New York, the onetime center of the pandemic, faced a growing crisis on Monday over the lagging pace of coronavirus vaccinations, as deaths continue to rise in the second wave and Gov. Andrew M. Cuomo came under mounting pressure to overhaul the process.
The small number of vaccine recipients is particularly striking in New York City, where roughly 110,000 people — in a city of more than eight million — have received the first of two doses necessary to help prevent serious cases of the disease. That is about a quarter of the total number received by the city.
Mayor Bill de Blasio called on the Cuomo administration to allow the city to inoculate a broad array of essential workers and New Yorkers who are 75 and older. The vaccinations are currently limited to health care workers and those living and working at nursing homes.
“There’s lots more we can do if we have both those categories approved,” Mr. de Blasio said at a news conference on Monday.
Shortly after the mayor spoke, Mr. Cuomo rejected any notion that his administration was at fault, asserting that the problem was a local issue, and urging Mr. de Blasio and other local leaders who oversee public hospital systems to take “personal responsibility” for their performance.
“They have to move the vaccine,” the governor said in Albany. “And they have to move the vaccine faster.”
The governor threatened to fine hospitals up to $100,000 — and redirect future vaccines to other hospitals — if they did not rapidly increase the pace of vaccination. He also named the slower-performing hospital systems in a slide show, something he said he did not do “to embarrass” them but to make sure they are “held accountable.”
“We want those vaccines in people’s arms,” Mr. Cuomo said, adding, “This is a very serious public health issue.”
But efforts to speed up vaccinations may prove to be at odds with the strenuous task of making sure to prioritize the right people.
In one possible example, the state has advised clinics and other facilities to rank each employee using a matrix that takes into account age, comorbidities, occupation and the section of the facility where the person works.
Mr. Cuomo said he would propose legislation that would impose criminal charges for facilities or health care providers that did not follow guidelines on who is eligible for the vaccine. “This vaccine can be like gold to some people,” the governor said.
Asked about whether his threat of fines for hospitals — already warned that they will face penalties if they break state mandates on who gets the vaccine — could be slowing down the process, Mr. Cuomo said no.
“I want to get needles in the arms and I want to get that done quickly as possible,” he said. “If there are some hospitals that are better at doing that, then they should be doing that.”
Covid-19 Vaccines ›
Answers to Your Vaccine Questions
With distribution of a coronavirus vaccine beginning in the U.S., here are answers to some questions you may be wondering about:
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- If I live in the U.S., when can I get the vaccine? While the exact order of vaccine recipients may vary by state, most will likely put medical workers and residents of long-term care facilities first. If you want to understand how this decision is getting made, this article will help.
- When can I return to normal life after being vaccinated? Life will return to normal only when society as a whole gains enough protection against the coronavirus. Once countries authorize a vaccine, they’ll only be able to vaccinate a few percent of their citizens at most in the first couple months. The unvaccinated majority will still remain vulnerable to getting infected. A growing number of coronavirus vaccines are showing robust protection against becoming sick. But it’s also possible for people to spread the virus without even knowing they’re infected because they experience only mild symptoms or none at all. Scientists don’t yet know if the vaccines also block the transmission of the coronavirus. So for the time being, even vaccinated people will need to wear masks, avoid indoor crowds, and so on. Once enough people get vaccinated, it will become very difficult for the coronavirus to find vulnerable people to infect. Depending on how quickly we as a society achieve that goal, life might start approaching something like normal by the fall 2021.
- If I’ve been vaccinated, do I still need to wear a mask? Yes, but not forever. Here’s why. The coronavirus vaccines are injected deep into the muscles and stimulate the immune system to produce antibodies. This appears to be enough protection to keep the vaccinated person from getting ill. But what’s not clear is whether it’s possible for the virus to bloom in the nose — and be sneezed or breathed out to infect others — even as antibodies elsewhere in the body have mobilized to prevent the vaccinated person from getting sick. The vaccine clinical trials were designed to determine whether vaccinated people are protected from illness — not to find out whether they could still spread the coronavirus. Based on studies of flu vaccine and even patients infected with Covid-19, researchers have reason to be hopeful that vaccinated people won’t spread the virus, but more research is needed. In the meantime, everyone — even vaccinated people — will need to think of themselves as possible silent spreaders and keep wearing a mask. Read more here.
