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Illustration: Aïda Amer/Axios

Poor timing, poor planning and a lack of resources have all led to a coronavirus vaccine rollout that is going much slower than anticipated.

Why it matters: The spread of the virus is vastly outpacing the U.S.’ efforts to inoculate people against it.

What’s happening: Although the vaccination effort has sped up over the last few days, only 5 million Americans have received their first dose of a vaccine, per Bloomberg — or only 1.5% of the population.

  • That means that only about 30% of the 17 million distributed vaccines have been administered.

The big picture: States have been warning for months that they don’t have the resources to pull off the ideal vaccination effort, but additional federal money only started flowing to states a few days ago, after President Trump signed the coronavirus relief package that Congress has been fighting over since the summer.

  • Initial vaccine doses went mostly to frontline health care workers, meaning that administration of the shots was largely the responsibility of the same hospitals that are overwhelmed by a flood of coronavirus patients.
  • Another few million doses are slotted for nursing home residents and staff, the vast majority of which haven’t yet been administered.
  • And on top of all that, the vaccine rollout coincided with Christmas and New Years, further slowing down the process.
Expand chart
Data: CDC. Map: Andrew Witherspoon/Axios

What they’re saying: “I think the biggest thing is that it’s not operating at a 24/7, flu vaccine kind of pace. It’s a lot more deliberate and there’s a lot more steps to getting that needle into people’s arms compared to other vaccines,” said Amesh Adalja, a senior scholar at Johns Hopkins Center for Health Security.

  • “It was all predictable, and I think there wasn’t enough planning,” he added.

Between the lines: The rollout has also illuminated the tension between rigid adherence to priority groups — which were created for a reason — and the urgency of getting as many people vaccinated as quickly as possible.

  • Unlike flu vaccine recipients, people must sign up to be vaccinated when it’s their turn to receive one, creating extra administrative burdens.
  • Some experts are also worried that providers are leaving vaccines on shelves rather than giving them to people who aren’t in the current priority group.
  • “I really hope that articulating these phases … isn’t leading to unnecessary barriers,” the CDC’s Nancy Messonnier told STAT’s Helen Branswell yesterday. “Don’t leave vaccine in the fridge. Don’t leave vaccine in the vial.”

Zoom in: New York City is responding to its slow rollout by setting up pop-up vaccine sites throughout the city, per the NYT, an approach that experts said is likely to be replicated across the country as the shots become more available to the general public.

  • “I expect that the number of distribution sites will increase significantly” in the next phase of vaccinations, said KFF’s Josh Michaud. “You’re going to have to reach a much broader population group, and vaccines will by definition start to be used much more quickly.”
  • But expanding the number of distribution sites, as well as the number of vaccine providers, will require resources.

The bottom line: “There has to be this change paradigm from being very, very measured to realizing we’re kind of in a warlike situation — we have to move as fast possible,” Adalja said.

Go deeper

Updated 9 hours ago - Politics & Policy

Coronavirus dashboard

Illustration: Sarah Grillo/Axios

  1. Health: Coronavirus deaths reach 4,000 per day as hospitals remain in crisis mode — CDC warns highly transmissible coronavirus variant could become dominant in U.S. in March.
  2. Politics: Biden says, "We will manage the hell out of" vaccine distribution — Biden taps ex-FDA chief to lead Operation Warp Speed amid rollout of COVID plan — Widow of GOP congressman-elect who died of COVID-19 will run to fill his seat.
  3. Vaccine: Battling Black mistrust of the vaccines"Pharmacy deserts" could become vaccine deserts — Instacart to give $25 to shoppers who get vaccine.
  4. Economy: Unemployment filings explode againFed chair: No interest rate hike coming any time soon —  Inflation rose more than expected in December.
  5. World: WHO team arrives in China to investigate pandemic origins.

Battling Black mistrust of the vaccines

Illustration: Annelise Capossela/Axios

Civil rights leaders and Black sports icons are publicly taking COVID-19 vaccines to encourage African Americans to follow their example as social media misinformation exploits Black distrust of vaccines.

Why it matters: The coronavirus has disproportionately struck Black, Latino, and Native American communities, and health officials are racing to reassure skeptical populations that the vaccines aren't clandestine experiments, but needed measures to tame the pandemic.  

Caitlin Owens, author of Vitals
20 hours ago - Health

Biden taps ex-FDA chief to lead Operation Warp Speed amid rollout of COVID plan

Photo: Alex Wong/Getty Images

President-elect Joe Biden has picked former FDA chief David Kessler to lead Operation Warp Speed, a day after unveiling a nearly $2 trillion pandemic relief plan that includes $400 billion for directly combatting the virus.

Why it matters: Biden's transition team said Kessler has been advising the president-elect since the beginning of the pandemic, and hopes his involvement will help accelerate vaccination, the New York Times reports. Operation Warp Speed's current director, Moncef Slaoui, will stay on as a consultant.