Note to readers: Utah officials on Sunday afternoon released additional vaccine data and requested the CDC confirm the state is getting its “fair share.” Read more here.
It’s unclear why thousands of COVID-19 vaccine doses delivered to Utah haven’t been given to eligible residents, even as the state reported dozens of deaths in the past week, hundreds of coronavirus patients were hospitalized and the rate of positive tests continued to hover around 1 in 5.
Utah has been allocated fewer doses per capita than all other states, an analysis by The Salt Lake Tribune has found.And under an earlier federal policy, our unused vaccine could have slowed the state’s already meager supply.
In a statement Sunday, Utah Department of Health executive director Rich Saunders said the government has “assured states this proposal is no longer under consideration.”
Still, the limited doses entering the state mean many vulnerable Utahns will face a long wait, even if they are considered a high priority.
Gov. Spencer Cox has vowed to speed up distribution, declaring any doses unused more than a week after delivery will be collected by the state and redistributed. State officials have said they are tracking the vaccine’s arrival in order to enforce Cox’s order.
But they still are not disclosing how many doses arrive in the state each day, or where they have been delivered, or whether they have been reclaimed by the state, thwarting public scrutiny of the rollout.
While at least 31,000 unused first doses have been in the state for more than a week, as of information that was available to The Tribune on Thursday, there is a dispute over who has much of that vaccine.
It’s known that a portion — 5,400 doses as of Thursday — was delivered to hospitals, local health departments and other distributors more than a week ago, but it’s not clear whether those doses have been collected for redistribution.
The Salt Lake Tribune submitted multiple questions to Cox’s Unified Command, which is overseeing Utah’s distribution of vaccine. Here’s what we know — and don’t know — about the pace of inoculations and where vaccine is going, as eligible residents clamor for their shots.
How much vaccine is Utah getting?
The federal government announces each state’s allocation every Tuesday. States then submit their orders, designating where those doses should be delivered. The orders are shipped the following Monday, and can take up to a week to arrive.
Utah has been allocated 524,000 doses through Jan. 25 — about 160 doses per 1,000 residents. That’s the least of any state, and well below the 190 doses that have been allocated per 1,000 people nationally.
Even excluding Utah’s disproportionately large population of children, who are ineligible for the vaccine under federal authorizations, Utah’s allocation so far amounts to the lowest of any state per capita, though to a lesser degree.
The U.S. Department of Health and Human Services did not respond to inquiries about Utah’s allocation.
It’s also unclear why the number of doses the state reports as shipped to Utah — 368,050 as of Thursday — is so far below the doses listed in the federal allocation: more than 454,000, as of the beginning of last week.
Joe Dougherty, spokesman for the state’s coronavirus response team, said the “allocation” includes doses that haven’t been ordered or shipped, but rather is advance notice of “what we’re allowed to draw from.”
However, the Jan. 25 allocation already has been announced, and it’s unclear why the state would not yet have ordered doses that were allocated on Jan. 18; even the total allocation a week before that, on Jan. 10, was 384,150 — many thousand more than the state reports have been shipped.
Where are Utah’s doses?
Let’s start with Utah’s second doses.
Of the 368,050 doses shipped to Utah, 141,025 have been designated as second doses that complete a COVID-19 inoculation. Those can’t be administered, state officials note, until three or four weeks after each patient receives their first dose.
As of Friday, 23,469 of those second doses had been distributed. That would leave a little over 120,000.
Cox said Thursday that state leaders have decided any second doses left unclaimed by patients for longer than seven days will be released as first doses.
The bigger question involves the state’s supply of first doses. As for those — Utah has been shipped 227,025, and 175,980 have been given to patients.
That leaves about 51,000 first doses that have shipped but have not gotten into patients’ arms.
State officials as of Thursday had not accounted for about 20,000 of those doses; they may have been in transit or may have arrived in recent days.
But at least 31,000 of those unused first doses arrived in Utah more than a week ago and still have not been used, state officials reported Thursday.
Where are those 31,000 unused doses?
Cox said this week that about 26,000 of those doses arrived more than a week ago and are waiting unused at CVS and Walgreens facilities in Utah, which have federal contracts to vaccinate residents and staff at nursing homes.
“Unfortunately, the federal partners are lagging behind in administering their first doses,” states a blog post on Utah’s coronavirus website. “This means vaccinations are sitting on shelves instead of getting those shots in arms.”
However, representatives for Walgreens and CVS have challenged Cox’s account in statements to The Tribune.
Federal officials control the terms of the contract with the chains, but the pharmacies take those doses out of the state’s share of the vaccine, Dougherty said.
