Thread by @megtirrell

Still confused about the 2nd dose vaccine supply? Me too, but I think this is what happened: 🧵

Let’s go chronologically. Last Thursday, governors wrote a letter to @SecAzar requesting second doses not be held in reserve and instead immediately be made available:

https://twitter.com/megtirrell/status/1347315633143349249

2. Friday, CNN reported the Biden team planned to do just that:

https://twitter.com/megtirrell/status/1347569025342197761?s=20

3. Tuesday @SecAzar said OWS would make the change as well.

Azar: "We can now ship all of the doses, that had been held in physical reserve with second doses being supplied by doses coming off of manufacturing lines with quality control going forward."

https://twitter.com/megtirrell/status/1349039938868830209?s=20

4. @SecAzar also noted in that announcement:

"Each week, doses available would be released to first cover the needed second doses, and then cover additional first vaccinations." (4)

5. There was an expectation that with release of 2nd doses would come an immediate increase in # of doses states could order.

That... didn't happen: washingtonpost.com/health/2021/01…

6. Governors, especially those who wrote original letter to @SecAzar, were angry.

MN's @GovTimWalz at a press conference yesterday: "They were lying. They don't have any doses held back. There is no strategic supply for the 2nd dose."

@OregonGovBrown:

https://twitter.com/OregonGovBrown/status/1350109252807913473?s=20

7. This sounds devastating. But wait... Pfizer says it still has ALL its second doses of previous shipments to the US? So... there is a reserve?

https://twitter.com/megtirrell/status/1350181849348403205?s=20

8. @SecAzar was asked by @LesterHoltNBC last night about a reserve.

Azar: "No, there's not a reserve stockpile. We did that in December to be extra cautious." Bc of more confidence in manufacturing, "we've made that available for states to order."

https://twitter.com/NBCNightlyNews/status/1350235064538284032?s=20

9. The wording around a reserve is confusing. Clearly, from Pfizer's statement, the 2nd doses to pair with the 1st exist. They will be used as 2nd doses, as we're now 1 month+ from 1st vaccines given, so many are now getting their 2nd shots.

10. Further, NYT reports it's all a big misunderstanding: nytimes.com/live/2021/01/1…

11. The change is that Operation Warp Speed is no longer putting half of newly made vaccines into reserve as 2nd doses.

Ok. But. It still doesn't 100% add up.

Let's think about this in simple numbers bc it all makes my brain hurt:

12. Let's say week 1, 5M doses were available from Pfizer. 2.5M shipped as 1st dose, 2.5M stored as second.

The data show, though, only 1/3 were administered. So, 330K used, 670K stored (by states).

Stored doses now = 3.17M. Way more than were given as first shots.

13. Next week, same thing happens. 5M made. 2.5M shipped, 2.5M stored.

But again only 1/3 administered, so another 670K stored by states. Stored doses in week 2 now (states & federal) = 6.34M. [Remember these are hypothetical numbers, me trying to puzzle out what's happening.]

14. HHS says states are only ordering 75% of what they could. We know CDC & state vaccination numbers have a lag, and more is getting used, but there seems to still be excess vaccine out there.

Did I say at the beginning of this thread I was going to clear this up? 🤷‍♀️

15. Finally, one thing @PresElectBiden pledged in his vaccine speech yesterday was transparency. Hope that is true bc it would help a lot (clearly).

Now, everyone tell me how I got this wrong (srsly) - what did I miss?

cc @walidgellad @CT_Bergstrom @jasonlschwartz

16. Actually one more thing, which was the impetus for me waking up on a Saturday AM & feeling like I HAD to write a 16-tweet thread:

This miscommunication had real implications for people trying to get vaccines. Oregon now says seniors will have to wait 2 more weeks:

17. We can argue over whose fault this miscommunication was (and that’s already happening between federal govt and states), but the bottom line is - this really sucks for people who desperately want vaccines.

We need much, much more clear communication on supply.

18. I did this before coffee and now realize my hypothetical math was all over the place (ie when I calculated 1/3 of hypothetical doses administered I did it out of 1M rather than 2.5M). So the hypothetical numbers are off, but they’re hypothetical so. Anyway more ☕️