After missing the mark on COVID-19 vaccinations, NC trying to hone in on target

By Julie Havlak

Raleigh, NC – After a slow start, North Carolina is ramping up its COVID-19 vaccinations.  

Some 9.2% of residents got the first shot of COVID-19 vaccines by Monday, Feb. 8, when 970,162 people had received a first dose, according to the N.C. Department of Health and Human Services. Two days earlier, an average 8.6% of COVID-19 tests came back positive.  

vaccine shot
photo by Steven Cornfield

North Carolina now ranks 24th in the nation for its percentage of COVID-19 vaccines administered, according to the Becker’s Hospital Review.  

The state shot up the rankings in late January, but its rollout got off to a rocky start. Elderly residents crossed the state border to get vaccines, hospitals canceled thousands of appointments, and the slow rollout left many confused and frustrated.  

North Carolina spent weeks lagging behind the nation. Early January saw massive backlogs — even as the federal government tied vaccine supply to the success of states’ vaccine rollouts. State lawmakers and health care advocates criticized North Carolina’s progress and questioned the governor’s vaccination plan. 

By the first week of January, North Carolina was sitting on almost three-fourths of its available doses. The state had given only 25.5% of its available doses, according to the CDC. Only five other states in the country had worse vaccination rates, and West Virginia’s rate was almost triple that of North Carolina. 

North Carolina had climbed to the lower middle of the pack by Jan. 26. It ranked 32nd out of the 50 states for administering 699,722 of 1,250,900 available vaccines, according to the CDC. North Carolina’s own data shows a better performance. The state has administered 69% of the doses. 

The state used mass vaccination sites to ramp up its numbers, but that tactic earned backlash from local providers. They argued it left elderly and rural residents without access to vaccine sites. Hospitals had to cancel thousands of appointments as the state diverted vaccines toward Charlotte and Durham. 

But the state gained ground. North Carolina had injected 99% of the first doses sent by the federal government by Jan. 27.  The state rocketed from 40th in first doses administered per 100,000 residents to 12th in a week.  

North Carolinians in nursing homes and long-term care homes aren’t so lucky. Only 64% of the first doses had reached patients’ arms in long-term care homes as of Monday, Feb. 8. The federal government manages that rollout. 

Secretary of the N.C. Department of Health and Human Services Dr. Mandy Cohen says a limited supply of vaccines is coming into the state, and health officials have little advanced notice when it does arrive.  

“North Carolina is ready to take on more vaccines, and we need those vaccines now,” Cohen said during a press conference in late January. “We know that this is hard on North Carolinians. Demand for vaccines is vastly greater than supply.” 

Here’s a look at the state’s progress in vaccinating its residents against COVID-19:  

1796: Edward Jenner discovers vaccines, using cowpox pus to immunize people from smallpox.  

1976: Researchers lay the groundwork for today’s COVID-19 vaccines. They make critical discoveries about mRNA — the genetic material behind the two leading COVID-19 vaccines. Scientists hope to use snippets of mRNA to hijack the body’s own cells and make copies of viral proteins. This would teach the immune system to fight viruses. But mRNA is fragile, and scientists struggle to get it to last inside the body. One researcher finally makes a breakthrough.  

2003: The severe acute respiratory syndrome (SARS) coronavirus is identified in China.  

2012: The Middle East respiratory syndrome (MERS) coronavirus is discovered on the Arabian Peninsula. Its discovery spurs another advance in coronavirus vaccines. Researchers learn how to present the immune system with the now-infamous spike proteins that cover COVID-19.  

2017: The U.S. National Institutes of Health partners with Moderna to see how quickly they could develop a mRNA vaccine in the event of a pandemic. 

2018: Scientists win a victory for the messenger RNA technology behind today’s vaccines. The FDA approves the first lipid nanoparticle carrier for mRNA — the technology that helps mRNA survive long enough to provide protection against viruses inside the body.  

December 2019: Chinese authorities publicly identify human cases of COVID-19.  

Jan. 10, 2020: Chinese researchers publish the sequence of the SARS-COVID-2 genome.  

Jan. 11, 2020: Researchers in the U.S. begin working to develop a mRNA vaccine.  

March 16, 2020: Moderna begins Phase 1 clinical trials for a COVID-19 vaccine.  

March 17, 2020: BioNTech and Pfizer join forces to create a COVID-19 vaccine. 

April 16, 2020: The U.S. bankrolls Moderna’s vaccine candidate. 

May 21, 2020: The U.S. federal government dumps $1.2 billion into AstraZeneca’s candidate vaccine, securing at least 300 million doses for the U.S.  

June 2020: China’s military approves the use of a vaccine being developed by Chinese vaccine maker CanSino and the Academy of Military Science. 

July 14, 2020: Moderna publishes initial clinical trial data. Pfizer follows suit Aug. 12.  

July 22, 2020: The Trump administration invests almost $2 billion in Pfizer for 100 million doses of its vaccine.  

July 27, 2020: Moderna and Pfizer launch Phase 2-3 trials with 30,000 volunteers across multiple countries. This will determine whether the vaccines are safe and effective.  

July 2020: China approves a coronavirus vaccine for emergency use that is developed by state-owned drugmaker Sinopharm.  

Aug. 8, 2020: U.S. spending passes $9 billion for developing and manufacturing candidate vaccines across seven companies.  

Aug. 11, 2020: Russian President Vladimir Putin announces the “world’s first” approved vaccine, Sputnik V, but researchers have only completed Phase 2 trials on 76 people. Global scientists question the ethics of his decision.  

