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'Waiting With Bated Breath': Health Clinics Anxious For Covid Vaccines Weeks After Rollout

A banner for vaccines is seen at a pharmacy on September 01, 2023 in the Flatbush neighborhood of Brooklyn borough in New York City.

Michael M. SantiagoGetty Images

Weeks after the approval of updated Covid vaccines, community health centers across the country say they are still waiting on their doses to arrive. The delays are preventing many vulnerable adults and children from getting vaccinated ahead of a potential winter wave.

Cahaba Medical Care, which has 26 community health clinics throughout Alabama, hasn't received a single shipment of the new Covid vaccines since the rollout began in September, said Veronica Ford, a nursing manager at the center.

"We are actually waiting with bated breath," Ford said. "We are checking daily to see if the state has received their supply so that we can get ours."

The clinics, Ford said, treat many patients with underlying conditions that make them more susceptible to severe illness. She's concerned that people who have already come in to get their annual flu shot won't return to get the Covid vaccine once the shipments come in. 

The shipment delays, experts say, underscore the enduring health disparities based on race and class in the U.S. 

Community health centers provide federally funded free or low-cost health services, making them pivotal in providing care to underserved populations, including people with low incomes, undocumented immigrants, and many Black and brown communities.

Because the clinics rely on federal funding, they cannot afford to cover the costs of the vaccines on their own. That wasn't a problem during the pandemic, when the federal government was the one buying and distributing the doses; Ford said that Cahaba, for example, gave about 50,000 Covid vaccinations throughout the pandemic that were supplied by the state and federal government.

Now that the government has largely stopped paying, many community health centers have had to rely on programs including the Centers for Disease Control and Prevention's Bridge Access Program, which aims to provide free Covid vaccines to adults without insurance or with limited insurance coverage. 

But shipments from that program are delayed, with community health centers facing weekslong wait times for their vaccine orders, according to Vacheria Tutson, the associate vice president of policy and regulatory affairs at the National Association of Community Health Centers.

"I've had health centers who have only received 100 vaccines," Tutson said. 

With limited shots on hand, clinics have had to prioritize doses for people who face the highest risk of severe illness, including older adults and those with weakened immune systems. Others will go without until the shipments arrive.

"Now that we don't have that government access, it's shining the light on how we really can't afford to vaccinate uninsured and underinsured adults," said Tutson, who added that she is hoping that the situation will improve within the next two weeks.

Delayed shipments or limited doses

Luis Borja, 70, of Los Angeles, was turned away last week when he went to get a free Covid vaccine at a local community health center in southern Los Angeles.

The clinic, run by St. John's Community Health, said it didn't have enough vaccines for everyone who wanted one, citing ongoing shipment delays from the Bridge Access Program. 

That meant Borja, who lives below the federal poverty line, was largely out of options: He couldn't afford to pay out of pocket, and his insurance, Medi-Cal, didn't cover the cost of the shot at most retail pharmacies.

Borja, who is originally from El Salvador, told NBC News in an interview in Spanish that he felt "a little frustrated." 

Jim Mangia, the president and CEO of St. John's Community Health, called it "a travesty."

"We don't have the resources to provide for the communities most in need," Mangia said. "The same vaccine disparities seen before the pandemic are rearing their ugly head again." 

Almost 14 million Covid vaccines have been shipped to pharmacies and other locations since they were approved last month, according to data from the Department of Health and Human Services.

A CDC spokesperson said in a statement that the agency "has been in frequent contact with state health departments and has not been made aware of any system-wide shortages or obstacles to distribution of the updated COVID-19 vaccine to community health centers."

Community Health Connection, in Tulsa, Oklahoma, only received a third of the vaccine doses it ordered when its shipments arrived this week, according to its CEO Jim McCarthy.

The health center requested 100 vials each from three federally funded programs, including the Bridge Access Program. 

"We got 33 in each program," McCarthy said. "So, we're trying to find out now, does that mean that there'll be 33 more tomorrow, or ever?"

The center serves more than 20,000 people, many of whom are Latino. McCarthy said challenges with vaccination efforts have long existed in Oklahoma, where vaccine hesitancy has increased as misinformation runs rampant. 

McCarthy said that a handful of people, mostly young, have come to the center asking about the new Covid vaccine. About 96% of patients live below the federal poverty line, and many are working individuals who travel back and forth to visit family in Mexico, he said. 