According to state data posted Thursday, the two pharmacies have used only about a quarter of the roughly 78,000 total doses they have received for Utah nursing homes. They have given out fewer than half of their 46,000 first doses, the state said.
In Thursday’s online post, Utah officials wrote that they want to “renegotiate the plan” for the pharmacies with the federal Centers for Disease Control and Prevention.
And Cox, speaking Thursday, said federal officials have “given them more vaccine than they need,” not just in Utah but in other states, too.
Utah is working with the pharmacies now “to get those extra doses back — we believe there are thousands of them, maybe tens of thousands of them — and redistribute those to our local health departments so we can get those in the arms of those 70 years old or older,” he said. “That’s a big change and something that will make a huge difference.”
On Chris Cuomo’s CNN show, Cuomo Prime Time, on Saturday, Cox said of the pharmacies: “We estimate they have 15 to 16,000 extra doses that they don’t need and can’t use right now. So we’re taking that back, and we’re giving it to our local health departments and it will be gone next week.”
Cuomo interjected: “So they’re agreeing to give you the stuff?” Cox responded, “Yes, yes they are.”
But spokespeople for Walgreens and CVS say they do not have thousands of unused doses sitting on shelves.
As of Thursday, CVS had only enough doses left to complete the nursing home clinics it had scheduled in Utah for the following seven days, said spokeswoman Monica Prinzing. It is possible, she said that the state is calculating an excess based on a federal allocation estimate, which is different from the amount the pharmacies actually order and receive.
“Vaccine allocations for CVS Pharmacy are based on an estimate held in queue, not the actual amount of vaccine that will be ordered and used for a clinic at a facility,” she wrote.
Both CVS and Walgreens say they will complete all of the facilities’ first doses by Monday.
And both say that state officials directly approve the number of doses the pharmacies receive each week — in contrast to state officials’ statements that federal authorities decide how many to remove from Utah’s allocation for them.
If the pharmacies do not have the 26,000 doses that the state asserts have been delivered to them, that leaves unresolved the question of who has had that vaccine for over a week.
What about the unused doses delivered to other distributors?
The state reported as of Thursday that more than 5,400 doses have not been used in hospitals, local health departments and other places, despite arriving more than a week ago. But it’s not clear whether those doses have been collected for redistribution.
And because the state is only reporting how many doses each local health department has administered — but not how many they have received — it’s impossible for Utahs to know whether their county or regional health department is taking longer than others to use its supplies.
What is the impact of unused vaccine on Utah’s supply, going forward?
In remarks this month, former Health and Human Services Secretary Alex Azar warned that, starting this week, each state’s allocation of vaccine would be based in part on how quickly its previous doses were being administered.
Doses previously were apportioned by population.
“This new system gives states a strong incentive to ensure that all vaccinations are being promptly reported, which they’re currently not, and it gives states a strong incentive to ensure doses are going to work protecting people, rather than sitting on shelves or in freezers,” Azar said.
Emails sent shortly after the presidential inauguration were not returned nor is there any public announcement from the CDC or the White House. Saunders said Sunday that the federal government has reversed the policy.
Will Utah’s younger seniors get their turn soon?
Probably not. New doses for 30,000 to 35,000 people are arriving in the state each week; long-term care residents, teachers and others are still being vaccinated, but most doses are going to local health departments to give to residents ages 70 and older, a group that includes close to 240,000 Utahns.
All vaccination appointments for seniors filled up within hours of opening in some areas — and that was after throngs of prospective patients crashed websites and phone systems.
State Senate President Stuart Adams has said he wants Utah to lower its eligibility age for vaccination to 65, adding that he believes that would allow the economy to reopen more quickly. That’s in line with CDC recommendations to extend eligibility down to age 65.
But with Utah’s supply already spoken for through at least the next month, the state has little power to conjure the doses that the 124,000 Utahns ages 65 to 70 would need.
“It really doesn’t make sense to tell the public more people are eligible if there aren’t vaccines for them. So we will open up eligibility when it’s logical to do so,” Dougherty said.
That could happen as early as March, he said.
What about other vulnerable groups?
Although the state previously anticipated giving priority to some younger groups, such as patients with certain high-risk medical conditions, their outlook is also uncertain.
“Keep in mind that something like half of adults have at least one of the three most common conditions that lead to severe effects of COVID-19: diabetes, obesity or heart disease,” Dougherty said.
“If we were to just open up to people with those conditions,” he said, “we would cause way too much frustration because we wouldn’t have adequate vaccines for them.”
Note to readers: This story was updated with additional information the state provided to The Tribune on Sunday, Jan. 24.