It’s no secret that there is a limited supply of vaccine doses.
“We need more vaccines,” Gov. Ned Lamont said during his Thursday press briefing. “We have the capacity to vaccinate a lot more people.”
Josh Geballe, Lamont’s chief operating officer, said the same: “We are in a position of scarcity in Connecticut at the moment.”
Deciding how to distribute what vaccine doses are available is a matter of balancing competing interests, and the goalpost has moved as more local providers get up to speed.
Within the last week, the state has shifted its strategy, Geballe said. The priority had been getting vaccine doses to those providers “who had the capacity and were scaled up,” the relatively small number of local distribution sites that could effectively distribute the vaccine.
“Now we have far more providers than doses to give them,” Geballe said.
The Yale New Haven Health system is an example. They’ve expanded the number of distribution centers — most recently opening up the Floyd Little Athletic Center in New Haven — and plan to open more in the coming week.
But demand has always “far outstripped supply,” according to spokesperson Vincent Petrini, which he said is “what’s keeping us up at night.”
“We’re using every dose of vaccine that we receive,” he said.
Nuvance Health, which runs hospitals in Norwalk, Danbury, Sharon and New Milford, is no different.
“Capacity at our clinics and how many healthcare workers we are able to offer vaccines to is dependent on supply,” spokesperson Amy Forni said in an email. “We have placed orders and though we receive most of what we request, the numbers have trended down this week due to limited supply to the state.”
The Yale New Haven Health system had been requesting between 10,000 and 12,000 vaccine doses a week, Petrini said, and more as the system scales up. “Presently we need at least 12,000 doses per week to meet the needs of our current appointments, ramping up to 40,000 per week by mid-February as we open up all of the community access sites,” Petrini said.
But the doses simply aren’t available.
“We’re getting far less than we request,” Petrini said, and they never know exactly how many doses they will be allocated. One week they received 6,000 doses. Another week, the 10,000 they asked for.
“It’s variable, that’s the challenge,” Petrini said. “There’s no window into the number of doses we’re going to get any given week.”
At last count, as of Thursday, Connecticut had distributed a total of 260,000 first doses, making it third in the nation in terms of doses per population. The state, Geballe said, weighs several factors in deciding how to distribute the doses it receives from the federal government.
“We’re making sure that we’re providing a fair share of doses across the state geographically by population,” Geballe said. They’re also favoring those providers “that have used their supply efficiently.”
Geballe said the metric is “throughput,” which he defined as “the number of doses they can administer per day.”
“We’re also allocating some doses for mobile vaccination clinics,” Geballe said, specifically intended to serve congregate communities like shelters and nursing homes.
Vulnerability and access is also a factor that must be weighed. Communities of color, for example, have been disproportionately impacted by the pandemic, and that must be taken into account as well.
“Our priority is to ensure the ones who are most vulnerable have access,” Petrini said.
The good news is that the supply issues may be easing off in the coming weeks. Lamont said Thursday that Pfizer may be able to double its vaccine production by the end of February, and then double it again by the end of March.
There are two vaccines available now, made by Pfizer and Moderna, but vaccines produced by Johnson & Johnson and AstraZeneca are expected to be approved soon, which will add more capacity.
President Joe Biden, when he released his administration’s COVID-19 response plan this week, said the goal was to administer 100 million vaccines in the next 100 days.
But vaccine production is only one problem of many. Lamont said that a “bottleneck” was the need for specialized machines to mix the vaccines, but staffing has also been a concern.
Petrini said Yale New Haven has been using medical and nursing students to bolster their staffing needs, and volunteers to act as greeters and support workers.
There’s also the question of how to seamlessly register millions of people, never knowing how many doses will be available on any given week.
“It’s like everything else with COVID, we’re learning new things every day,” Geballe said. “We’re building the plane as we fly it.”
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