More than a dozen states will open vaccination eligibility to all adults this week in a major expansion of COVID-19 shots for tens of millions of Americans amid a worrying increase in virus cases and concerns about the balance between supply and demand for the vaccines.
Meanwhile, the head of the Centers for Disease Control and Prevention said on Monday that she had a recurring sense of “imminent doom” about a potential fourth wave of infections after falls in the United States rose 10% in the past week.
She urged Americans not to relax with preventative measures such as social distancing and masking.
“Please wait a little longer,” said Dr. Rochelle Walensky during a briefing in the White House.
Several northeastern states and Michigan have seen the largest increases, and some report hundreds or thousands more new cases per day than two weeks ago.
A new study from the CDC concluded that the Pfizer and Moderna vaccines were 90% effective after two doses, a result that Walensky said should give hope.
States that open eligibility to anyone 16 years and older on Monday included Texas, Oklahoma, Louisiana, Ohio, North Dakota and Kansas.
The rapid expansion has raised concerns that the number of avid vaccine seekers will exceed the available range of shots, frustrating millions of new entrants who have been waiting since the end of last year for a chance to get an injection.
Other officials have relied on a promised amount of vaccines and instead turned their attention to the next challenge: to push as many people as possible to get the shots so that the nation can achieve herd immunity at the earliest opportunity.
Vaccination levels in Texas have lagged behind much of the United States, and although government officials blame at least part of the blame for delays in data reporting, they also acknowledged that meeting places are not being filled.
Demand “has definitely declined in recent weeks,” said Imelda Garcia, head of the state’s expert panel on vaccine allocation.
Texas will receive more than 1 million new doses this week. On Monday, the state launched a new scheduler and an online telephone number that played a larger role in efforts that had largely been made at the local level.
In Kansas, where some local health officials have said they are also struggling to find people to vaccinate, another 400,000 people are now eligible for shots.
Democrat Laura Kelly has been criticized by Republicans for slow, disorganized vaccine development, and she received more criticism on Friday when she announced plans to expand the jurisdiction.
A Republican lawmaker said people with chronic medical conditions could be left behind.
Louisiana Gov. John Bel Edwards has said that the state will soon have enough shots for anyone who wants one and that the challenge now is to make sure people want to be vaccinated.
Some counties in Illinois may extend their eligibility to this entire week if they feel that doses are not being used. But in Chicago, the vaccine will not be available to everyone until at least May 1 because the city does not have enough shots on hand.
On Tuesday, Minnesota opens eligibility, followed by Indiana and South Carolina on Wednesday, Connecticut and Montana on Thursday and New Hampshire and Colorado on Friday.
In New York, the government of Andrew Cuomo announced that residents over 30 will be eligible for vaccinations from Tuesday, and anyone over 16 can sign up from April 6.
Connecticut officials said “priority access” will be given to people at high medical risk or developmental disabilities when all 16 years and older are eligible. It may include some hospitals that organize dedicated clinics or reserve meeting places for people with these conditions, officials said.
Arizona opened eligibility for all adults last week, but it has since had an unintended consequence: Interest in volunteering at four state vaccination sites dropped almost immediately.
Since February, thousands of volunteer shifts were filled within an hour. Now many remain vacant, says Rhonda Oliver, CEO of HandsOn Greater Phoenix, a non-profit management of online volunteer recruitment.
“People saw it as a way to get the vaccine earlier,” Oliver said. “We expected a departure, but we did not expect it to go off a cliff within 24 to 48 hours like this.”
On Wednesday, the first day of the new eligibility, only 70 of the planned 145 volunteers showed up at State Farm Stadium in Glendale, and dozens of people either withdrew earlier or did not show up.
Oliver said it was an unfair burden for volunteers who showed up and could not take breaks.
The lack of volunteers should not affect the waiting times for those with meetings, Oliver said.
HandsOn Greater Phoenix hopes to reduce bleeding by reaching out to large companies and community groups looking for service activities. The group also encourages friends or family members who have been vaccinated to participate together voluntarily.
Many other states are still limited by a continuing lack of access.
California officials said the state can administer 3 million shots a week now, and Democratic Gavin Newsom has predicted that maximum capacity will rise to 4 million by the end of April.
But deliveries have so far limited the effort to 1.8 million images per week, a figure that is expected to increase to 2.5 million per week during the first half of April and then 3 million at the end of April, when all 16 and older will be offered the vaccine.
Santa Clara County has been told it will receive 58,000 doses this week, says health officer Dr. Marty Fenstersheib, but the state will begin allowing about 400,000 more people between the ages of 50 and 64 in the county to register starting Thursday, except current lag.
“We do not have the vaccine, and we are worried,” said Fenstersheib.
Among the methods that officials use to reach substandard communities are vans used as mobile clinics that travel to hard-hit areas and provide on-site vaccinations.
In California, mobile clinics help vaccinate farm workers who may not have transportation to major vaccination sites or cannot navigate the state’s online portal. Los Angeles also plans to have ten mobile vaccination teams.
Colorado Gov. Jared Polis said Monday that four mobile bus clinics will distribute vaccines to preserving communities.
While demand has fallen in some communities, it is as fast as ever in others, and registration problems continue.
Lena Lawson, a 37-year-old technical consultant in Phoenix, tried to book a vaccination since the new eligibility rules began. She worked from home and could regularly update meeting sites but had no luck in three days.
She happened to be up at two o’clock on Sunday and finally got a place at a Walgreens on Tuesday.
“I was quite surprised. My God, I got a time. I’m fine, ”Lawson said.
The effort was softer for a professor at Johnson University in Utah. He said he was bracing for a time-consuming and confusing experience but instead thought it was remarkably simple.
“We had to make an appointment and came in two days later,” said Johnson, 59, who received his first shot at the Salt Lake City Convention Center. “It took us 10 minutes to drive there, and they bumped into us two minutes after we arrived.”