When Tulsa schools opened in August, before the new Covid vaccine was available, he said many parents also called the center asking about vaccines for their children.

"There were a lot of calls at that point in time about, 'OK, our kids are going back to school — they possibly get exposed more, what do we do?'" he said. "And of course, we didn't have the vaccine."

Lack of demand 

Other centers are facing a different problem: People don't want to be vaccinated. 

The Life Health Center in Wilmington, Delaware, which primarily serves Black patients, hasn't received any shipments of the updated vaccine, said Sharon Farrell, a primary pediatric nurse practitioner at the clinic. 

Farrell said she recently ordered 200 doses: 100 for children under 12 and 100 for children and adults ages 12 and up. The doses, she said, should arrive next week. 

"I've never not gotten the order that I asked for, but we asked for very low numbers," she said. "So, I don't know. We'll see, I guess."

But for Farrell, the problem is less about vaccine supply and more about people's willingness to get it. The center hasn't had to turn anyone away yet, because no one has come in to get the vaccine. 

Farrell said that feelings of mistrust in federal government regulations and vaccine mandates are not uncommon among Black and brown patients. These groups have historically been mistreated and medically abused in the past, she said. 

It's a similar story in parts of Pennsylvania, where the vaccine rollout has also been slower than expected. 

The Pennsylvania Association of Community Health Centers, which represents clinics across the state that serve an estimated 1 million people a year, received just 900 Covid vaccines so far, according to Eric Kiehl, the organization's director of policy and partnership. 

While the state Health Department has prioritized getting vaccines to health centers with a larger uninsured population, health centers that serve fewer uninsured patients "are probably still on the waitlist to get some vaccine," Kiehl said.

"Our Department of Health is not getting the amount of vaccine that they had anticipated, or at least as quickly as they thought," Kiehl said. "But, we have not been hearing a lot from our health centers that they have patients banging on their doors to get access to the vaccine."

Novavax's Updated COVID Vaccine Is Here. What To Know About The Shot.

Unlike Moderna and Pfizer's mRNA vaccines, the Novavax vaccine utilizes a protein-based approach. (Photo illustration by Nikos Pekiaridis/NurPhoto via Getty Images)

About 4 million Americans got updated COVID vaccines in September, according to the U.S. Department of Health and Human Services. Now, another vaccine option has arrived.

What's happening?

On Oct. 3, the Food and Drug Administration (FDA) authorized the updated COVID-19 vaccine by Novavax for people ages 12 and older. The Centers for Disease Control and Prevention and its advisory panel had already recommended the vaccine before the FDA authorization, so Novavax has all the regulatory approval it needs to start distributing vaccines — meaning Americans now have three brands of COVID shots to choose from this fall.

How is the Novavax vaccine different?

Side effects in clinical trials were similar to side effects experienced with other COVID vaccines, including headache, nausea, muscle or joint pain, injection site tenderness, and pain and fatigue.

But unlike the Pfizer and Moderna vaccines, which use first-of-their-kind mRNA technology to deliver immunity, the Novavax vaccine utilizes a protein-based approach.

Emily Smith, an assistant professor at the George Washington University Milken Institute School of Public Health, explains that while mRNA vaccines tell your body to create a protein that your body then responds to and triggers immunity, the more "traditional" protein-based vaccine platform provides the protein itself. She tells Yahoo Life that the updated Novavax vaccine can be a good alternative for those hesitant to use the newer mRNA approach.

"I think many people are excited about it because it doesn't feel as new of a technology, so they just feel more comfortable or confident with it," Smith says. "This is kind of a more traditional approach to getting immunity. One isn't better or worse than the other, I don't think — just a different approach to having your body respond."

Like the updated Pfizer and Moderna vaccines, the new Novavax vaccine targets the XBB strains of the virus, meaning it should offer protection against dominant strains circulating nationwide.

"All three vaccines have shown good protection against COVID-19," Bethany DiPrete, an assistant professor of epidemiology at the University of North Carolina, tells Yahoo Life. "With this new approval, Americans now have even more options for the type of vaccine they can receive."

Who can get the Novavax vaccine?

The Novavax shot is approved for anyone over age 12. (Children 6 months and up can get the Moderna or Pfizer vaccines instead.)

