State officials warn that the US government has underestimated the number of Americans who are at least partially vaccinated against the coronavirus, leaving millions more susceptible as the pandemic’s winter spike gains momentum.
The Centers for Disease Control and Prevention (CDC) changed a key indicator — the percentage of persons 65 and older who have had at least one shot — last weekend. The agency dropped the proportion from 99.9 percent, where it had been fixed for weeks, to 95 percent, while maintaining the agency’s raw shot totals.
The action recognized a dynamic state’s discovery: in compiling reams of immunization data, the US incorrectly counted too many shots as initial doses when they were actually second doses or booster shots.
According to the CDC, 240 million people, or around 72.5 percent of the population, have had at least one shot. However, the agency reports that just 203 million people are fully vaccinated, or 61.3 percent, a gap of 11 percentage points more than in other industrialized countries.
State and local regulators assert that it is impossible that 37 million Americans received one shot without receiving all of their shots. Rather than that, they assert, the government has routinely and mistakenly classified booster shots and subsequent dosages as initial doses.
This means that both the completely vaccinated and unvaccinated are undercounted officially. Although the precise number of miscounted vaccines is unknown, data revisions in three states — Illinois, Pennsylvania, and West Virginia — discovered sufficient over-counting of first shots to indicate that millions of unvaccinated people nationwide have been incorrectly counted as having received a dose.
Adjustments to national data on the extent of Pennsylvania’s changes, for example, would result in an increase of more than 10 million unvaccinated Americans.
“The truth is, we have no idea,” Clay Marsh, West Virginia’s Covid czar, admitted.
The White House directed questioning regarding the overcount of first injections to the Centers for Disease Control and Prevention, whose spokespeople did not respond to repeated requests for comment.
The Biden administration is bracing for the new omicron variant of the virus to spread across the United States this winter, escalating an outbreak that is already threatening to overload hospitals. State and federal governments may struggle to effectively target resources such as awareness campaigns without more reliable data on who is unvaccinated and where they live.
“Where it has really made it difficult for us is targeting our booster messaging,” said James Garrow, a spokesperson for the Philadelphia Department of Public Health, which has collaborated with the state to combine data sets to provide a more accurate picture of vaccination trends.
“We don’t have any faith in the numbers on the CDC website, and we never refer to them,” he said.
President Joe Biden cautioned Thursday that those who are not vaccinated will pay the price. Omicron is “here now, and it’s spreading, and it’s going to increase,” he said. “For unvaccinated, we are looking at a winter of severe illness and death.”
While some states assert that their data is accurate and no updates are necessary, others have begun submitting revisions. Last month, the Pennsylvania state government revised its estimate of adults with at least one shot to 94.6 percent from 98.9 percent in a data revision provided to the CDC. Additionally, the fraction of fully immunized older adults decreased. Another data update is scheduled by the end of the year.
Illinois discovered that it had 540,000 more totally unvaccinated people, aged 12 and older, than previously estimated – around 6 percent of what the count would have been otherwise. However, the audit discovered 730,000 people who were fully vaccinated but were not counted in earlier statistics.
The official US margin between those who have received only one dose and those who have received all vaccines – approximately 11 percent share – greatly outpaces that of other nations. The United Kingdom has the second-largest difference among Group of Seven countries, at 6.7 percent, according to the Bloomberg Vaccine Tracker. This figure is more consistent with Illinois and Pennsylvania’s revision.
State officials assert that the answer is not because Americans are especially unlikely to receive a second injection, but rather that the country’s health system is exceptionally fragmented, in comparison to its G-7 neighbors. Each state maintains its own set of data; some states maintain multiple sets, and all states combine their data with that of health providers such as pharmacies and federal programs.
The system has difficulty accurately recording individuals who receive immunizations in a number of locations or from a number of sources. For instance, someone who had a shot in one county and a second shot in another may be counted as having received two initial doses rather than being fully vaccinated.
Another example: a patient who is vaccinated through the Department of Veterans Affairs and subsequently receives a booster shot at a private pharmacy may similarly have two first doses incorrectly recorded.
The overcount increased during the summer and early fall, officials said, as some fully vaccinated individuals sought booster doses before they were officially permitted by federal regulators. Those injections were almost certainly incorrectly reported as first dosages.
On the plus side, the error indicates that more Americans received booster doses than shown by official federal data.
Nationally, CDC assessments of seniors 65 and older who have received at least one shot outnumber state totals by approximately 4.5 million, Bloomberg statistics indicate. While there are several possible explanations for the gap — some states do not count injections delivered by federal agencies such as Veterans Affairs, while others do — it also indicates a multimillion-dollar discrepancy.
One of the largest disparities was observed in Pennsylvania, where the CDC’s estimates of first doses for the elderly are almost 850,000 higher than state estimates.
According to Alison Beam, the state’s acting health secretary, their assessment revealed that some first doses were actually second doses, implying that fully infected individuals were listed twice as half-vaccinated.
Other states, including Minnesota, Colorado, New Jersey, North Carolina, and Maine, have made amendments to the CDC for a variety of reasons. Other states, including California, want to follow suit.
Many states have declined to modify their data, claiming that they are convinced it is accurate, that the CDC’s requirement for line-by-line review is too onerous, or that their data vendors restrict their capacity to make adjustments. Others assert that they lack the resources necessary to sift through the data. New York, where the CDC’s estimate of elderly first injections exceeded the state’s estimate by more than 700,000 as of this week, checked its statistics and discovered no major changes.
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