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Short of Vaccine, States Find Hidden Stashes in Their Own Backyards

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Millions of doses of coronavirus vaccine are still sitting in freezers, allocated in excess to nursing homes or stockpiled for later use. Now states are claiming them.

A resident of the Somanath Senior Apartments received her first vaccine dose in Richmond, Va., this month. Federal officials estimate that up to six million doses are being unnecessarily stowed away. A resident of the Somanath Senior Apartments received her first vaccine dose in Richmond, Va., this month. Federal officials estimate that up to six million doses are being unnecessarily stowed away. Credit…Carlos Bernate for The New York Times

  • Feb. 19, 2021Updated 8:43 a.m. ET

RICHMOND, Va. — When tiny glass vials of coronavirus vaccine began rolling off production lines late last year, federal health officials set aside a big stash for nursing homes being ravaged by the virus. Health providers around the country figured as well that it was prudent to squirrel away vials to ensure that everyone who got a first dose of vaccine got a second one.

Two months later, it is clear both strategies went overboard.

Millions of doses wound up trapped in logistical limbo, either set aside for nursing homes that did not need them or stockpiled while Americans clamored in vain for their first doses. Now a national effort is underway to pry those doses loose — and, with luck, give a significant boost to the national vaccination ramp-up.

In New York, Gov. Andrew M. Cuomo has pushed the Biden administration to allow him to claw back 100,000 excess doses that were allocated to the federal program for long-term-care facilities. In Michigan, Dr. Joneigh S. Khaldun, the chief medical executive, is raiding nursing home doses that she said had been locked in a “piggy bank” controlled by CVS and Walgreens, the two pharmacy chains in charge of the federal initiative.

And in Virginia, Dr. Danny Avula, the state’s vaccine coordinator, said he has been “wheeling and dealing like on a trading floor” to free up tens of thousands of doses for the general population.

Dr. Avula, a 42-year-old pediatrician and preventive medicine physician, came to the job in early January to find multitudes of Virginians languishing on vaccination waiting lists and less than half of the state’s vaccine allotment actually making it into arms.

So first he cut off the spigot of doses for nursing homes until existing stocks were exhausted. Then, in talks with six of the state’s hospital systems, he offered a deal: If they released the vials they were saving for second doses, they would be guaranteed two doses later for every vial they surrendered.

The hospital administrators agreed, with some trepidation. “You’ve got to be sure about this,” he said they told him. “Because we can’t be left empty-handed.”

ImageWhen Dr. Danny Avula became Virginia’s vaccine coordinator in early January, less than half of the state’s vaccine allotment was making it into arms. When Dr. Danny Avula became Virginia’s vaccine coordinator in early January, less than half of the state’s vaccine allotment was making it into arms.Credit…Carlos Bernate for The New York Times

The get-tough approach in Virginia and other states has begun to pay off. The gap between the number of doses shipped to states and the number injected into arms is narrowing: More than three-fourths of the doses delivered are now being used, compared with less than half in late January, according to the Centers for Disease Control and Prevention’s data tracker.

President Biden is pressing for speedier inoculations as well — a case he is expected to make on Friday, when he travels to Kalamazoo, Mich., to visit the manufacturing plant of Pfizer, one of the two manufacturers of federally authorized vaccine.

Federal officials estimate that as many as six million vaccine doses are still being unnecessarily stowed away. Freeing them up could increase the number of doses used by more than 10 percent — significantly stepping up the pace of the nation’s inoculation program at a time when speed is of the essence to save lives, curb disease and head off more contagious variants of the virus. So far, 56 million shots have been administered, and only 12 percent of Americans have received one or more doses.

The idea that doses are sitting in cold storage while millions of people languish on waiting lists has deeply frustrated government officials. The roots of the problem are twofold.

First, when the federal vaccination program for long-term-care facilities began late last year, the C.D.C. based allotments on the number of beds, even though occupancy rates are the lowest in years. According to the American Health Care Association, a trade group, only 68 percent of nursing home beds and 78 percent of assisted living beds are now filled.

Then the C.D.C. doubled that allotment to cover staff. But while four-fifths of long-term-care residents agreed to be vaccinated in the first month of the program, 63 percent of staff members refused, the agency reported. More have since agreed, although it is not clear exactly how many more.

Despite the lack of uptake, the pharmacy chains that administer the program continued tapping their allotments from the federal government. At one point in Virginia, Dr. Avula said, they had used fewer than one in every three doses they had on hand.

As “good, corporate, risk-averse companies,” Clark Mercer, the chief of staff to Gov. Ralph Northam of Virginia, said, “if they can draw down, they are going to draw down.”

Even more vaccine has been hoarded as second doses, federal and state officials say. Both authorized vaccines from Moderna and Pfizer-BioNTech require two doses, spaced three to four weeks apart.

Gov. Ralph Northam of Virginia at a mobile vaccination clinic in Richmond. Mr. Northam said he wanted doses used within three or four days after shipments arrived.Credit…Carlos Bernate for The New York Times

The White House has been urging states not to squirrel away second doses ahead of time, and is providing three-week projections of supply as reassurance that they will not come up short.

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