For days after Florida Gov. Ron DeSantis (R) announced that the potentially lifesaving vaccine would be available to seniors, Shlevin had no idea when she and her husband would have a chance at it.
“You had at least six months to get ready. You could have figured out a better way to do this,” said Shlevin, of Pompano Beach, Fla. “It shouldn’t be this hard.”
After months of anticipation, millions of doses of the two authorized coronavirus vaccines — made by Pfizer-BioNTech and Moderna — are flowing into hospitals and health departments across the nation, putting the end of the pandemic in sight. But Americans trying to access shots are encountering systems that vary widely county to county and that, in many places, are overwhelmed.
Some counties and hospital systems launched reservation websites, only for them to quickly become booked or crash. Others announced appointments only through Facebook, with slots filling before some residents knew to look. And many have not revealed how the vaccine will be made available to anyone beyond health-care workers and long-term care residents and employees, the focus of the first round of vaccinations.
In one striking image, Florida health departments offering doses on a first-come, first-served basis saw scores of older residents bring lawn chairs and blankets and camp out overnight.
On Sunday, Moncef Slaoui, chief science adviser to Operation Warp Speed, the Trump administration’s effort to expedite development and delivery of vaccines, mostly deflected questions about the lag in administering shots, saying on CBS’s “Face the Nation” that his team is available for requests from states for assistance.
“We need to improve,” he acknowledged.
Surgeon General Jerome Adams said vaccine administration was accelerating, with 1.5 million doses given in two days. Speaking on CNN’s “State of the Union,” Adams said Sunday he’s “still optimistic” about the national outlook for defeating the virus, even as only 4 million of the 14 million doses delivered to states have been administered, according to Centers for Disease Control and Prevention figures.
Federal officials had estimated 20 million doses of the coveted vaccine would be delivered and administered by the end of 2020. Adams pointed to a strain on resources brought on by the nationwide surge in covid-19 cases and by the holidays as possible causes of the slower-than-expected rollout, while President Trump has blamed states.
“I’m telling you that things are changing,” Adams said, adding that the administration’s coronavirus task force is “working every single day to figure out how we can help the states.”
At the state and local level, authorities urge patience as they sort out distribution plans. Michael Kilkenny, physician director of West Virginia’s Cabell-Huntington Health Department, described it as a “massive logistical operation.”
“I understand that anxiety and I understand that desire to get their vaccine, and so we feel a little pressure when the vaccine hasn’t flowed as fast as we’d like,” he said. “But we also realize that this is not something that’s been sitting on shelves for five years. This is brand-new stuff.”
There has been confusion over when, where and how to get the shot, with different jurisdictions taking different approaches in the nation’s patchwork, decentralized public health system.
Even health-care workers have struggled to figure it out. Marla Deibler, a psychologist in New Jersey, said people in her line of work were unsure whether they qualified, with professional listservs full of questions about the vaccine. Through “lots of investigating,” she found a hospital that was inoculating health-care workers and made an appointment by phone.
The state on Wednesday sent providers an email listing vaccination sites. By then, she’d already been pricked.
“In my experience, just because there hasn’t been a central plan, it just hasn’t been managed well in terms of how to carry this out,” Deibler said. “But once we knew what to do, it went very smoothly.”
Whether you can easily access appointments or information about how to get in line depends on where you live. Officials in some areas are telling residents not in the top priority health-care group to hold tight, while others have been more proactive.
In several states, health officials were caught off guard when governors suddenly announced availability would expand to senior citizens or others. Some state officials chose to depart from Centers for Disease Control and Prevention guidelines for the second vaccination priority group, which prioritized front-line essential workers alongside people 75 and older.
“There’s been understandable hiccups — this is a big program, it came just as we were entering the holidays,” said Josh Michaud, associate director for global health policy at the nonprofit Kaiser Family Foundation. “There are many aspects that are complicated here. But the number of people that’s been actually vaccinated has been, I think, below a lot of people’s expectations.”
New Mexico has a website where residents can register in advance to be vaccinated and find out, via text message, whether to keep waiting or head to a specific location to get the shot. D.C. launched a similar portal, with text at the bottom of the page saying it is “currently open only for healthcare providers.” Some were puzzled, though, because the survey allows nonmedical personnel to proceed.
