Why does Utah rank as one of the slowest states at vaccinating residents against COVID-19?

Utah is using its doses relatively quickly. But it would get more if the government would stop using outdated population data, analysis shows.

(Rick Egan | The Salt Lake Tribune) Tahmeena Ameen administers a Johnson & Johnson Covid-19 shot to Nate Mayfield at the Orthopedic Specialty Hospital in Murray on Thursday, March 4, 2021.

Utah this week invited its biggest group yet to join the line for COVID-19 vaccinations, as residents over 50 and with more common health conditions — like diabetes or a lower level of obesity — started snapping up appointments.

Yet Utah consistently appears at or near the bottom of nationwide rankings of how quickly states are vaccinating their populations — with just 6.1% of its population fully vaccinated as Friday morning, on The Washington Post’s tracker. At the other end of the spectrum, Alaska has 14.2% of its residents vaccinated.

The New York Times tracker has similar numbers. Data on the Covid Data Tracker from the federal Centers for Disease Control and Prevention shows Utah had administered fewer vaccine doses per capita than all but six states as of Friday.

But analyses also show Utah is administering the shots it receives relatively quickly, compared to other states. The New York Times pegged Utah as having put 78% of its delivered doses into arms as of Friday, putting it a little below the top 10 states, led by New Mexico at 86%.

What gives? State and federal officials say the explanation is that vaccines are allocated according to each state’s adult population, rather than their whole population. Utah has a larger share of children than other states.

And The New York Times, for example, confirmed its analysis is based on the total population of each state, using the most recent 2019 Census Bureau estimate.

But another piece of the puzzle, the Las Vegas Review-Journal reported this week, is that vaccine allocations are based on outdated state population data — which hurts fast-growing states.

Utah, the youngest state

Here are some examples an official with the CDC’s COVID-19 Response team provided state officials, when they inquired in January whether Utah was receiving its fair share of doses.

In the population data the federal government is using, Utah has a total population of 3,045,350, said Taran Pierce, a regional coordinator with the U.S. Department of Health and Human Services. The Salt Lake Tribune requested and received Pierce’s email from the state health department.

Of those residents, 918,822 are 17 years of age or younger. That’s just over 30% of Utah’s population. Pierce offered comparisons to other states similar in total population size:

Utah: 30.2%.

Iowa: 23.3% of 3.13 million.

Nevada: 23.1% of 2.92 million.

Puerto Rico: 21.6% of 3.19 million.

Connecticut: 21% of 3.58 million.

“Utah gets about 10% fewer allocations than if we included the entire population,” Pierce explained. “Put another way, Utah makes up about 0.93% of the U.S. population when people of all ages are eligible for the vaccine. When we exclude those who are not eligible to receive the vaccine, Utah makes up 0.84% of the U.S. population.”

‘I hate that metric’

Gov. Spencer Cox made this point in late February, when KSL-TV reporter Jacob Klopfenstein asked at the weekly coronavirus briefing about a Wall Street Journal report that put Utah last in the nation for the share of the population that has received vaccine.

“That is the worst possible metric to use. I hate that metric,” Cox said. “Obviously I hate it because it puts us last. But it’s also incredibly unfair.

“Because you can’t say, what is the share of the total population who’s gotten the vaccine and then say, yeah, but you can’t vaccinate anybody under the age of 18.

“And then .. we’re here over in the corner saying, hey, ... we have the youngest pop in the nation?”

The government distributes vaccine based on the population numbers it chose, Cox said.

“We can’t change that formula, right? — they have their formula, it’s fair, we can argue there that should be a different way to do it, but we can’t change that formula — all we can do, is get the vaccines in arms that come to us. And that’s what we’re doing.”

Cox said his focus is on which portion of the population is getting vaccinated — noting that at that point, 73% of the state’s deaths were among residents age 70 or older.

“I’d rather have 70-plus percent of our, those 70 years old and older vaccinated than having, you know, 14 percent versus 11 percent of the entire state,” he said. “...That’s where our focus is.”

But is it fair?

Nevada health officials wondered earlier this year why their vaccination progress looked slower than other states, and questioned whether the state was being shortchanged on doses.

In January, the Las Vegas Review-Journal calculated the doses allocated to each state per 100,000 adult residents, using population estimates data from 2018, 2019 and projections for 2020.

In each analysis, Nevada had one of lowest allocation rates nationwide, it found, ranking alongside other western states — including Utah.

Utah was being allocated 13,032 doses per 100,000 adult residents, close to Nevada’s 13,074, the Review-Journal said. At the other end of the spectrum, Vermont was receiving 15,127 doses per 100,000 adult residents.

This week, the Review-Journal followed up and reported that the federal government is relying on old data to make its allocation decisions — each state’s estimated adult population as calculated in the Census Bureau’s 2014-18 American Community Survey.

Using that data to calculate Utah’s share of total U.S. adults puts it at a disadvantage, as it does Nevada and other fast-growing states, analysis by The Tribune shows.

Utah gained roughly 46,960 adults in newer Census population estimates issued in December with the 2015-2019 American Community Survey — and that difference gave the state a slightly bigger share of total U.S. adults as a result, up from 0.85% to 0.87%.

Even that small difference could have accounted for as many as 13,385 vaccines being allocated to other states instead thus far in the rollout, based on Tribune data analysis.

HHS officials have not returned emails to The Tribune this week about Utah’s allocation per capita, or its use of outdated population numbers.

What if the government used Utah’s current population?

An unnamed White House official told the Review-Journal this week that changing to updated population estimates was an “active point of discussion.”

“I think we are certainly wanting to balance using the best numbers, the most recent numbers,” the official said. “I would expect that there will be a change at some point.”

To assess Utah’s allocation against current population data — and how it might look if the feds used that instead — The Tribune looked at July 1 estimates of the total population and the portion specifically age 18 and older.

This updated data shows an adult Utah population of 2,320,000 — compared to the 2,126,528 figure in the example cited by Pierce.

Federal data shows Utah has been allocated 526,395 first doses of Pfizer and Moderna’s two-dose vaccines, and single doses of Johnson & Johnson’s one-dose vaccines, as of March 1.

That amounts to vaccines for fewer than 227 of every 1,000 people, using an adult Utah population of more than 2.3 million.

By contrast, the national average (based on the same population figures) is about 239 first or only doses of vaccine per 1,000 people.

The difference amounts to vaccinations for at least 28,000 Utahns. Only Idaho and Arizona had received lower vaccine allocations per adult as of March 1.

Allocations are made during the week before they’re shipped from the manufacturers, and each state submits orders telling drug makers where to ship them — typically to health departments, pharmacies, or hospitals. After shipping, it still takes a few days for them to be delivered.

Utah is not quite so far down the rankings for doses actually delivered to each state, according to federal data.

But, based on the 2020 data, it still is below the national average — about 387 total doses per 1,000 adults, compared to a national average of about 396 within the 50 states and Washington, D.C.

That amounts to 21,000 additional doses Utah would have received if it were on par with the rest of the country and the government used current data.

— Reporter Tony Semerad contributed to this story.