The US has entered a difficult phase of the COVID-19 vaccination effort as suppliers try to increase the number of people getting first shots, while also ensuring a growing number of other second doses just when millions of Americans are eligible come to receive vaccinations.
The need to give each person two doses a few weeks apart complicates the country’s largest vaccination campaign to date. And continued uncertainty about future vaccine supply allows some people not to get their second shots on time.
In some cases, local health departments and providers have said they should temporarily limit or even cancel appointments for first doses to ensure there are enough second doses for people who need them.
Nola Rudolph said she struggled to make appointments for her 71-year-old father and 68-year-old mother, who live in rural New York State. Everywhere she looked was booked within driving distance.
“Since they are eligible, I was excited,” she said. “Since they were in a death zone, I again went very hopelessly to hopeless.”
She was able to arrange a second dose for her father, but could not yet find a slot for her mother. “It’s like walking around in a circle.”
The United States has administered an average of 900,000 first doses over the past month, according to data from The Centers for Disease Control and Prevention analyzed by The Associated Press. Now many of the people have to receive second doses, and the average number of Americans getting second shots peaked on Tuesday – 539,000 a day over the past week.
The increasing demand for second doses comes as the government of Biden is taking steps to increase the supply of doses.
White House COVID-19 coordinator Jeff Zients announced Tuesday that states will increase their dose allocation starting next week to 11 million a week, up more than 2 million weekly doses since President Joe Biden took office.
Since the vaccine was approved in late December, about 33 million people in the U.S. have received shots.
“It is really important and critical to realize that there are not enough doses to go around yet,” said Dr. Nirav Shah, director of the Maine Center for Disease Control and Prevention, said.
To date, about 10% of the U.S. population has received at least one dose of the vaccine. About 3% received both doses, according to the AP analysis.
Across Los Angeles County, health officials say limited supplies mean most vaccinations will be for second doses this week. In the state of Napa County, some first-dose appointments were canceled last week to ensure there was enough for second-doses.
‘We get a lot of questions from community members asking,’ Is my second dose in danger? “And at the moment we do not have an answer, because it all depends on the stock coming from the state,” said Alfredo Pedroza, a provincial supervisor.
Both COVID-19 vaccines distributed in the US require two shots with a few weeks apart to maximize protection. For Pfizer, the doses should be three weeks apart. For Moderna it is four weeks. But if necessary, the amplifier could be delayed by up to six weeks, according to the CDC, which updated its lead late last month.
State and local health officials are now emphasizing the extended time frame in public messaging to alleviate the concern that people may not get their second survey in time.
Federal officials have said they are confident there will be enough doses to ensure people get their second chance.
In some places it is difficult to discuss the second dose. Although many places schedule the booster when the first shot is given, other people ask to schedule it later due to logistical issues.
Tanny O’Haley is 64 and has Parkinson’s, but he is not eligible for the COVID-19 vaccine in Los Angeles County, where he lives. He was able to get a first dose when he accompanied his 69-year-old wife to her vaccination because there was a surplus on site.
O’Haley was unable to plan his second dose, despite numerous calls to local officials and the country’s health department. He plans to try again when he brings his wife to her second date on Wednesday.
“The whole experience was pretty awful,” O’Haley said.
In New Hampshire, officials are working to make the current scheduling system disappear after thousands of people struggled to book their boosts within the recommended time – some get appointments two months later. People now get appointments for their second shots when they get their first shots.
New Hampshire is one of several local jurisdictions that have registered for the use of the CDC’s Vaccine Administration Management System, or VAMS.
In the Las Vegas Convention Center in Nevada, a different kind of scheduling problem arose last week when the website opened as a clinic dedicated only to second doses. When appointments were made available online, people eager for their first doses picked up slots.
“We had enough vaccine – we just had to control the crowd one way or another,” said JoAnn Rupiper of the Southern Nevada District.
Appointments of people who planned a first dose on the premises have been canceled, Rupiper said. To ensure that suitable people who have had difficulty obtaining online appointments get their second chance, allow the conference center to walk in.
Despite the schedule confusion, health officials and suppliers say their biggest challenge remains the limited supply and the variability in how many doses are distributed week to week. Even with the increase in shipments announced by President Joe Biden’s government, local officials and suppliers say they do not have enough doses to meet demand.
The shortage is one of the reasons why dr. Anthony Fauci, the nation’s leading expert on infectious diseases, notes the potential value of the one-shot vaccine by Johnson & Johnson, which recently applied for emergency consent. The shot is also cheaper to manufacture and easier to steer.
Pedroza said the cancellations took place in Napa Province, California last week after leading to an increase in deliveries a few weeks ago, thinking the country would receive at least as many doses. But the peak appears to be a one-time windfall, Pedroza said.
In Seattle, at the end of January, UW Medicine temporarily stopped making new appointments due to limited supplies, combined with the need to give others their second doses.
“If there were more supply, we would like to do more first-dose appointments,” said Cynthia Dold, vice president of clinical surgery at UW Medicine.
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Associated Press journalists Paul J. Weber in Texas, Nicky Forster in New York, Olga R. Rodriguez in San Francisco, Michelle R. Smith in Providence, Rhode Island and Holly Ramer in Concord, New Hampshire, contributed to this report.
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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Scientific Education. The AP is solely responsible for all content.