COVID-19 Vaccines: How NJ Tries to Juggle Supply and Demand

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This story was written and produced by NJ Spotlight. It is being republished under a special NJ News Commons content-sharing agreement related to COVID-19 coverage. To read more, visit njspotlight.com.

Click here for the original article, written by Lilo H. Stainton.

In New Jersey, COVID-19 vaccines are now available at more than 160 locations — including hospitals, pharmacies, community health centers and government-run clinics — and four of the state’s planned six mega-sites are now immunizing eligible individuals.

But six weeks after the first New Jersey resident got her initial dose, the statewide operation continues to run at far less than full speed. Concerns include public confusion, a complex sign-up system, an initial workforce shortage in some places, and perhaps the biggest hurdle of all, not enough vaccines to meet the demand.

“We’ve got plenty of people (to administer vaccines), it’s not an issue” at the Gloucester County mega-site, state Senate President Steve Sweeney (D-Gloucester), a former county freeholder, told NJ Spotlight News last week. “We just need the vaccine,” he said. “We’ve really got to step it up now.”

New Jersey officials agree that more doses are needed statewide and have blamed the federal government for an unpredictable supply. Early on, state leaders said some expected shipments were cut by more than one-third and they continue to receive about 5% fewer doses than requested.

Waiting for a Biden surge in supplies

The Trump administration promised last week to release additional COVID-19 vaccines from a stockpile it had allegedly maintained, but news reports on Friday indicated this “reserve” had already been distributed. President-elect Joe Biden has pledged to beef up the vaccine rollout once he takes office this week.

“The vaccine supply is extremely limited and will be for some time,” New Jersey Department of Health Commissioner Judy Persichilli said Friday. “We understand that people are anxious to get the vaccine,” she said, adding, “we urge everyone to be patient.”

More than 1.5 million individuals have enrolled through the state-run registration process to be vaccinated; some county, local and hospital clinics are also operating their own online sign-up processes, which are not linked to the state system. Eligible residents are encouraged to sign up either through a nearby system or use the state version, which will alert them by email when they can make an appointment at a convenient facility.

“The state is working hard to vaccinate as many eligible people as possible with the available doses we have,” Persichilli said. She has encouraged people to sign up through whatever system is most convenient, noting, “we just want people to be vaccinated.”

Currently, operators at county and local vaccination sites request vaccine supplies from the state, which places orders with the federal government. Once federal officials notify the state of its weekly allotment, state health department staff review the local requests, the site’s current inventory, its vaccination capacity and geographic location, and distributes vaccines accordingly “to ensure a broad allocation throughout the state,” DOH communications director Donna Leusner said Friday. Vaccines are then shipped from manufacturers directly to hospitals and other vaccine sites.

Murphy: ‘Supply/demand imbalance’

“It’s a concern we know exists,” Gov. Phil Murphy said Friday of the need for more supplies at county and local levels. “We continue to be on this supply/demand imbalance.”

By the end of last week nearly 310,600 New Jerseyans had received at least one of the two required doses of a vaccine, Murphy said, a figure that had grown by nearly 23,000 in 24 hours. The process currently is open to health care workers, long-term care residents, firefighters and law enforcement, individuals over age 65 and people with specific pre-existing conditions, including cigarette smoking.

Persichilli said Friday the state is now receiving around 106,000 doses a week, half from Pfizer and half from Moderna, the pharmaceutical companies that have had vaccines approved. But New Jersey needs to get 460,000 doses a week to meet current demand and efficiently reach its target of immunizing 4.7 million residents, or 70% of those eligible, she said.

The DOH has repeatedly declined to say how many vaccines the state has received to date, but insists it is not stockpiling doses. According to the federal Centers for Disease Control and Prevention tracker, as of Friday morning 658,800 doses had been shipped to New Jersey and 317,000 administered. That means 3,600 New Jerseyans per 100,000 have had a shot so far, compared to roughly 3,200 in Delaware, 3,500 in Pennsylvania and 3,900 in New York, the CDC reported.

“For whatever reason, the supply chain has not really opened up,” said Passaic County administrator Anthony DeNova, resulting in outsize local demand. Passaic County has been vaccinating around 215 people daily through its health department, he said, for a total of more than 13,700 by Friday. But DeNova said the county had to cancel nearly two days’ worth of appointments recently when it received less than half of what was requested from the state.

Speaking of frustrations

“It has been somewhat frustrating,” DeNova said, noting people don’t want to hear the county blame the state and the state blame the federal government, even if that is the truth. He said county officials have had people show up in person to demand vaccination and vent their anger online. “We are not alone,” he added, noting other counties are facing similar shortages, “because the vaccines just weren’t available from the state.”

Passaic County plans to open a new, much larger operation Wednesday at a former Modell’s sporting goods store in Woodland Park, which DeNova said has roughly five times the daily capacity as the county health department. But that can only happen if county officials receive the 2,000 vaccines they ordered through the state, he added.

“Our goal is to have six days a week” at sites across the county, DeNova said, “but we have to make sure we have enough vaccines to cover it all.”

Sweeney said the Gloucester County site, one of the first mega-sites to be established in the state, could handle immunizing as many as 4,000 people a day. As of Friday, it had provided more than 10,200 shots. But several times staff had been sent home and vaccination appointments canceled because “we didn’t have vaccines to put in anybody’s arms,” he said.  “Every person we can get a needle into is one less person we have to worry about.”

From a county perspective, limited vaccine supply is one of several challenges. The New Jersey Association of Counties shared letters it had sent to Murphy in December asking for additional communication from state officials concerning the vaccine rollout, assistance coordinating scheduling and reporting systems, help purchasing items like dry ice and more funding to pay for the operations.

The DOH suggested the state has worked hard to keep county and local officials in the loop throughout the pandemic, including by holding daily conference calls at the start in March. County representatives said they now talk several times a week, but state officials don’t always give them enough advance notice to be able to accommodate policy changes.

Caught off guard

For example, when the state announced last Wednesday it would open up the vaccination system to more than 2 million additional residents — including those over 65 and smokers of any age — some county leaders said they were caught off guard. They did not have enough time to update their online signup system or recruit additional vaccinators, while demand suddenly skyrocketed.

The expansion in eligibility also frustrated some residents who took issue with Murphy’s decision to add smokers to the priority group before certain essential workers, like teachers. On Friday, Murphy pushed back on what he called this “false narrative,” stressing that the state has sought to vaccinate those most at risk first, and coronavirus attacks the respiratory system, putting those who smoke in real danger.

“What we need to end this divisive and unproductive debate is an increase in our vaccine supply, and for that we need a federal administration that will unleash the process to meet demand,” Murphy said, welcoming the pledge by fellow Democrat Biden to increase supplies. “We should not hold back — we should be throwing everything we have at ending this pandemic,” Murphy said.

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