CBS News reports that Novavax was previously authorized only as a first booster dose for people unwilling or unable to get an mRNA shot. But now, DiPrete explains that if you've previously been vaccinated with other COVID vaccine brands, you can get a single dose of the new Novavax vaccine if it's been at least two months since your last COVID shot. If you've never received a COVID shot, you'll get two doses of the new Novavax shot spaced three weeks apart.

When will it be available?

"I would expect that the whole process would allow us to start seeing shots in arms taking place next week," Novavax chief commercial officer John Trizzino told Yahoo Finance, adding that "vaccinations are going to continue to take place over the next eight weeks."

Novavax says that the shots will soon be available nationwide at thousands of locations, including doctors' offices, clinics and pharmacies. Free shots will also be available through the Vaccines for Children and Bridge Access Program, according to USA Today.

So far, the rollout of Moderna's and Pfizer's mRNA vaccines has been rocky. Some people have encountered canceled appointments or have been unable to get a vaccine appointment at all, in part thanks to reported shipping delays and insurance issues stemming from the end of the COVID public health emergency earlier this year.

Trizzino told Yahoo Finance that the extra-cold storage requirements for mRNA vaccines are an added complication that the protein-based Novavax vaccines shouldn't encounter.

"[The mRNA doses are] shipped frozen, and the distributors are thawing and relabeling prior to shipping. And it's our understanding that that's created a backlog," he said. "We've already arranged where there are situations where a particular facility within that distributor is dedicating to do that process, we're [avoiding] that facility and making sure that we're being fulfilled out of another warehouse."

One Month Later: Where Are The Pediatric COVID Vaccines?

Oct. 13 2023— It's been a month since the CDC recommended the updated COVID-19 vaccine for everyone 6 months old and older, and promised the vaccines would be "available by the end of this week at most places you would normally go to get your vaccines."

But since that recommendation on Sept. 12, legions of parents are still searching for the vaccine, especially for their youngest children, and growing increasingly frustrated.

Public health officials say the situation is improving and will continue to do so. But that's not comforting for parents like Christina Sellers. In late September, she was busy preparing for her family's move from the Atlanta area to Lansing, MI. Anticipating that movers would be in and out of the house, her to-do list included not just the usual packing up but also getting the updated COVID vaccine for her, her husband, and their 4-year-old son. She's immunocompromised, so keeping the whole family up to date on the vaccine is important.

She and her husband got their vaccines before the move, but they are still waiting for their son's. While still in Atlanta, she reached out to pharmacies, the health department, and her pediatrician's office. No one had it for his age group.

The day after the family got to Lansing, "I started calling CVS, Walgreen's, Rite Aid, a few independent pharmacies, the health department and the big health systems in the area," she said. She was willing to drive 100 miles, which in Lansing generally takes about an hour and a half, she said.

Finally, the Ingham County Public Health Department scheduled her son for the vaccine Oct. 20. "They did book us, but I've been trying to persist to see if I can get it sooner."

Sellers' story is not uncommon. She and about 7,000 others belong to the Facebook group Protect Their Future, an advocacy group for access to childhood vaccines and other health care. Members post their efforts and share information about vaccine availability. On X, formerly known as Twitter, users who can't find the vaccine point out how many days have passed since the 2023-2024 COVID vaccine was recommended by the CDC and call out inaccurate or outdated information about availability on such sites as Vaccines.Gov.

The number of children under age 18 with confirmed COVID-19 when admitted to a hospital increased almost five times from mid-June to early September, from 237 to 1,175, an analysis by the American Academy of Pediatrics found. More than half of children under age 17 hospitalized with COVID have no underlying conditions, according to the CDC. 

Obstacles, Solutions

Public health officials and COVID vaccine manufacturers have acknowledged the obstacles, especially in obtaining the vaccine for the youngest children, but point to solutions that are in progress or in place.

Supplies: Adult vaccines were rolled out first, but more pediatric doses are coming, said spokespeople for both Pfizer BioNTech and Moderna, the two vaccines approved for ages 6 months and older. 

According to a Pfizer spokesperson, "Pfizer shipped and delivered more than 18 million doses of its 2023-2024 COVID-19 vaccine, including more than 1.5 million pediatric doses for children under 12. We're continuing to meet demand from wholesalers and customers and anticipate delivering millions of additional doses each week."

