. Anthony Fauci, head of the National Institute of Allergy and Infectious Disease, dispatching him in the pre-dawn hours, U.S. time, to address a gathering of the World Health Organization via video link. Former President Donald Trump had withdrawn the U.S. from the WHO, but Fauci was there to assure the body that the country is back and not going anywhere. “This is a good day for the WHO and a good day for global health,” said the organization’s chief, Dr. Tedros Adhanom Ghebreyesus, later referring to Fauci as “my brother Tony.”
All numbers unless otherwise specified are from the Johns Hopkins University Center for Systems Science and Engineering, and are accurate as of Jan. 21, 1 a.m. E.T. To see larger, interactive versions of these maps and charts, click here.
WHAT ELSE YOU SHOULD KNOW
Vax in the Trash
With vaccines such precious commodities across the U.S., it’s almost unthinkable that any doses could wind up in the trash. But as ProPublica reports, that’s exactly what’s happened to unused or spoiled vaccines in states across the country. Too many local officials are not reporting the waste to the CDC as required. Read more here.
The Dilemma of the Pregnant Health Care Worker
It’s hard enough being a health-care worker in the time of COVID-19 and it’s hard enough being pregnant. Being both presents special challenges for women who need to be vaccinated to stay safe on the job, but don’t have enough clinical data to know if the vaccines are safe for them and their babies. My colleague Jamie Ducharme writes about how they are facing that agonizing decision. Read more here.
A New Affliction: Vaccine Guilt
If you’re lucky enough to have gotten a vaccine, it ought to be a time for little relief. Not so, writes Washington Post Jerusalem bureau chief Steve Hendrix. Hendrix got his shot in Israel and found himself troubled by thoughts of “my elderly in-laws in Delaware and Palestinians living in the West Bank just miles from my apartment,” who have not been so fortunate. Read more here.
Not Going for the Gold
The uncertainty about how and when the Tokyo Olympics will happen has left many athletes to face a tough choice: keep training—and putting the rest of their lives on hold—or give up the dream. A growing number are choosing the latter—a painful decision after a lifetime of work. Read more here.
Thanks for reading. We hope you find the Coronavirus Brief newsletter to be a helpful tool to navigate this very complex situation, and welcome feedback at coronavirus.brief@time.com. If you have specific questions you'd like us to answer, please send them to covidquestions@time.com.
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Today's newsletter was written by Jeffrey Kluger and edited by Elijah Wolfson.
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