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State Department scrambles to distribute scarce COVID-19 doses to diplomats

The State Department has so far received less than a quarter of the 315,000 COVID-19 vaccine doses it requested for employees in the United States and worldwide, forcing the department to scrap an ambitious plan for swift global distribution and instead follow a piecemeal process in which the internal Bureau of Medical Services, or MED, is forced to make hasty, difficult decisions about distribution, multiple officials said.

The State Department receives vaccine allotments directly from Operation Warp Speed, a public-private partnership, launched by the Trump administration in May 2020, charged with accelerating COVID-19 vaccine development and distribution.

The FDA issued emergency use authorizations for vaccines from Pfizer and Moderna in mid-December. Though the Trump administration ordered 200 million doses that month, and the Biden administration has ordered millions of additional doses in its first month at the White House,  vaccine supply is still not keeping up with demand, which may help explain the discrepancy between expectations and reality. As of Feb. 19, nearly 73.4 million doses had been delivered nationwide, and just more than 16 million people had received both doses of their vaccine, far short of the Trump administration’s goal of vaccinating 20 million people by the end of 2020. President Joe Biden has said he’s aiming to vaccinate 100 million Americans in his first 100 days in office.

Along with the challenges the shortages have created for state and local governments,  slower-than-expected distribution has left government officials on the front lines of diplomacy, charged with being the face of America in their respective countries, more vulnerable as new variants emerge. And as of now, there is no clear timeline for full vaccination in sight.

“The mRNA technology looks really great in terms of protective efficacy, but it’s still a young technology and not robust enough to scale it to the level that we need,” Dr. Peter Hotez, an infectious disease specialist at Baylor College of Medicine, recently told the PBS NewsHour.

The State Department is one of five federal entities, along with the Defense Department, Veterans Affairs , Indian Affairs, and Bureau of Prisons, receiving vaccines through Operation Warp Speed. They were chosen for their ability to coordinate logistics for large employee populations all around the country and the world, said Bill Hall, a spokesman for the Department of Health and Human Services, which helped oversee vaccine distribution. He added that each allotment the agencies receive is proportional to the total adult population they provided to Operation Warp Speed.

WATCH: How the Biden administration is trying to ramp up the pace of vaccinations

Spokespersons for the other four bureaus did not respond to requests for information about their vaccine rollouts.

As the federal COVID-19 vaccine rollout took shape, the State Department’s MED established a plan to distribute the vaccine to State Department employees in the United States and at its approximately 270 posts worldwide, based on the understanding that it would receive all requested vaccines at once. A 2020 fact sheet put the total State Department population, including family members, at 76,000. This does not include other federal employees, like Pentagon diplomatic representatives, known as attaches, who fall under the authority of diplomatic chiefs of mission when abroad.

In the United States, MED was preparing to turn part of the State Department’s new museum in Washington, D.C., into a vaccine distribution center, working from 7 a.m. to 7 p.m. EST to vaccinate all personnel in the “national capital region” and then embark on a “roadshow” to vaccinate State Department employees around the country.

Worldwide, MED planned on a hub-and-spoke model of distribution. Large airplanes would deliver temperature-controlled pallets of vaccine to seven regional hubs, from which they would be distributed, using smaller airplanes, to the region’s posts.

“We were expecting that we would get vaccines out to the whole world within two or three weeks,” a senior official with knowledge of the vaccine distribution process, authorized by the State Department to speak about the rollout, told the PBS NewsHour.

But those plans went up in smoke in early December, when MED learned, just a few days before the expected delivery, it would only be receiving 13,650 doses of the Pfizer vaccine, or less than 4 percent of its requested allotment.

“The department was disappointed. But we adjusted very rapidly to the realities of what we were dealt,” the senior official said. “How do we do the most good with the vaccines we have available?”

READ MORE: Average U.S. virus cases dip below 100K for 1st time in months

The first tranche went to people working at the main State Department complex, including medical personnel and diplomatic security, along with New York-based employees working with the United Nations.

The Baghdad, Kabul and Mogadishu embassies also received doses because employees there live in close quarters and because Baghdad and Kabul both saw “large outbreaks,” according to a cable sent to all State Department employees on Feb. 2 and obtained by the PBS NewsHour.

