The New York State Department of Health says appointments to get the Covid-19 vaccine are booked for the next 3½ months, quickly filling up after the state expanded eligibility criteria to adopt new federal guidelines.
Federal officials have been pressuring states to expand the eligibility requirements in an effort to speed up what has been a slower-than-anticipated rollout. On Tuesday, the Centers for Disease Control and Prevention urged states to expand eligibility largely from health-care workers and nursing home residents to all people 65 and older, and younger people with compromised immune systems.
States that thought they would be vaccinating millions of people a week by now have in reality given out a few hundred thousand shots of the two-dose vaccines since federal regulators cleared Pfizer and Moderna’s vaccines for public use in mid-December. Local officials across the U.S. are struggling to ramp up vaccine distribution as millions clamor for a few thousand open slots to get the first inoculations.
In New York state, vaccine providers across the state are in various stages of establishing their programs, said Jill Montag, a spokeswoman for the state Health Department. Some aren’t yet administering shots but will open up more reservations online when they do, she said. Demand, however, is still far outpacing supply.
New York Gov. Andrew Cuomo said further expanding to those 65 and older will open the eligibility to about 7 million of the state’s 20 million residents.
The Health Department’s vaccine information site, in the meantime, warns in an all-caps banner: “ALERT! OVER 7 MILLION NEW YORKERS ARE NOW ELIGIBLE FOR THE COVID VACCINE BUT THE STATE ONLY RECEIVES 300,000 DOSES PER WEEK FROM THE FEDERAL GOVERNMENT.”
The alert, which appears to have been posted Wednesday, informs New Yorkers that all appointments have already been booked for the next 14 weeks.
Some public health specialists have said expanding the eligibility criteria is the right move, citing reports of doses sitting in refrigerators or spoiling due to low uptake in prioritized groups. Others have said expanding eligibility so drastically could sew further confusion in what’s already a herculean logistical and public communications effort.
Representatives for the CDC did not return CNBC’s request for comment.
“States should not be waiting to complete phase 1a prioritization before proceeding to broader categories of eligibility,” U.S. Health and Human Services Secretary Alex Azar said Tuesday, explaining the new guidance. “Think of it like boarding an airplane. You might have a sequential order in which you board people. But you don’t wait ’til literally every person from a group is boarded before moving on to the next.”
Frustration and anxiety
Cuomo quickly announced Tuesday that the state would adopt the new guidance. The state had prioritized health-care workers, and expanded that over the weekend to include those 75 and older and some public workers, such as teachers and police officers.
But in accepting the new CDC guidance, Cuomo warned that it would create outsized demand for the vaccines. He added that if the government is unable to meet the demand, it could cause people to lose “belief in the competence of government.”
The state has received 1.7 million doses of the vaccines from the federal government, about 300,000 doses a week, but has been able to administer just 632,473, according to CDC data collected from the states. Even if the state was able to administer every shot in real time, it will take two to three years to vaccinate New York’s 20 million residents at the current pace.
“So you’re telling people today, ‘You’re eligible,’ but you’re simultaneously telling people, ‘We don’t have enough dosages to get to you for the next six months,’” Cuomo said Tuesday. “Is that helpful? I don’t think so. I think it creates more frustration and more anxiety.”
The Health Department’s Montag called the quick filling of appointments “good news.”
“New Yorkers are showing they trust the vaccine and want to get vaccinated as soon as possible. The challenge is we can only vaccinate as fast as the federal supply allows,” she said. “We ask for patience as we implement the largest single vaccination effort in state history. In the meantime keep wearing your mask, be smart, be safe and be ready when a vaccine is available for you.”
‘Outstripping supply’
All indications are that the federal government will ramp up distribution of doses to states in coming weeks, said Dr. Jen Kates, senior vice president and director of global health and HIV policy at the Kaiser Family Foundation. The Trump administration announced earlier this week it will begin releasing nearly all of the vaccine doses it has held in reserve so people can get the second shot required for full immunization. And more vaccine manufacturers, like Johnson & Johnson, could soon receive authorization and increase supply.
“Demand is definitely outstripping supply,” Kates said Thursday. She and her team are closely tracking state vaccine distribution plans. She said situations like New York’s are playing out across the country, including Los Angeles County and several counties in Florida.
“If you look at the full group of people who the federal government is saying should be vaccinated, that’s more people than the manufacturers say they have doses for,” Kates said.
About 53 million Americans are older than 64 and 110 million people between 16 and 64 have comorbid conditions, according to the CDC. If every state adopts the new federal recommendations, millions of people will be stuck waiting for months, even if the ramps up quickly, Kates said.
In the initial weeks of the rollout, state plans for vaccine eligibility have varied widely. Kates said the new recommendation appears to be an attempt to align more states with federal guidance, but she added that it’s confusing, given that the CDC’s original recommendation was released only a few weeks ago.
“Now less than a month later, they’re coming out and saying something totally different and almost throwing that out,” she said, adding that changing guidelines adds complexity for state officials. “There has to be a balance between fixing things as we go forward and maintaining guidelines.”
