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The New York Times

A new COVID dilemma: what to do when vaccine supply exceeds demand?

And now, for a thorny new dilemma for states attempting to vaccinate their residents against COVID-19: What to do when vaccine supply greatly exceeds demand? Several states, long desperate for as many doses as they could get, are now inundated with unused doses of COVID vaccines as demand declines and supply continues to rise. And many must either find new and creative ways to immunize the hard-to-reach and hesitant people or start cutting back on their supplies, even though 43% of Americans haven’t received any immunizations. About 112.6 million people, or 34% of the population, were fully vaccinated on Saturday. Sign up for the New York Times newsletter The Morning The demand slowdown was somewhat expected. During the initial wave of vaccine distribution throughout the winter and into the spring, appointments were coveted and often difficult to find. But today vaccines are more widely available and those responsible have been left to target groups who may have missed out on vaccines because they are too poor, isolated or hard to reach, or because they are either skeptical of the vaccine or be convinced not to. I do not want it. Of the 329 million doses shipped by the federal government to states, about 257 million have been administered, according to the Centers for Disease Control and Prevention. Several states are now sitting on surpluses, leaving officials to grapple with how best to find willing weapons and, in the meantime, telling the federal government not to send in their full allowances. While some states, including Colorado and Maryland, are still asking for their full allocations, others are reducing their deliveries, according to the Associated Press. North Carolina cut deliveries by 40% last week. Connecticut only requested 26% of its full delivery, and South Carolina requested only 21%. At the end of last month, Arkansas asked for a complete halt to its shipping for at least a week, the Arkansas Democrat Gazette reported. As demand for vaccines has slowed, the outlook for the pandemic in many parts of America looks bright. Michigan hospitalizations, which rose sharply from mid-March to mid-April, have continued to decline since then. Illinois Governor JB Pritzker said last week that the state would fully reopen next month. Announcing his plans to reopen, New York City Mayor Bill de Blasio said, “It will be New York summer.” Despite these signs of optimism, some public health officials fear that slowing demand for vaccines could lead to lingering problems from the coronavirus, including hospitalizations and deaths that are now preventable. At a press conference last week, West Virginia Governor Jim Justice pleaded with residents, especially the younger ones, to “really step up.” “If you can bear to see a loved one die, fine. I can’t stand it, ”Justice said. “This thing is far from over.” “I can’t stand these masks,” he added, throwing one on his desk. “I want to get rid of it.” The federal government distributes vaccines to jurisdictions based on population, but the Biden administration confirmed last week that it plans to change allocations based on the number of vaccines ordered by each jurisdiction. At a press conference last week, Governor Asa Hutchinson of Arkansas set a goal of vaccinating 50% of the state’s population over the next 90 days. If the state does not use the vaccines that were previously allocated to it by the federal government, he said, “these vaccines could be sent to Massachusetts because the acceptance rate is higher there.” This change in vaccine allocations reflects a trend in many states: fewer and fewer people are vaccinated over the weeks. “This is actually what we expected,” said Dr Amesh A. Adalja, infectious disease specialist at the Johns Hopkins Center for Health Security, adding that the next phase of vaccines would present “a much more difficult prospect.” . Jennifer Nuzzo, senior public health researcher for the Johns Hopkins COVID-19 Testing Insights Initiative, said that in many cases the easiest-to-reach populations had already been vaccinated. The rest fall largely into three groups: people who want the vaccine but couldn’t get it; people who are somewhat hesitant about the vaccine or who are slow to get the vaccine even though they could find one; and those who oppose vaccination, whether for religious or philosophical reasons, or because they trust misinformation that the vaccine is either dangerous, ineffective, or part of a conspiracy. “Even though I think the demand is down, I think there are still people who really want to get it but haven’t been able to,” Nuzzo said. “I don’t think we’ve got past the access issue.” Among these populations are elderly people confined to the house, who may not have been able to access a vaccination site or who could not make an appointment due to technological problems; and some working parents, or others who live in communities where vaccine suppliers are not nearby, she said. Many states and local governments are prioritizing access, strengthening mobile clinics, and eliminating appointment requirements at mass vaccination sites. The Biden administration is promoting similar policies to increase availability, including directing pharmacies to offer walk-in appointments and shipping new vaccine allocations to rural health clinics. Nuzzo said the effort to reach these groups could look like a “get out of the vote” campaign, where different networks, such as pharmacies, primary care physicians and community organizations, reach out to people on an individual basis. door-to-door. or by contacting them in another way. The second category – those who might be skeptical of the vaccine or who take a “wait and see” approach to getting vaccinated – present other challenges. As the rate of new COVID-19 cases declines, the incentives to get the vaccine may wane as the perceived threat of becoming ill decreases. The drop in demand for vaccines coincided with a significant drop in coronavirus cases from mid-April, from around 70,000 cases per day to 42,000 on Sunday. Still, Nuzzo said the reasons for not getting a shot, such as a certain level of skepticism, could also diminish over time. As more and more people get vaccinated, those who are unsure will find that serious side effects are almost nonexistent. The third group – those who are adamantly opposed to the vaccine, and especially those who have been convinced by misinformation and conspiracy theories – might be less likely to be persuaded by the absence of side effects. “The spread of disinformation online, we must tackle,” Nuzzo said. “Never in my career have I seen the reach as wide as it is.” Promoting the idea of ​​freedom for those vaccinated could be an effective way to encourage more vaccinations, especially among those who are open to persuasion and still making up their minds, officials say. While hesitant people seek out side effects – and find few, if any – they will also see their vaccinated friends and family enjoying the luxuries of a pre-pandemic life like going to concerts and seeing older relatives. and do all of these activities without the lingering fear of getting sick or making someone else sick. Adalja said federal health guidelines should be careful to avoid “underselling the vaccine,” and that federal officials appeared to be “several steps behind what infectious doctors like me tell people who are fully vaccinated this way. that they can do. ” It is still unclear how the rest of unvaccinated Americans fall into these three categories. On average, providers administer about 1.98 million doses per day, up from 3.38 million on April 13. While the Food and Drug Administration is set to approve the Pfizer-BioNTech vaccine for teens next week, it’s unclear how much demand will increase as a result. According to data from the US Census Bureau, the soon-to-be approved age group, 12 to 15, could be less than 20 million people. Nuzzo said if vaccination rates continued to lag, local communities could see large outbreaks. While the nation as a whole will not suffer like it did last winter, some communities with lower vaccination rates may continue to see more hospitalizations than necessary. “So many people have lost their lives,” she said, “and all of this can be avoided now.” This article originally appeared in The New York Times. © 2021 The New York Times Company

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