Why some vaccine sits on shelves while shortages intensify nationwide

The president’s advisers have said they were left no plan by the Trump administration. But what they inherited this week was more like a black box than a bare cupboard — the result of fractured communication among federal, state and local officials and a juggling act between manufacturers making a new product and thousands of providers, from big hospital systems to tiny clinics, struggling to plan around an unknown amount of vaccine.

“We don’t have the visibility that we would hope to have into supply and allocations,” Jeff Zients, the Biden administration’s coronavirus coordinator, acknowledged in a Wednesday briefing.

The delays in ordering and distribution have many causes, including uncertainty about vaccine supply and the status of second doses as well as the hesitancy of some people to get the shots. Also at issue are the logistical hurdles of performing immunizations in long-term-care facilities and the ultracold storage requirements and batch size of the product developed by Pfizer and German company BioNTech. That vaccine, one of two authorized for emergency use in the United States, comes in a minimum order of 975 doses. Once vials are opened, doses must be used within six hours. ...

David Kessler, a top Biden adviser who now leads the federal government’s vaccine accelerator effort, has made few immediate changes to how vaccines will be allocated to 64 jurisdictions and five federal agencies. The new administration has vowed to set up federally run mass vaccination sites but does not anticipate new federal allocations, instead drawing on supply already made available to states, according to an administration official who spoke on the condition of anonymity to discuss ongoing deliberations. ...