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As the virus spikes, vaccine distribution is one more hurdle for states

People waited in line for COVID-19 vaccines at the East County Regional Library in Lehigh Acres, Fla., Dec. 29, 2020.OCTAVIO JONES/NYT

The coronavirus vaccine may end the pandemic at some point, but for now its slow rollout is straining relations between the federal government and states and cities, and is adding one more huge challenge for overstressed health departments.

In a tweet on Friday, President Donald Trump said the states were to blame for the slow start to inoculating Americans, after the federal government’s “successful and very large scale distribution of vaccines.”

But Mayor Eric Garcetti of Los Angeles said that at a time when the coronavirus is infecting a new person every six seconds in Los Angeles County, and the number of people hospitalized with COVID-19 across California has more than doubled in a month, the sluggish distribution of vaccine was not acceptable.


The Trump administration had said 20 million people would be vaccinated by the end of 2020. The figure was closer to 4 million.

“We are at a pace right now to deliver vaccines in L.A. over five years, instead of over half a year,” Garcetti said on the CBS program “Face the Nation.” He criticized the Trump administration for not planning ahead by training more medical workers to administer the vaccine, and for not giving enough assistance to state and local governments.

“The federal government can’t tell the local governments and state governments to do something and not give us aid,” he said.

Congress passed a stimulus package on Dec. 27 that will provide $9 billion toward vaccination costs, on top of $340 million that the Centers for Disease Control and Prevention sent to the states in September and December. But the new funds will arrive long after local health departments — already overburdened with mass testing and contact tracing efforts — had to begin planning for and administering vaccines.

The process is entering a new level of chaos as public health departments begin to make the vaccine available to high-risk members of the general public. In Houston, the city health department’s phone system crashed on Saturday, the first day of a free vaccination clinic, after receiving more than 250,000 calls.


Older people in Tullahoma, Tennessee, lined up on a sidewalk Saturday, leaning on walkers and sitting in lawn chairs, wrapped in blankets and heavy coats, to wait for the county health department to open its free clinic. The clinic exhausted its supply of vaccine before 10 a.m.

States have said their efforts are beginning to build momentum, and that some of the initial problems have been worked out.

Surgeon General Jerome Adams said Sunday that the slow start to the vaccination campaign was due in part to the holidays, when many public health workers were on vacation. It was also a time when virus cases were surging nationwide, leaving fewer local public health resources available than if the vaccine had arrived when cases were under control.

“The good news is that we’re seeing it quickly ramp up, thanks to our state partners,” Adams said on the CNN program “State of the Union.” “In the last 72 hours, we saw 1.5 million first shots reported.”

He said it was not a surprise that the program ran into snags.

“This was always going to be the most difficult vaccine rollout in history, even if it wasn’t superimposed on a surge and a holiday season,” Adams said, repeating a message he attributed to Dr. Anthony Fauci, the country’s leading infectious disease expert.


Another obstacle looms now, one that Adams said he is “terribly concerned” about: persuading enough Americans to take the vaccine.

In Ohio, for instance, Gov. Mike DeWine has said that about 60% of nursing home workers in the state have declined to be vaccinated so far, a statistic he repeated in a television appearance on Sunday. DeWine did not elaborate on where the figure came from; his office referred inquiries to the state’s Department of Health, which did not respond to inquiries about it on Sunday.

The figure rang true for Pete Van Runkle, executive director of the Ohio Health Care Association, which represents about two-thirds of Ohio’s skilled nursing facilities. In conversations with the association’s members, Van Runkle said many were reporting that less than half of their employees were choosing to receive the vaccine, and one said just 30% had done so.

Van Runkle attributed the low figures to misinformation and fear, and expressed hope that the reluctant workers will change their minds after seeing colleagues vaccinated without adverse effects.

“Folks are susceptible to that misinformation,” he said. “As they see what real life brings, hopefully that will make a difference.”

In an appearance on CNN Sunday, DeWine said the low acceptance rates among nursing home workers alarmed him, and would prompt more education efforts about the vaccine’s safety. He noted that nursing homes that educated their workers about the vaccine ahead of time have had far higher compliance.


“You have a risk,” he said of nursing home workers, “but also the people in that nursing home have a risk, and this shot does work, and is in fact very, very safe.”

In Los Angeles, which has become one of the country’s worst coronavirus hot spots, Garcetti warned that mask orders and restrictions on businesses have not been enough to slow the virus in private settings, where people let their guard down.

“This is something now that really is spreading in the home,” Garcetti said. “It’s a message for all of America: We might not all have the same density as L.A., but what’s happening in L.A. can and will be coming in many communities.”