“I’d read right past that text on the first page & had nearly submitted before a friend mentioned I shouldn’t,” said one tweet to the health department. “Could the survey end itself if you later answer No to the question of whether you’re in these groups?”
In Texas, the Department of State Health Services created an online map showing all the providers that have received a vaccine shipment. Before it can be viewed, a pop-up warns that “not all providers are vaccinating the public or people in all priority groups” and directs users to call in advance.
But after Gov. Greg Abbott (R) and state health commissioner John Hellerstedt pressed for vaccine providers to move more quickly, some clinics saw lines form outside. The commissioner had said in a statement there was “no need” to ensure that everyone in the first priority group — health-care workers and staff and residents of long-term care facilities — was vaccinated before moving onto the next, which in Texas includes senior citizens and those with underlying conditions.
Officials with the Northeast Texas Public Health District were surprised Wednesday when hundreds of people, mostly seniors, showed up at a vaccine clinic it was hosting in Tyler. Of the 1,000 doses the agency received so far, nearly 600 were administered in one day. George T. Roberts Jr., the health district’s chief executive, said it had gone “amazingly well, under the circumstances.”
“Our plan was ultimately to have it only by appointments,” he said. “But today the word of mouth got out, and it was basically first-come, first-served.”
Hospitals and county health departments in Florida scrambled to accommodate the demand after DeSantis’s Dec. 23 announcement that the state would prioritize seniors over essential workers. Counties and hospitals were left to make plans on their own, with the governor saying Wednesday that each would be “offering the vaccine in ways that best fit the needs of that particular community.” That approach, he added, “cuts out the middle man.”
At Memorial Healthcare System in Broward County, officials responded to the governor’s mandate by asking his office for more doses, according to system spokeswoman Kerting Baldwin. They made the request Tuesday and had not yet heard back, she said Wednesday, adding that the hospital system is “receiving calls from people who want the vaccine, but it is not available at this time.” Broward Health, another health-care system in the county, was inundated with calls and is booked for appointments through February.
On the opposite side of the state, Lee County authorities announced that anyone older than 65 could be inoculated, no appointment necessary. They decided it was the most expeditious way to get vaccine out, County Commission Chairman Kevin Ruane said, and asked the public “not to camp out like they were waiting for a concert or Black Friday.”
“But people did,” he said. “I have every ounce of sympathy for what they’re going through.”
Among them were Fort Myers residents Barbara Hooper, 69, and her husband, Michael, 71, who arrived at a vaccine site near their home at 3:30 a.m. Wednesday. They brought water and chairs. The line stretched down the block.
At 6:30 a.m., the couple got the Moderna shot.
“Waiting in line wasn’t the end of the world,” Hooper said. “The main thing everybody in line was talking about was how excited we were to get the shot.”
But Florida should have had a centralized, state-managed plan, the sole Democratic member of the Florida Cabinet said, blasting the lack of preparation and progress as “inexcusable.” Agriculture Commissioner Nikki Fried urged the governor to mobilize the National Guard, writing in a Wednesday letter that vulnerable Floridians had been “left without answers or clear direction from overwhelmed local agencies on when, where and how to receive the vaccine.”
When the Broward County health department announced an online vaccine portal, Shlevin hurried to try it. She thought she’d managed to snag appointments in February — until she tried to hit “confirm” and found out they were no longer available. After that, the site went down.
In messages posted to Twitter, agency officials apologized that their website “did not work as intended.” They said they recognized that older residents were anxious to get the shot, noting “this is just the beginning of COVID-19 vaccination opportunities.”
By Saturday, after requesting a call through the Broward Health system website, Shlevin had heard back. She and her husband have appointments to get vaccinated this month. They’re thrilled — but she still thinks the process could have been smoother.
“I understand the logistics, but growing up in the ’50s and ’60s, when they came around with the polio vaccine, they managed to get it done,” Shlevin said. “I remember getting shots at the fire station when I was in school. We’re a huge country, but this can be done, with some planning.”
Shayna Jacobs contributed to this report.