States Complain of Smaller Vaccine Shipments Than Expected

By Katie Thomas and Sharon LaFraniere

The smaller number of expected doses, which appeared to be the result of a scheduling hiccup, reignited tensions between the federal government and Pfizer over vaccine supply.

A first batch of vaccines arriving at a hospital in Fargo, N.D., on Monday.
A first batch of vaccines arriving at a hospital in Fargo, N.D., on Monday.Credit...Tim Gruber for The New York Times

Officials in several states said that they were caught off guard on Wednesday when they learned that next week’s shipment of the Pfizer-BioNTech vaccine would contain fewer doses than the first week.

In Oregon, state health officials said they were told they were only scheduled to get 25,350 doses of the vaccine next week, significantly less than the 40,950 doses that the state received this week. Iowa’s public health department issued a similar release, saying they were told “they will not receive the volume of vaccine initially anticipated,” and that their shipment would be as much as 30 percent less than what they received this week.

Officials with Operation Warp Speed, the federal effort to distribute a Covid-19 vaccine to the public, also said Wednesday that they had allocated only 2 million doses for next week’s shipment, less than the 2.9 million that were delivered this week. The officials said they expect to ship 5.9 million doses next week of a vaccine developed by Moderna, which is expected to be authorized by the Food and Drug Administration on Friday.

The move sent some states scrambling to adjust their plans and raised questions about whether federal officials will be able to meet their goal of administering an initial shot of the two-dose Pfizer and Moderna vaccines to 20 million people by January 1, just two weeks away.

The smaller shipment appeared to be the result of a scheduling hiccup created when federal officials, responding to a request by states, decided to allocate next week’s doses this Tuesday instead of on Friday, as they had planned. States had asked federal officials for more time to plan their allotments before deliveries begin on Monday, but doing so meant that the federal government could not include in that shipping estimate additional vaccine batches that were released after Tuesday, according to a senior administration official.

The batches of vaccine that were not included in next week’s allocation will be included in the shipment the following week, the official said.

The official, who agreed to speak on condition of anonymity because he was not authorized to discuss the shipments, said it was unclear whether future weekly shipments would increase because the government did not have a good view into Pfizer’s manufacturing process. Unlike other companies that took federal funding for development and manufacturing of their Covid vaccines, Pfizer signed an advance purchase agreement in which it is only paid if the vaccines are delivered. The official also said that the company’s production estimates had fallen in recent weeks.

Pfizer said in a statement on Wednesday that the company “is not having any production issues with our Covid-19 vaccine, and no shipments containing the vaccine are on hold or delayed.” The company also said, “We have millions more doses sitting in our warehouse but, as of now, we have not received any shipment instructions for additional doses.”

The company also said it had shared with the federal government “every aspect” of its production and distribution process. “They have visited our facilities, walked the production lines and been updated on our production planning as information has become available,” the statement said.

With distribution of a coronavirus vaccine beginning in the U.S., here are answers to some questions you may be wondering about:

