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Vaccinations in the United States are slowing down. What to blame?

As the country approaches 150 million vaccinated people, the pace of implementation is slowing, signaling a new phase of the campaign in which supply exceeds demand in many areas. The average number of people receiving the first or single dose each day fell by about 50% from the peak on April 13.

Average share of the United States population receiving the first dose per day, by manufacturer

Pfizer or Moderna

Johnson and Johnson

0 0.25 0.5%March 22May 3Johnson and
Johnson paused

Source: Centers for Disease Control and Prevention Note: The figures show a 7-day average based on the date the photos were reported, not the date the photos were taken, so the break announced on April 13 did not affect the data from that date. Johnson & Johnson vaccinations also appear in the data throughout the pause, as vaccinations may be reported several days after administration. Estimates for Pfizer and Moderna vaccinations include a small proportion of vaccinations from an unknown manufacturer.

Vaccinations fell sharply in the days after April 13, when health officials announced a break in the Johnson & Johnson vaccine to investigate reports of rare side effects and they did not fully recover. Experts say the 11-day break is partly responsible, but the data also show a delay in the absorption of Pfizer and Moderna vaccines.

“That’s a factor, but not the main factor,” said Dr. Cyrus Shahpar, director of data at Covid-19 at the White House, about the Johnson & Johnson break.

The Johnson & Johnson vaccine has begun to return across the country, but it is too early to say how much its use will be restored. A survey by Survey Monkey of Boston Children’s Hospital found that the desire to take Johnson & Johnson fell during and after the break, especially among women, but interest in getting a single-dose photo is slowly returning.

Health officials say the national delay is an inevitable part of the introduction once it reaches the people who are most eager to take their pictures in most countries. The decline is visible in the data for those looking for their first or second shot, but also for the total doses administered, which reached just over three million shots per day, just before the break took effect.

“The idea that it would be a linear magnification and hit a million shots a day, two million shots a day, three million shots a day, four, four and a half, and then keep going up that speed, never really expected that, ”said Ben Wakana, deputy director of communications for the White House Covid-19 team. “We believe we will continue to vaccinate millions of people a day.”

A New York Times analysis of data from the Centers for Disease Control and Prevention shows more than a dozen countries with first-dose Pfizer and Moderna vaccinations in early April.

These states include some who discovered vaccinations for all adults earlier in the year, such as Arkansas, Kansas and Oklahoma; Southern states with large rural populations such as Louisiana and Mississippi; and places that were particularly effective in the early days of their campaigns, such as North Dakota and West Virginia.

Average share of the state population receiving the first dose per day, by producer

In some states, vaccinations against Pfizer and Moderna are already declining before the Johnson & Johnson break begins on April 13.

Source: Centers for Disease Control and Prevention Note: Figures show a 7-day average based on the date photos were taken, not the date the photos were taken. As a result, Johnson & Johnson vaccinations appear in the data throughout the pause. Vaccination estimates for Pfizer and Moderna include a small proportion of vaccinations from an unknown manufacturer.

In contrast, some states open to all adults on or after April 15, including California, Hawaii, Massachusetts, Rhode Island, and Vermont, show increasing use of Pfizer and Moderna in the days after Johnson and Johnson’s break, showing the remaining demand. Most of these countries have had a subsequent decline.

In Connecticut, where the Johnson and Johnson vaccine became popular, especially in mobile clinics, all three vaccine brands rose and then fell after the Johnson and Johnson break.

It is difficult to know with certainty what role the pause in the decline played, said Josh Gebale, the state’s chief operating officer. “It certainly didn’t help.”

“But we’ve always expected to start seeing a slowdown around the end of April,” he added, noting that more than two-thirds of the state’s eligible population has received a first attempt.

“You’re starting to run out of people to vaccinate,” he said. “Naturally, it would start to slow down.”

Average share of the population receiving the first dose per day, by age groups

CDC data reveal that the decline since mid-April is strongest for those aged 18 to 64, who were eligible for the vaccine in most countries last month. Just over 50 percent of this age group remain unvaccinated.

Health experts and officials say a lot of work needs to be done to reach those adults who have not yet received the vaccine.

Some who have not yet been vaccinated will refuse to shoot themselves, but others may have had trouble finding time to make an appointment or have questions about the safety or efficacy of the vaccine, said Dr. Nirav Shah, director of Maine Center for Disease Control and Prevention.

Officials across the country say they believe there is still a significant portion of the population who will receive the vaccine if they receive more support and more information from trusted envoys, such as GPs.

“We need to be in the community, ask the community what works for them, and maintain that presence,” said Dr. Karen Landers, assistant public health officer in Alabama. “We are not giving up,” she added.

And this work will take some time to make vaccinations more convenient, answer questions and get the message right, said Dr. Shah.

“In no project in human history is the second half as fast as the first,” he said.

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