Once those doses were distributed, other Washington-based employees received what was left. There was enough supply to vaccinate around 60 percent of that workforce, the cable said. A total of 6,825 employees received vaccinations from the first tranche.

As the reality of distribution became clearer, MED officials developed a new list of distribution criteria, factoring in the local disease burden and the quality of local health infrastructure, supply chain logistics and the impact on U.S. foreign policy priorities.

“I cannot promise that our operation will always be smooth moving forward, but I can promise that it will be thoughtful, data driven and forthright,” acting under secretary for management Carol Perez wrote in the Feb. 2 cable.

Two diplomats based in Europe who spoke to the NewsHour on condition of anonymity because they were not authorized to speak on the record said they feared the new criteria de-prioritized posts in developed nations with strong public health infrastructure but severe outbreaks.

For example, the United Kingdom is experiencing a dramatic case spike related to a strain that is more transmissible, overwhelming the country’s National Health Service. But London is traditionally considered a medical oasis, not a desert, and served as a medical evacuation hub for much of Africa and Asia pre-pandemic.

“I’m glad my colleagues in Sub-Saharan Africa are getting it. But why people in places like London or the rest of Europe have been pushed to the bottom just because it’s some sort of theoretically ‘developed world’ is bamboozling,” one of the diplomats in Europe said.

The State Department senior official said those concerns were valid.

“I wish I had a vaccine for everybody,” the official said, noting that MED has conducted 38 medevacs worldwide due to COVID-19, and that more people have been taken directly to the United States than would be in a non-pandemic year.

The official said as of Feb. 8, there had been 5,219 total instances of COVID overseas among diplomatic mission staff and that almost 85 percent of those infected have since recovered. Locally employed staff have had more than 65 percent of the cases, due in part, the official said, to factors like taking mass transit and living in multi-family households.

No American State Department employees have died from COVID overseas. In January, Secretary of State Antony Blinken said five American State Department officials in the U.S. and 42 locally employed staff overseas had died of COVID.

Domestically, there have been 1,124 cases within the State Department, the senior State Department official added.

MED has received two additional tranches of the Pfizer and Moderna vaccines over the past two months. The second batch went to Mexico City, which has seen the most locally employed people die of COVID, and a hub in West Africa serving 28 different posts. The mission in Ashgabat, Turkmenistan, where logistics are already “problematic,” according to the cable, also received a delivery, due to a “window of opportunity” for safe transport. Three U.S. passport offices also received vaccines.

The third tranche is expected to go sometime in march to southern and eastern Africa, employees in the D.C. area who have not yet received the vaccine, and additional staff in New York. By the end of that allotment, more than 36,000 direct-hire employees and their families, locally employed staff and contractors will have received the vaccine.

Those numbers exclude U.S.-based employees with the U.S. Agency for International Development, who have been advised to seek vaccines through state and local authorities. USAID, which has approximately 4,000 American employees, is an independent agency but operates abroad under the State Department’s “chief of mission” authority, meaning overseas USAID employees would be eligible for the vaccine if their post receives a batch.

It also means that USAID officials in Washington are treated differently from their colleagues down the street at State. “[MED] understands that it would make no sense whatsoever to say, ‘let me vaccinate the State Department people but not the AID people’” at a foreign mission, a USAID official said, speaking on the condition of anonymity.

The senior State Department official said MED vaccinated more than 100 stateside USAID employees before the presidential transition to ensure “continuity of government.”

Some host nations have also offered to vaccinate American diplomats. The U.S. has accepted offers of FDA-approved vaccines, including from the UAE and Slovakia.

Slovak ambassador to the U.S. Radovan Javorcik said the U.S. accepted Slovakia’s offer in late January. “They are part of our society,” Javorcik said, noting that Slovakia offered to vaccinate all foreign diplomats there. “We understand their very important work and we know how difficult it is to have these vaccinations brought from abroad.”

The senior State Department official said the next allotment should come in March, but that it was too soon to determine where it might get sent.

“I don’t know where we’re going to go yet because I haven’t looked at that data at that time or the next few weeks and months after that,” the official said.