Sept. 8, 2020: Major vaccine companies, including Pfizer and Moderna, pledge to “stand with science” and to “adhere to high scientific and ethical standards” for individuals’ safety and wellbeing.  

Sept. 12, 2020: Pfizer and BioNTech say they will expand their U.S. trial to 44,000 participants.  

Oct. 6, 2020: The FDA updates its guidelines on vaccines, requiring drugmakers to collect two months of safety data after the second injection before applying for an emergency authorization. The new guidance effectively eliminates the likelihood of approving a vaccine before the election, and the Trump administration criticizes the guidance.  

Nov. 8, 2020: Pfizer and BioNTech release the preliminary analysis of their first 94 cases. 

November 2020: Chinese state-owned vaccine developer Sinopharm has vaccinated almost 1 million people in China under its emergency-use program.  

Dec. 2, 2020: The United Kingdom becomes the first Western country to approve a vaccine for emergency use.  

Dec. 8, 2020: The FDA determines that Pfizer’s vaccine has an efficacy rate of 95%.  

Dec. 9, 2020: North Carolina’s vaccine tracker is set to go live. North Carolina chose to build its own vaccine tracker, the Coronavirus Vaccine Management System, for a $1.2 million price tag. State officials will later complain the software is slowing down the vaccine rollout.  

Dec. 11, 2020: The FDA approves the first vaccine for emergency use in the U.S., the Pfizer-BioNTech candidate. The federal government funnels more money into Moderna for a total of $4.1 billion in federal funding.  

Dec. 13, 2020: Workers in Michigan load vaccines onto trucks for the first deliveries across the U.S.  

Dec. 14, 2020: The U.S. gives its first vaccinations to health-care workers.  

Dec. 15, 2020: North Carolina vaccines its first volunteer.  

Dec. 21, 2020: The European Union approves the Pfizer vaccine.  

Dec. 23, 2020: Brazil reports data showing that China’s CoronaVac vaccine protects just over 50% of people, less than previously advertised.  

Jan. 4, 2021: North Carolina has some of the lowest vaccination rates in the nation. The state has vaccinated only 966 people per 100,000 people. Only five other states rank lower. 

Jan. 5, 2021: Gov. Roy Cooper enlists the N.C. National Guard to help the state’s vaccinate effort.  

Jan. 8, 2021: Eight governors demand the release of all available vaccine doses, including the ones held in reserve for the second shot required for immunity. Cooper is not among them.  

Jan. 8, 2021: President-elect Biden announces plans to ship out all available doses of the vaccine. He says he will stop the Trump administration’s policy of keeping doses in reserve for the second shot.  

Jan. 12, 2021: The Trump administration makes big changes in its plan for vaccine rollout. Officials begin recommending vaccinating anyone 65 or older, and anyone with underlying conditions. They also change how states get vaccine doses. The federal government will begin prioritizing states by their speed of vaccine rollout, as well as by population size. They will also stop holding doses in reserve.  

Jan. 12, 2021: Lawmakers in the N.C. General Assembly question department officials about the slow rollout of vaccines. Lawmakers criticize the speed of distribution. Secretary of N.C. Department of Health and Human Services Mandy Cohen says, “I think there are a lot of issues. I think, overall, for North Carolina, our decision to prioritize every county … means there are some that are going to be great and some that are going to struggle.” 

Jan. 14, 2021: Cooper opens COVID-19 vaccines to people 65 older. The state abandons its original rollout plan, which separated residents into tiers of priority.  

Jan. 18, 2021: The U. S. has delivered more than 31 million doses of coronavirus vaccines. But only 39% of those doses have been administered.  

Jan. 19, 2021: Biden announces plans to activate the National Guard to help Americans get the vaccines. North Carolina has already beat him to it.  

Jan. 19, 2021: 450,000 people have been vaccinated in North Carolina, Cohen says.  

Jan. 20, 2021: North Carolina begins vaccinating prisoners and staff.  

Jan. 21, 2021: Cohen acknowledges that vaccine doses are being wasted. She says the number is in the “tens.” 

Jan. 21, 2021: Cohen disputes the CDC’s data on North Carolina’s vaccine rollout. She says she’s working with officials to fix discrepancies on the federal website.  

 Jan. 24, 2021: North Carolina reports its first case of COVID-19 variant from the United Kingdom. The variant B.1.1.7 is identified in an adult in Mecklenburg County. 

 Jan. 25, 2021: The N.C. Healthcare Association and the N.C. Association of Local Health Directors both send letters criticizing the governor and Cohen’s plans for vaccine rollout. Cone Hospital in Greensboro says it had to cancel 10,400 appointments after the state unexpectedly diverted first-dose vaccines. Lincoln and Gaston counties complain that they will receive no vaccines for the week as the state hosts vaccination megasites in Charlotte. Cohen apologizes and guarantees to give some providers a baseline of minimum vaccines. North Carolina ranks 43 out of 50 states for distribution.  

Jan. 26, 2021: Cohen says 95% of all COVID vaccine first doses have been administered. The state has given more than 110,000 doses. Some 260,000 first doses were given in the past week alone. “We’re ready to take on those vaccines now,” says Cohen.  

Jan. 27, 2021: North Carolina is scheduled to receive another shipment of 120,000 vaccines from the federal government. 

Jan. 29: Cohen announces North Carolina’s spot in the top 10 states for total doses administered. 

Feb. 8: North Carolina has gotten 1,390,947 shots into arms. It has administered 88% of its first and second doses. About 9.2% of its 10.5 million residents have received their first shot.