Reynolds’ ’90 percent’ vaccine claim: What does it really mean?

Gov. Kim Reynolds speaks at a news conference at Iowa PBS in Johnston, Iowa. (Screen shot from Iowa PBS livestream)

Earlier this week, Gov. Kim Reynolds told Iowans the state had administered 90% of the first-dose COVID-19 vaccines it had received — a claim that might seem at odds with data showing Iowa lagging far behind other states in getting vaccines into arms.

“As of yesterday, Iowa had administered nearly 269,000 first doses of the vaccine, approximately 90% of all first doses received,” Reynolds said at her Wednesday press conference.

The governor’s claim is entirely accurate, according to data from the federal Centers for Disease Control and Prevention, which shows that almost all states have delivered 80 to 95 percent of their first-dose vaccines.

The problem with that particular measure is that it’s a poor indicator of how well a state is performing in administering the vaccines it has in hand. The CDC points out that vaccine orders “do not specify if the vaccine is to be administered as a first dose or a second dose. Jurisdictions are instructed to use the delivered supply (first and second doses combined) to best meet the current needs of their community.”

This means that states can designate as “first doses” only those vaccines that that they’re poised to immediately deliver as a first dose. All the remaining stock can be considered a second dose. That means the percentage of so-called “first-dose vaccines” that are actually administered will be extraordinarily high in almost every state, creating a “Lake Woebegon effect” in which everyone is above average.

That’s why the Centers for Disease Control and Prevention and others typically look at two other measures to gauge a state’s performance. They look first at the entire pool of vaccines that have been delivered to a state and measure that against the number of vaccines the state has successfully administered. Then, separately, they look at the percentage of a state’s population that has received at least one dose of the vaccine.

As of Friday, Iowa had administered only 387,370 doses of the 579,200 doses it had received, according to the CDC. That means it has administered only 67% of the vaccine it has received.

With regard to the percent of Iowans who have been vaccinated, CDC data compiled by the New York Times shows that Iowa continues to rank among the states with the slowest rollout, with only 9% of the population having received at least one dose of the vaccine. Only seven other states reported a smaller percentage of their citizens having received at least one dose.

Iowa Department of Public Health spokeswoman Sarah Ekstrand said her agency knows “that other states are experiencing the same kind of discrepancies when comparing the various numbers published by the CDC. This is a common topic of conversation in state and regional calls. Some of the issues are due to timing and misunderstanding of definitions.”

The vaccine data isn’t the only instance in which COVID-19 information reported by the state has clashed with data reported by the CDC and others. For several months, the daily number of new infections and deaths in Iowa, as reported by the state’s Department of Public Health, has conflicted not only with what the CDC has reported, but with other elements of what IDPH itself has reported.

For example, the number of new infections IDPH has reported for individual days has, at times, been hundreds fewer than the department’s own calculation of that day’s growth in the cumulative number of infections. On any given day, IDPH might report 200 new infections, but the growth in the cumulative total of infections might be 400 or more from the previous day.

In June and July, the Iowa Capital Dispatch repeatedly asked IDPH for an explanation for the conflicting numbers. None was provided.

The department has also blocked access to pandemic information it once treated as public, and it has refused to share pandemic-related data other Iowa agencies treat as public.

For example, IDPH won’t disclose the total, statewide number of nursing home workers who have died of COVID-19 during the pandemic, nor will it identify the state-run care facilities where resident deaths have occurred.

The Iowa Department of Corrections, however, has publicly reported the names and workplaces of its employees who have died of COVID-19. And through its inspection process, the Iowa Department of Inspections and Appeals not only identifies specific nursing homes where deaths have occurred, it also provides a death count for the individually named homes.

In December of last year, the Iowa Capital Dispatch requested an updated list of all the Iowa nursing homes where COVID-19 outbreaks have occurred during the pandemic. The agency has yet to provide that list, which it once treated as a public record.

More recently, the Capital Dispatch asked IDPH for data showing the number of workers in privately run nursing homes who were accepting or refusing the vaccine. In response, Ekstrand, the agency spokeswoman, said that was “not something that IDPH is reporting.” When asked again for the information, she said on Jan. 28 that she would try to “pull something together.” The information has yet to be disclosed.