    • If I live in the U.S., when can I get the vaccine? While the exact order of vaccine recipients may vary by state, most will likely put medical workers and residents of long-term care facilities first. If you want to understand how this decision is getting made, this article will help.
    • When can I return to normal life after being vaccinated? Life will return to normal only when society as a whole gains enough protection against the coronavirus. Once countries authorize a vaccine, they’ll only be able to vaccinate a few percent of their citizens at most in the first couple months. The unvaccinated majority will still remain vulnerable to getting infected. A growing number of coronavirus vaccines are showing robust protection against becoming sick. But it’s also possible for people to spread the virus without even knowing they’re infected because they experience only mild symptoms or none at all. Scientists don’t yet know if the vaccines also block the transmission of the coronavirus. So for the time being, even vaccinated people will need to wear masks, avoid indoor crowds, and so on. Once enough people get vaccinated, it will become very difficult for the coronavirus to find vulnerable people to infect. Depending on how quickly we as a society achieve that goal, life might start approaching something like normal by the fall 2021.
    • If I’ve been vaccinated, do I still need to wear a mask? Yes, but not forever. Here’s why. The coronavirus vaccines are injected deep into the muscles and stimulate the immune system to produce antibodies. This appears to be enough protection to keep the vaccinated person from getting ill. But what’s not clear is whether it’s possible for the virus to bloom in the nose — and be sneezed or breathed out to infect others — even as antibodies elsewhere in the body have mobilized to prevent the vaccinated person from getting sick. The vaccine clinical trials were designed to determine whether vaccinated people are protected from illness — not to find out whether they could still spread the coronavirus. Based on studies of flu vaccine and even patients infected with Covid-19, researchers have reason to be hopeful that vaccinated people won’t spread the virus, but more research is needed. In the meantime, everyone — even vaccinated people — will need to think of themselves as possible silent spreaders and keep wearing a mask. Read more here.
    • Will it hurt? What are the side effects? The Pfizer and BioNTech vaccine is delivered as a shot in the arm, like other typical vaccines. The injection into your arm won’t feel different than any other vaccine, but the rate of short-lived side effects does appear higher than a flu shot. Tens of thousands of people have already received the vaccines, and none of them have reported any serious health problems. The side effects, which can resemble the symptoms of Covid-19, last about a day and appear more likely after the second dose. Early reports from vaccine trials suggest some people might need to take a day off from work because they feel lousy after receiving the second dose. In the Pfizer study, about half developed fatigue. Other side effects occurred in at least 25 to 33 percent of patients, sometimes more, including headaches, chills and muscle pain. While these experiences aren’t pleasant, they are a good sign that your own immune system is mounting a potent response to the vaccine that will provide long-lasting immunity.
    • Will mRNA vaccines change my genes? No. The vaccines from Moderna and Pfizer use a genetic molecule to prime the immune system. That molecule, known as mRNA, is eventually destroyed by the body. The mRNA is packaged in an oily bubble that can fuse to a cell, allowing the molecule to slip in. The cell uses the mRNA to make proteins from the coronavirus, which can stimulate the immune system. At any moment, each of our cells may contain hundreds of thousands of mRNA molecules, which they produce in order to make proteins of their own. Once those proteins are made, our cells then shred the mRNA with special enzymes. The mRNA molecules our cells make can only survive a matter of minutes. The mRNA in vaccines is engineered to withstand the cell's enzymes a bit longer, so that the cells can make extra virus proteins and prompt a stronger immune response. But the mRNA can only last for a few days at most before they are destroyed.

This fall, Pfizer halved initial estimates that it could make 100 million doses by the end of the year after running into manufacturing delays caused by difficulties locating equipment and raw materials, as well as needing more doses for an expansion of its clinical trial. In November, the chief executive, Dr. Albert Bourla, said about 25 million doses would go to the United States. On Wednesday, a Pfizer spokeswoman said that the company would be able to distribute 20 million doses in December in the United States.

The controversy over short-term deliveries is playing out against a backdrop of tense negotiations between Pfizer and the federal government over a new contract for tens of millions of more doses in the first half of next year. The two sides hope to reach an agreement by Christmas, but Pfizer has said it needs the federal government to use its authority to force suppliers to prioritize its orders — a request that one person familiar with the negotiations said has been pending for months.

The government wants Pfizer to sell it 100 million more doses — enough to cover an additional 50 million Americans — between the start of April and the end of June. Pfizer has said that it can only provide about 70 million doses then because other countries have already bought its remaining stock.

The issue is especially fraught because, according to people familiar with Pfizer’s version of events, the firm repeatedly asked the Trump administration to pre-order more doses beginning in late summer but the administration failed to act until Nov. 25 — more than two weeks after Pfizer announced the results from clinical trials showing its vaccine was safe and more than 95 percent effective.

Now both sides are scrambling to figure out how Pfizer can boost its manufacturing to double the number of doses the firm can deliver for Americans in the first half of next year. So far, the Trump administration has only locked in a total of 300 million doses from Pfizer and Moderna. Because both vaccines require two doses, excluding the children and teenagers for whom no vaccine is yet approved, that still leaves more than 100 million Americans uncovered.

Alex M. Azar, the secretary of Health and Human Services, alluded to the friction with Pfizer in an interview on Thursday morning with CNBC, saying “I do wish we would just stop talking about this Pfizer thing.” He added that the federal government was willing to help Pfizer manufacture more “if they are willing to take our help.”

Abby Goodnough contributed reporting.