- Will it hurt? What are the side effects? The Pfizer and BioNTech vaccine is delivered as a shot in the arm, like other typical vaccines. The injection into your arm won’t feel different than any other vaccine, but the rate of short-lived side effects does appear higher than a flu shot. Tens of thousands of people have already received the vaccines, and none of them have reported any serious health problems. The side effects, which can resemble the symptoms of Covid-19, last about a day and appear more likely after the second dose. Early reports from vaccine trials suggest some people might need to take a day off from work because they feel lousy after receiving the second dose. In the Pfizer study, about half developed fatigue. Other side effects occurred in at least 25 to 33 percent of patients, sometimes more, including headaches, chills and muscle pain. While these experiences aren’t pleasant, they are a good sign that your own immune system is mounting a potent response to the vaccine that will provide long-lasting immunity.
- Will mRNA vaccines change my genes? No. The vaccines from Moderna and Pfizer use a genetic molecule to prime the immune system. That molecule, known as mRNA, is eventually destroyed by the body. The mRNA is packaged in an oily bubble that can fuse to a cell, allowing the molecule to slip in. The cell uses the mRNA to make proteins from the coronavirus, which can stimulate the immune system. At any moment, each of our cells may contain hundreds of thousands of mRNA molecules, which they produce in order to make proteins of their own. Once those proteins are made, our cells then shred the mRNA with special enzymes. The mRNA molecules our cells make can only survive a matter of minutes. The mRNA in vaccines is engineered to withstand the cell’s enzymes a bit longer, so that the cells can make extra virus proteins and prompt a stronger immune response. But the mRNA can only last for a few days at most before they are destroyed.
The governor estimated that about 300,000 people had received the vaccine in New York, but offered no single reason for the slow pace of vaccination. “There is no one cause,” he said, noting that he had spoken to dozens of hospitals about the issue.
He did suggest, however, that “management capacity and efficiency” were causing problems, saying there was a lack of “urgency” at some hospitals.
“It’s bureaucracy,” he said.
Mr. de Blasio acknowledged that the city’s rollout had been slow, blaming the logistical challenges of dealing with a new vaccine, and said the city took a cautious approach as it laid the groundwork for more widespread distribution.
“Now it’s time to sprint,” Mr. de Blasio said.
Avery Cohen, a spokeswoman for the mayor, said that Mr. de Blasio has stressed to the city’s public hospital system — NYC Health and Hospitals — that they should “get as many vaccines in arms as possible.” But she questioned the logic of Mr. Cuomo’s pledge to cut off hospitals that are not fast enough for his taste.
“Threatening to revoke the privilege of vaccination from the city’s public hospital system is punitive and unnecessary,” Ms. Cohen said.
Other elected officials in the city have been urging a more aggressive plan of attack, with round-the-clock operations. On Monday, the mayor seemed to agree, promising three new “vaccination hubs” would open on Sunday in Brooklyn, Queens and the Bronx, and pledging to offer shots of the vaccine seven days a week and 24 hours a day when possible. The city also hoped to double the number of locations offering vaccination to 250 sites by the end of the month.
The mayor repeated his pledge to reach a rate of 400,000 doses per week by the end of the month, with a goal of one million doses — safeguarding at least a half-million residents — by February.
Mr. de Blasio and Mr. Cuomo have long had a difficult relationship, but they have tried to show a united front in recent weeks as the state and city face a second wave of the virus. Mr. de Blasio was careful on Monday not to directly criticize Mr. Cuomo, but called on “the state” several times to alter its approach.
The mayor showed no such restraint when it came to the federal government, suggesting in a slide show that the “feds” needed to “PICK UP THE PACE” on distributing the vaccine.
Mr. Cuomo, a third-term Democrat, has touted his own response to the coronavirus crisis and the state’s vaccination plan in recent months, though statistics continue to bear troubling news: On Monday, more than 8,200 residents in the state were hospitalized with the coronavirus, levels not seen since early May, as deaths have topped 100 a day for several weeks. On Monday, the governor reported 170 deaths, the highest daily count since the dark days of the spring.
Over the past week, the state has seen more than 10,000 new cases per day, as the statewide rate of positive test results has also jumped alarmingly, even before an expected increase tied to holiday travel and gatherings. New York continues to be the hardest hit state in the nation, with more than 38,000 deaths.
Mr. Cuomo said on Monday that “there have been issues with the delivery of the vaccine,” laying that blame with federal officials whom he has regularly criticized for their handling of the crisis.
He said that the state would expedite delivery and injection of the vaccine to nursing homes — where thousands of New Yorkers have died — aiming to get 85 percent of residents vaccinated by the end of this week.
“The federal program has not worked as quickly as we would have liked,” Mr. Cuomo said.