A Moderna spokesperson said, "Our pediatric COVID vaccine is currently available, and we've completed our shipments to the CDC, which manages much of the distribution. We also continue to ship to retail pharmacies and other points of care." She didn't immediately provide the number of pediatric doses shipped. 

Mixing and matching: The CDC has said parents should stick with the same vaccine manufacturer for children's vaccines if possible, which can complicate finding the updated vaccine. However, at a town hall hosted by the American Academy of Pediatrics on Oct. 4, CDC Director Mandy Cohen, MD, MPH, said that for children who completed the primary series with one manufacturer, "going to an updated vaccine with a different one is perfectly OK."  

Pharmacy availability and age cutoffs: In August 2020, the U.S. Department of Health and Human Services (HHS) allowed pharmacists in all states to give the COVID vaccines to children 3 years and older to expand the availability of vaccination options. 

In May, that declaration was amended, extending it until December 2024. 

"Pharmacies in all states can administer the COVID-19 vaccine to individuals ages 3 and up," an agency spokesperson said. COVID-19 vaccines for ages up to 2 years "must be administered in a provider's office," she said.

Even so, policies vary from pharmacy to pharmacy as to which ages they will vaccine. For instance, pediatric COVID-19 vaccine appointments for those age 5 years old and older can be made online at CVS or via the CVS Pharmacy app, said Matthew Blanchette, a spokesperson. Those 18 months old and older can get the vaccine at the CVS' MinuteClinic, the in-store clinics, and make the appointment at Minuteclinic.Com.

The rationale: MinuteClinic locations are staffed with providers such as nurse practitioners, physician assistants and physician associates as well as support staff who are experienced in giving vaccinations to younger children, he said.

It's best to call ahead and verify any online information, even appointments -- as parents in the Facebook group can attest after scheduling appointments, going, and being told there is no vaccine for their child. 

Doctors' buy-in: As the vaccine supplies became commercialized and doctors now have to pay, some pediatricians were reluctant to order the vaccines, citing tight profit margins and uncertainty about how many of their patients would opt for the updated vaccine.

Now, Pfizer is allowing a 100% return policy, which is expected to result in more pediatrician offices ordering the vaccine, which comes in three-dose vials. In an email, a Pfizer spokesperson confirmed that "Pfizer has a 100% return policy for wasted/expired vaccines for under 5 and [buyers] will receive credit within 60 days of Pfizer receiving the return." 

Moderna's pediatric COVID vaccine is provided in single-dose vials, a spokesperson said, noting that pediatricians "have more precision when ordering and there is therefore less waste. Moderna does allow for a percentage of an order to be returnable."

These policies seem to have helped. 

"I have seen increased willingness from pediatricians to order the vaccine," said Pia Pannaraj, MD, MPH, a professor of pediatrics at the University of California, San Diego, and a member of the American Academy of Pediatrics' Committee on Infectious Diseases. 

Efforts Continue, Sometimes Success

For some parents, improved availability can't come soon enough. 

"In our group, we have so many families right now clamoring to figure out where they can find the vaccine," said Fatima Khan, parent to a 5- and 7-year-old and a co-founder of Protect Their Future. "We've had parents drive 2 hours to be told the vaccine is not available [after making an appointment]. What was really disturbing was that even last week we were hearing from people in Manhattan not being able to find it." 

Khan, of Novi, MI, found the vaccine for her children but had to drive about an hour to get it.

The vaccine is sometimes hard to find even for older children, and parents often report that information on vaccine websites is out of date or entirely inaccurate. After one appointment was made, then canceled by the pharmacy because they had no supply, Lynn Fingerhut of Peoria, IL, managed to get the updated vaccine for herself, her husband and her 14-year-old son. 

She had to make multiple phone calls to find the vaccine for her 10-year-old son. "I spent about 2 hours, 20 minutes on calls on hold just on Tuesday," she said. She has a home-based sales job and a dog-walking business, and often multi-tasked on the walks, staying on hold for a long time. 

Finally, she struck gold. The pharmacy at a Kroger in East Peoria told her she can just walk in this week. She did on Thursday and her son got the vaccine.

Sellers, the mother of the 4-year-old who's not vaccinated, is a nurse practitioner and is hoping for similar success. "If I could get my hands on the shot, I'd stick my own kid."

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