The first vaccine was administered in New York City about two weeks ago. Since then, however, only 78,530 New Yorkers have received the first dose of the vaccine. The vials are here — as of Wednesday, the city's Department of Health dashboard has logged 390,425 vaccine doses delivered to NYC, out of a current expected delivery of 392,100. So what's the hold up?

The vaccination rollout is still in its early stages, but has already been criticized for moving too slowly — not just here in New York, but nationwide, where around 2 million have received a dose as of this week (the goal was 20 million by year's end).

I asked epidemiologist Dr. Stephen Morse at Columbia University for his thoughts on the lag in New York, and what he thinks of the vaccine rollout here so far.

Vaccination numbers as of Wednesday, Dec 30th.


Where is New York State on vaccine distribution so far?

New York State has an allocation of about 909,425 initial doses, and [as of Tuesday] about 148,372 have been reported as administered. The state has about just under 90,000 nursing home residents (not counting other long term care facilities, which I think would bring it up closer to 275,000), according to the Kaiser Family Foundation.  So we really don’t yet have enough even for the highest priority groups.  Hopefully more vaccine will materialize.

In your opinion, how is the rollout going?

It’s a start. Rollout has been a bit bumpy at first, and not nearly rolling out as quickly as we’d all like, but that’s not very surprising.  It’s a complicated job.  In any program of this scale, there are bound to be kinks along the entire supply chain, starting with production (which has been less than manufacturers had expected but hopefully will be increased soon), and running all the way down to the state and local level, where a lot of hard work has to be done and limited resources.

Resources will also vary from place to place within each state.  The original rollouts were in institutions, where we have many of the highest priority recipients, and should be easier to manage.  It also seems reasonable to start with smaller and pilot programs to help guide scale up.  The resources, including funding, personnel, and infrastructure are really still just in the pipeline.  Hopefully the rollout will get smoother as supply increases and more of the pitfalls are worked out, and as funding becomes available to states, but it won’t be overnight.

What happens after more vaccines are administered?

Even once we have widespread immunization, I think it’s necessary and wise to keep up the precautions we’ve all been advised to take: masks, distancing, keep hands clean, avoid crowds.  Now is no time to get careless, with a goal in sight, even if months or a year off. As always, perhaps most of all, complacency also worries me a lot.

Are you concerned too many will choose not to get vaccinated?

Another big challenge has been communication.  All the attention, and especially showing important national and community leaders getting vaccinated, is a classic way to be reassuring and encouraging.  (Pres. George W. Bush got his smallpox vaccine on TV, after 9/11 when bioterrorism was a big concern.).  We’ve been afraid of vaccine hesitancy, and we need a high proportion of people to take the vaccine if it’s going to have its greatest value.

To counteract that hesitancy, you see all the TV coverage about people getting vaccine and feeling fine afterward.  Overcompensating, however, can make many people more eager to get the vaccine but frustrated because they don’t know when they’ll get their chance.  The classic problem of navigating between Scylla and Charybdis.

That’s one thing I worry about.  I also hope we can depoliticize these issues and put them back in public health and science, where they belong.  Many of the non-pharmaceutical interventions were introduced ad hoc, so we don’t have real standards for optimizing these improvised masks, or choosing them. 

Will the current vaccines work against a new variant of COVID-19?

On the science side, I’ll admit sloppy data and sloppy language about the virus and the disease worry me, too.  We’ve heard about many variant viruses.  Mutations are not unusual in RNA viruses (usually somewhat less in coronaviruses than flu or HIV), and most mutations don’t noticeably change the virus’ behavior.  We have recently heard in the news about some variants from the UK and South Africa that may be much more transmissible, although I’d like to see more data.  Most scientists opine (I agree) that the vaccine will work just as well against these variants, but it wouldn’t be hard to be sure by testing experimentally.  Several labs have said they’re going to do the work, but I haven’t seen any results yet.  In any case, the same familiar, mundane non-pharmaceutical precautions will work just as well to keep these variants from getting into our bodies.