Vaccine supply chain woes

Supply chains are boring, until things are in short supply. And there are many steps in a supply chain that can cause supplies to be short. Below are some news stories on how the U.S. is having trouble delivering vaccines, with the limiting factors not yet being shortage of the vaccines themselves.

I notice a few things about these stories. 

• It seems to be widely recognized that it is worth spending billions (or at least hundreds of millions) to save trillions (i.e. to speed up vaccinations to hasten the reopening of the economy).
• It seems also to be widely recognized that it would be regarded as repugnant to allocate initial inoculations by charging high prices for them while they are scarce: instead we are trying to establish priority orders for recipients: e.g. first health care workers and the elderly in nursing homes, then the independent elderly and the ill, etc,
• Keeping strictly to priorities may partly be what is slowing down vaccinations: when not enough high priority people show up, the vaccines go back in the freezer to wait for the next day (at least I hope they go back in the freezer, and are not spoiled and unusable by the next day).  It might be better to try to find people ready to be vaccinated, when it's hard to find enough high priority people quickly.
• A lack of confidence that more vaccine doses will be reliably arriving on schedule is causing some stockpiling, which is the enemy of fast distribution.
• Holiday schedules make it hard to get lots of people vaccinated fast; maybe we'll do better this coming week.

Here's a story from the Financial Times:

Trump administration admits missing Covid vaccination goals--Officials say US states have used only a fifth of the doses they were given  by Kiran Stacey 

"Officials had aimed to distribute enough doses to vaccinate 20m people by the end of the year, but recently admitted they were not likely to hit that target until early January after underestimating how long it would take to perform quality control checks on manufactured doses.

"Figures released by the federal government, however, show a bigger hurdle is getting the vaccines to people once they have been manufactured and sent out. The US Centers for Disease Control and Prevention said on Wednesday just under 2.6m people in the country had been vaccinated, even though 12.4m doses had been distributed.

...

"Nancy Messonnier, the director of the National Center for Immunisation and Respiratory Diseases, blamed a range of factors. She said part of the problem was that pharmacies that were largely responsible for vaccinating people in care homes had been waiting to schedule appointments until they could be sure they had enough doses to perform booster shots."

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From the NY Times:

Here’s Why Distribution of the Vaccine Is Taking Longer Than Expected--Health officials and hospitals are struggling with a lack of resources. Holiday staffing and saving doses for nursing homes are also contributing to delays.  By Rebecca Robbins, Frances Robles and Tim Arango

"In Florida, less than one-quarter of delivered coronavirus vaccines have been used, even as older people sat in lawn chairs all night waiting for their shots. In Puerto Rico, last week’s vaccine shipments did not arrive until the workers who would have administered them had left for the Christmas holiday. In California, doctors are worried about whether there will be enough hospital staff members to both administer vaccines and tend to the swelling number of Covid-19 patients.

"These sorts of logistical problems in clinics across the country have put the campaign to vaccinate the United States against Covid-19 far behind schedule in its third week, raising fears about how quickly the country will be able to tame the epidemic.

...

"Complicating matters, the county health department gets just a few days of notice each week of the timing of its vaccine shipments. When the latest batch arrived, Dr. Gayles’s team scrambled to contact people eligible for the vaccine and to set up clinics to give out the doses as fast as possible.

...

"In Florida, some hospital workers offered the vaccine declined it, and those doses are now designated for  other vulnerable groups like health care workers in the community and the elderly, but that rollout has not quite begun

...

"It may be more difficult, public health officials say, to vaccinate the next wave of people, which will most likely include many more older Americans as well as younger people with health problems and frontline workers. Among the fresh challenges: How will these people be scheduled for their vaccination appointments? How will they provide documentation that they have a medical condition or a job that makes them eligible to get vaccinated? And how will pharmacies ensure that people show up, and that they can do so safely?"