WASHINGTON — State public health officials had one message for lawmakers on Tuesday: send us more COVID-19 vaccine.

“Michigan’s biggest challenge with the vaccine rollout has been the limited supply of vaccine, lack of predictability regarding vaccine amounts week to week, and the lack of a national strategy until now,” said Joneigh Khaldun, MD, MPH, chief medical executive of the Michigan Department of Health and Human Services, at a virtual House Energy & Commerce Health Subcommittee hearing on ways to increase vaccination rates. “Despite this, Michigan has made significant strides …We have jumped more than 20 spaces in the rankings over the past few weeks as it relates to the proportion of the population vaccinated.”

“From the outset, vaccination efforts in Illinois have been limited by vaccine supply and sometimes complicated by inconsistent messages regarding allocations,” said Ngozi Ezike, MD, director of the Illinois Department of Public Health. “Operation Warp Speed’s promise to Illinois and the nation of a steady cadence of vaccine oftentimes fell short, with reduced or postponed allocations which left Illinois receiving fewer-than-expected doses.”

In addition to Khaldun and Ezike, witnesses also included the health state health directors of Colorado, Louisiana, and West Virginia. Committee members were particularly interested in finding out why West Virginia had a relatively high percentage of its residents vaccinated — 10.8% of West Virginia residents have gotten at least one dose of vaccine, compared with, for example, 6.4% in Illinois, according to CDC data reported by NPR.

Clay Marsh, MD, the state’s coronavirus czar, said West Virginia “created a ‘team of teams’ approach that has been led by the National Guard — our logistics experts … As we started to focus and clarify our priorities, we agreed with the [Advisory Committee on Immunization Practices] and were also informed by data from the U.K. and the CDC that demonstrated truly that older patients were the most vulnerable for death and hospitalization … so we targeted this age group along with the vulnerable populations outlined by the CDC.”

State officials also decided not to activate a federal/state pharmacy partnership that used two large pharmacy chains — CVS and Walgreens — to distribute the vaccine. “We have 250 pharmacies in West Virginia, half of which are privately owned,” he explained. “We started partnering these pharmacies with nursing homes, and we were able to immunize all of our nursing home/assisted living residents before the New Year and we just finished our second dose … Our goal is to move every vaccine within 5 days into somebody’s arm.”

Rep. Lori Trahan (D-Mass.) asked Marsh to elaborate on why his state decided not to use the federal pharmacy program. Marsh said state officials asked the leader of West Virginia’s long-term care association and a member of the state pharmacy board, who said that the federal program wouldn’t work as fast as if they partnered with local pharmacies.

Rep. Tom O’Halleran (D-Ariz.) asked what could be done to address vaccine hesitancy now and in the future. Ezike responded that one idea would be to enlist kids “from a very young age, to talk about the importance of vaccines, and explain the science of vaccines — explain to youngsters how they don’t know about measles and polio because so many diseases have been eradicated by vaccines … That’s infrastructure building that may not give us the full fruits for this pandemic but will help toward the next.”

Members also took the opportunity to score some political points. Rep. Frank Pallone (D-N.J.) chair of the full committee, said he disagreed with a comment by Rep. Cathy McMorris Rodgers (R-Wash.) that the vaccination rollout should be best left to the states, noting that earlier in the pandemic, states were competing with one another to procure masks, gloves, and other supplies. “We need a national strategy which is what Biden is trying to accomplish … I don’t think one-size-fits-all works when you have a pandemic of this size … The fact that President Trump so much stressed that states were on their own and didn’t need a national strategy was a huge mistake.”

“Complaining about not getting enough vaccine is like complaining about the size of your meal,” said Rep. David McKinley (R-W.Va.) “You should be grateful to have any food on the table.” (Photo courtesy House Energy & Commerce Committee livestream)

Rep. David McKinley (R-W.Va.) defended the Trump administration. “We’ve heard a lot of criticisms today of the Trump strategy, but I want to remind people that on September 16, the states were given a 57-page guidance document,” he said, holding up a copy. “For people who say there were no plans, that just means that the state didn’t create one that works.”

“Some states can’t get it right,” he said, noting that some states have complained they need more vaccine but have only given out 50% of their current supply. In particular, he called out Illinois and Michigan for their low vaccination rates compared with West Virginia’s. “Apparently they didn’t develop a plan that is flexible enough to work. I’m just concerned about that.”

McKinley evinced little sympathy for states complaining that they haven’t received enough vaccine. “Complaining about not getting enough vaccine is like complaining about the size of your meal,” he said. “You should be grateful to have any food on the table.”

Rep. Tim Walberg (R-Mich.) asked Khaldun why lots of doses in Michigan were sitting unused despite the fact that Michigan governor Gretchen Whitmer (D) said the state was ready to administer them. Today, “we’re one of the top-tier states when it comes to vaccinating our population,” Khaldun responded.

“There were a couple reasons why in the beginning it appeared that Michigan was one of the bottom 10 states … One of those was actually data not coming into the CDC — we found more than 30,000 doses we were not getting credit for.” In addition, many doses were sitting unused in long-term care facilities, and “we were able to take those out and vaccinate people across the state,” she said.

Last Updated February 02, 2021

Joyce Frieden oversees MedPage Today’s Washington coverage, including stories about Congress, the White House, the Supreme Court, healthcare trade associations, and federal agencies. She has 35 years of experience covering health policy. Follow