City councilmembers sparred with health officials over the sluggish rollout of the COVID-19 vaccine at a hearing on Tuesday, with the two sides disagreeing on what's holding back the city from meeting demand in order to reach the ambitious targets set by the mayor's office.

Councilmembers argued that immunization sites need to drastically ramp up their capacity to deliver the drugs, as less than 36% of the city's supply has been administered. But inconsistent deliveries from federal officials have created logistical headaches. This disorganization makes it harder to plan appointments—even as new vaccine sites come online and the state has expanded eligibility to include a vast swath of the population.

"Often we are not made aware of that allotment until a few days prior to receiving the doses for the week," NYC Health Commissioner Dr. Dave Chokshi said at the City Council oversight hearing on vaccine distribution. "In some weeks, we’ve received upwards of 200,000 doses. In other weeks, including this one, we’ve received about 100,000 doses."

This week, NYC will receive another 100,000 doses, but it currently does not have enough supplies allocated to reach its goal of administering 1 million doses this month, with about 669,000 delivered out of 885,000 reserved in total.

A sufficient supply would allow health regulators to plan for the entire course of the vaccination campaign, Chokshi said, which would quicken the pace of vaccinations and permit clearer communication around when the next stage of the campaign begins for those who are not currently eligible. David Rich, the executive vice president of government affairs at the Greater New York Hospital Association, echoed Chokshi regarding vaccine deliveries.

"We often don’t find out that we’re getting vaccines until it actually shows up at the loading dock from one day to the next," Rich said during the virtual hearing.

But City Councilmember Mark Levine, who chairs the health committee, said during the hearing that capacity remains the "bigger challenge" in NYC.

About 1,000 to 3,000 appointments remain open this week and another 5,000 to 10,000 next week at city-run sites—numbers Levine called a "pittance" compared to the need.

Eligibility in phases 1a and 1b comprises 2 million people in NYC alone, according to the commissioner. That was before Tuesday when Governor Andrew Cuomo expanded eligibility to everyone older than 65 and people who are immunocompromised, following new guidance from the Centers for Disease Control and Prevention.

Levine and other councilmembers want to see 24/7 sites in all neighborhoods with a plan to reach homebound people, a multi-lingual communication strategy, and an easy online and phone system to schedule appointments. Currently, some of the city's informational flyers are in 13 languages and counting, but critics noted the phone hotline is still just in English and Spanish.

"We need an army of thousands of people who are out there doing this work," Levine said.

NYC Health and Hospitals could handle another 27,000 appointments each week, on top of the newly opened sites at the Bathgate postal station in the Bronx and the Brooklyn Army Terminal, according to the city hospital system's representative Dr. Andrew Wallach. Those facilities are open 24/7 and can administer 10,000 and 15,000 doses a week, respectively.

To meet de Blasio's goal of administering 1 million doses by the end of the month, 38,000 individuals per day would need to receive doses, or about 266,000 a week, according to the city's data. The daily tally, on average, since the beginning of the year is hovering around 10,000.

Mayor Bill de Blasio aims to administer 175,000 this week alone and 400,000 doses per week by the end of the month.

"We know we're not going to meet our goals," City Councilmember Helen Rosenthal said. "That's a given. So please don't—no one should pretend we are."

The city and country mounted a slow start with deploying the Pfizer and Moderna vaccines, which require two doses. Rather than immediately deliver full allotments to states, the federal government had withheld supplies for the second doses. On Tuesday, the Trump administration rolled back this policy, citing the new CDC guidance. Last Friday, the incoming Biden administration had announced a plan to reverse the rule.

This additional supply could place ever greater strain on NYC's vaccination sites. Already with expanded demand, New Yorkers scrambled to sign up for appointment slots as they or loved ones became eligible but were met with a host of technical issues on city and state websites.

Chokshi said the city's vaccine finder tool aggregates information to streamline appointments but acknowledged there is no single unified scheduling system.

In the coming days, the city Health Department will launch a system to pre-register New Yorkers and alert them when they are eligible for the vaccine.

"The city will operationalize the plans with respect to giving additional information about where people will be with respect to their turn for getting vaccinated and implement that more proactive system," Chokshi said. New Jersey launched a similar pre-registration system previously.

Councilmember Carlina Rivera questioned why the city wasn't better prepared, as virus cases and hospitalizations continue to surge.

"We all knew for at least eight months that a vaccine was coming," Rivera said. "Why are we just now figuring out where and how to administer? ... We need to pick up the pace."