Pennsylvania has a shortage of second doses of the Moderna vaccine, which will result in delays and rescheduled appointments.

Acting Department of Health Secretary Alison Beam said Feb. 17 this will result in delays for more than 115,000 people.

“As the Department of Health works to improve the complex processes necessary to get the COVID-19 vaccine from the manufacturers into the arms of Pennsylvanians as quickly as possible, we discovered some providers inadvertently used the Moderna vaccine shipped to them intended as second doses, as first doses,” Beam said.

Basically, Beam said the second-dose Moderna vaccine requests far exceed the vaccine allocated to the state this week.

The Pfizer vaccine was not affected.

It wasn’t clear if anyone would be held accountable. Beam would not confirm who or how many providers made the mistake.

“We’re not here to have blame placed anywhere,” Beam added. “In fact, we want to make sure that all of us are focusing on the path forward and the fix directionally moving Pennsylvania forward as well.”

Beam labeled it as a “structural issue” which started in the beginning of January.

“It was an issue that compounded week over week,” Beam said. “This is the week where we’ve addressed it, because it has become so significant, that again, the amount of requested second doses of Moderna was almost equal to our entire allocation of Moderna. … Over the next two to three weeks, we will have corrected for it.”

Plan of correction

Part of the plan is to make extensive vaccine appointment reschedulings and delays - within the Centers for Disease Control and Prevention guidelines.

Patients should expect some kind of communication from their provider for a rescheduling of their first or second Moderna dose.

“Adjusting the timing of Moderna’s second-dose administration - all providers will be following CDC guidelines that sets that minimum time between doses at 28 days and the maximum time at 42 days.”

Second doses of the two-shot Pfizer and Moderna vaccines are typically administered 21 and 28 days apart, respectively, but the U.S. Centers for Disease Control and Prevention recently updated its guidance to allow the second dose of the shots to be delayed up to six weeks past the initial dose.

Pennsylvania has been holding second doses in reserve to ensure they will be available for residents who have gotten the initial shot, but Beam said a “structural issue” with vaccine deliveries emerged at the beginning of January and then festered for weeks.

Inconsistent vaccine supply, confusion about deliveries and a lack of clear communication between the health department and vaccine providers created a “perfect storm,” Beam said.

Where it started

The health department said that while it’s still determining “root causes,” part of the problem stemmed from vaccine shipments not clearly labeled as first and second doses.

State health officials told providers they didn’t need to sit on vaccine because second doses had been accounted for in the state’s distribution calculation.

“So, when providers heard department staff saying things like, ‘There is no need for vaccine providers to hold back any first doses,’ they may have felt pressure to use all of the vaccine they had on hand, when in reality, some of those doses were earmarked for second dose vaccinations,” health department spokesperson Barry Ciccocioppo said.

“By extending the time between doses, while remaining within CDC guidelines, we can minimize any disruption to first-dose vaccinations. Our goal remains getting the extremely limited supply of vaccine to people as quickly and efficiently as possible,” Beam said.

Who is affected

Overall, up to 115,000 Pennsylvanians could be forced to reschedule appointments due to the mistakes and shortage of vaccine.

“For second appointments, that would likely need to be rescheduled out one or two weeks max, there are roughly 30,000-60,000 that would need to be rescheduled one or two weeks out,” Beam said.

“For first appointments, there could be 30,000-55,000 first doses that providers had expected and anticipated that would not be delivered this week.”

Change in providers

Additionally, moving forward, primary-care physicians will no longer be administering vaccines. However, patients who already received a first dose from their physician may go back for their second dose when available.

“For first doses within the primary care physician offices, you’ll be seeing that tapering, but the second doses will still go to the provider which you received your first dose,” Beam said.

“We are working very closely with our provider partners to understand the rescheduling process that our providers will go through for those second doses to make sure that folks are rescheduled for their second-dose appointment at their same provider.”

Same dose

Beam said, the medicine in both the first and second Moderna doses are the same.

“For patients who had inadvertently received a second dose as a first dose, their experience likely would not even be something that is visible to them in understanding that it was as a second dose that was used as a first dose,” Beam said. “They should not start their vaccination process over again.”

Through Feb. 16, 1,749,949 doses have been administered by local vaccine providers.

“Ultimately, it’s a scarcity of commodity,” Beam said. “We still do not have enough vaccine to go around. We don’t want to have that get lost in the messaging today. We still need vaccine.”