States that roll out vaccines the fastest will be prioritized for future doses, officials say: 'We need doses going to where they'll be administered quickly'

• Starting in two weeks, states with the speediest vaccine rollouts will be prioritized for additional doses, US officials announced Tuesday.
• The new system is meant to incentivize states to promptly record vaccinations and prevent doses from sitting in freezers.
• But it could also punish states that lack the funding or resources to accelerate vaccine administration.
• The strategy is set to take effect after President-elect Joe Biden takes office, though, so it's possible the new administration will change course.

Operation Warp Speed officials announced Tuesday that states that administer their allotted vaccine doses at the quickest pace will soon get higher priority for additional doses.

"We will be allocating them based on the pace of administration as reported by states and by the size of the 65-and-over population in each state," Alex Azar, Secretary of the Department of Health and Human Services, told reporters. "We're giving states two weeks' notice of this shift to give them the time necessary to plan and to improve their reporting if they think their data is faulty."

He added that the new system "should not necessarily hurt many states, but will enhance the benefit to those that are actually getting vaccines done and performed."

The decision came after a relatively slow rollout of vaccine doses in December and January. States have struggled to get shots into arms quickly, since state health departments are simultaneously dealing with an unprecedented surge of coronavirus cases that has overwhelmed hospitals. States weren't given extra funding heading into the vaccine rollout, so resource and staffing shortages have slowed vaccine administration in some places.

Warp Speed missed its goal of vaccinating 20 million people by the end of 2020. Only around 9 million shots have been administered so far, Azar said Tuesday.

Still, the pace of vaccinations has ramped up considerably in the last two weeks. The US is now conducting roughly 700,000 vaccinations per day, compared to around 500,000 per day at the beginning of January. Azar said the country is on track to hit 1 million vaccinations per day in the next seven to 10 days.

"With the case counts we face now, there is absolutely no time to waste," he said. "We need doses going to where they'll be administered quickly and where they'll protect the most vulnerable."

Read more: What's coming next for COVID-19 vaccines? Here's the latest on 11 leading programs.

An incentive for speedy rollouts

Azar said the new system for vaccine distribution is intended to motivate states to get shots into arms rather than "sitting on shelves or in freezers."

"If you're not using vaccine that you had the right to, then we should be rebalancing to states that are using that vaccine," he said. "It is common sense."

Azar didn't provide further detail about what metrics states would need to hit to be prioritized for more doses, but he pointed to Connecticut and West Virginia as examples of states that had successfully ramped up vaccinations to older Americans in recent weeks.

West Virginia Gov. Jim Justice told CNBC on Monday that the state had no vaccines sitting on shelves. Bloomberg's COVID-19 vaccine tracker shows that the state has administered nearly 67% of its available doses so far - second only to North Dakota, which has administered nearly 80%. Connecticut ranks third in the country for vaccines administered, having given out 60% of its available doses.

In some cases, states may have simply been slow to record the shots they've administered, Azar said. The number of reported vaccinations typically lags 24 to 72 hours behind those that have actually been administered.

Prioritizing states with speedy rollouts, Azar added, "gives states a strong incentive to ensure that all vaccinations are being promptly reported."

Jim Blumenstock, a senior vice president at the Association of State and Territorial Health Officials, said one reason for the initial slowness is that states had to learn how to use a new set of data collection and reporting systems.

"Training for the vaccination providers needed to be provided, which couldn't be accomplished until the terms and conditions of the [emergency use authorizations] were issued by the FDA," he said. Blumenstock's group, a nonprofit, represents US public health agencies.

Another possible explanation for the slow pace of vaccinations, Azar said, is that states have been too strict about their criteria for administering shots.

The Centers for Disease Control and Prevention recommended vaccinating healthcare workers and nursing home residents first. US officials are now encouraging states to distribute doses to people ages 65 and over, as well as people under 65 with health problems that raise their risk of severe disease.

But many state health officials have said they don't have the resources for a more widespread rollout. That means the new priority system could punish states whose health departments are underfunded or understaffed.

In many states, however, the vaccination process could speed up soon: States are set to receive roughly $8 billion in new funding for vaccine distribution from the coronavirus relief package passed in late December.

"Whether it's enough is uncertain," Dr. Steven Stack, Kentucky's public health commissioner, said on a recent press call. "Obviously that would have been more helpful a few months ago."

Operation Warp Speed's new priority system could be short-lived anyway, since the Biden administration will assume responsibility for the US vaccine rollout in two weeks.