The United States is lagging behind several other countries in its Covid-19 vaccination efforts, according to a CNN analysis of government data.
In the US, 2,589,125 vaccine doses were administered from December 14 through December 30 at 9 a.m., according to data posted Wednesday by the US Centers for Disease Control and Prevention. That’s an average of 161,820 shots per day, or a daily rate of 49 shots per 100,000 people in the country.
That is significantly lower than the daily vaccination rates for Israel, the United Kingdom and Bahrain. The daily rate per 100,000 in Israel is 608, for Bahrain it’s 263 and for the UK it’s 60, according to data from those governments.
The US is doing better than Canada, where the daily rate is 10 doses per 100,000 people, according to researchers at the University of Toronto.
In the US, there’s a significant difference between the number of vaccines that have been distributed to various locations and the number of shots that have actually gone into arms.
According to the CDC, 12,409,050 doses have been distributed, and 2,589,125 vaccinations have been administered between December 14 and December 30 at 9am.
“Clearly, we need to get better at this,” Dr. Paul Offit, an advisor to the US Food and Drug Administration on vaccine, told CNN’s Bianna Golodryga Wednesday.
An administration official said it’s expected the vaccination rates will improve with time.
“I worry a little bit that talking about the rate of administration at this point is like saying, ‘after opening day, my favorite player is on pace to hit 340 home runs.’ We’ve been working with jurisdictions since September on their vaccination plans and have great confidence in our partnership with them as they ramp up,” the official wrote in an email. “We are so early in this effort and there is tremendous work being done at all levels to get vaccines to Americans as quickly as possible.”
The official added that according to data reviewed by government officials, the US has distributed more vaccines total than any other country.
“Based on publicly reported vaccination totals, the U.S. has currently vaccinated more people than any country on earth just 16 days after the first COVID-19 vaccination program began in the U.S.,” the official wrote.
At a press briefing Wednesday, Gen. Gustave Perna, chief operating officer of Operation Warp Speed, said the vaccination numbers are likely higher, since there is a time lag of 72 to 96 hours between the shots and when they get reported to the CDC. He said he’s working to address that delay, noting that the data will “tighten up” as reporting becomes more routine.
“A+” for first part of the mission
Claire Hannan, executive director of the Association of Immunization Managers, gave the US an “A+” for the first part of the mission: getting vaccines distributed across the county.
When asked what grade she would give for the second part of the mission – getting those shots into arms – she laughed.
“I don’t want to give them a grade,” she said.
“Anyone with experience with vaccines knows that logistics are the easy part,” she added, referring to the planes and trucks that distributed the vaccines. “Getting vaccines into arms is the hard part.”
Organizing vaccination clinics takes time. The CDC has recommended that health care workers and residents of long-term care facilities should be the first two groups to receive the vaccines, and each group pose special challenges. Each group pose special challenges. Both the Moderna and Pfizer/BioNTech vaccines can make people feel sick the next day, so shots need to be staggered for health care workers. Obtaining consent for nursing home residents can be complicated, since some are not capable of giving consent, and family members must be located.
In addition, Pfizer’s vaccine must be stored at ultra-low temperatures.
“Pfizer’s vaccine doesn’t lend itself to large mass vaccinations, because it has very, very specific storage and handling requirements,” said Hannan, whose group has been helping states for several months with Covid-19 vaccination plans.
No national health service in US
Hannan pointed out that the countries that are outperforming the US – Israel, Bahrain, and the UK – have centralized national health services, which the US does not.
She said while reasonable people can disagree about whether a national health service is best for the US in general, there’s no question that such a service helps when launching a mass vaccination campaign.
In Israel, Bahrain, and the UK, “they already have a vaccine program that’s government run. They’re already providing vaccines to their citizens. They’re not building an entire infrastructure to do this – they already have it,” she said.
In the US, that public health infrastructure does not exist. For the Covid-19 vaccine campaign, legal agreements had to be arranged between the federal and state governments. Nurses had to be enrolled in a special program in order to give the vaccines. Surveys needed to be done to see which facilities had ultra-cold freezers to store Pfizer’s vaccine.
“The structure we have in the US doesn’t lend itself to vaccinating 300 million people in four months,” she said. “This just isn’t the way we do business.”
Dr. Celine Gounder, a member of the Biden-Harris transition Covid-19 advisory board, agrees.
Tuesday, she told CNN’s Jim Sciutto that health care in the US is “very decentralized, very fragmented,” compared to the National Health Service in the UK, “where they have really one system that they can roll this out smoothly to. We have many, many different small systems in this country.”
Hopes for the Biden administration
Wednesday morning, President Trump tweeted about vaccine distribution:
“The Federal Government has distributed the vaccines to the states. Now it is up to the states to administer. Get moving!”
Offit, a pediatrician at the University of Pennsylvania who’s advising his state on its Covid-19 plan, said this was less than helpful.
“To sort of stand back and point a finger at the states saying ‘it’s all your problem’ it just doesn’t make any sense,” he said.
Hannan, who worked with Operation Warp Speed for months on the vaccination implementation plan, said it was clear to her that government officials did not realize how much money, effort and organization was needed on the state level to get the vaccines into arms.
“I just don’t think they had an understanding of it,” she said. “There was a lack of understanding of the funding necessary to support the last mile.”
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In September and December, the US Department of Health and Human Services announced awards to state totaling $480 million to help with vaccine preparedness.
But Offit said more money is needed.
“Hopefully when the new administration comes in – which I think is more committed to making sure we can get the vaccine out there in an efficient way – things will get better.”
Naomi Thomas, Amir Tal, Andrew Carey, Samira Said, Michael Nedelman and John Bonifield contributed to this report