Many U.S. states and cities have a growing surplus of Covid-19 vaccines, a sign that in some places demand is slowing before a large percentage of the population has been inoculated, according to an analysis by Bloomberg News.

The data indicate as many as one in three doses are unused in some states. Appointments for shots often go untaken, with few people signing up.

Bloomberg analyzed state and U.S. data from Monday, providing a snapshot of vaccine use before Johnson & Johnson shelved millions of shots pending federal health officials’ investigation into rare cases of blood clots. That pause will likely cause the number of unused shots to fluctuate, but will little change the comparisons of states.

Overall, demand remains strong. In the U.S., 37% of people have gotten at least one dose, and the country is one of the world leaders in vaccinations. But even some states that are doing well are struggling with stubborn pockets where uptake is low.

In Virginia, for instance, 83% of vaccines supplied to the state have been used — but the number of people getting shots differs sharply from city to city. That difference is especially stark in Charlottesville and Lynchburg, separated by a mere hour’s drive on U.S. 29 past vineyards and open farmland.

“Virginia is sort of a microcosm of the country,” said Costi Sifri, director of epidemiology at UVA Health in Charlottesville. “We’re going to have this same type of challenge played out in every state in the country. How do we close the vaccine gaps that are going to occur geographically?”

In Charlottesville, a mostly Democratic area that is home to the University of Virginia, vaccine appointments are tough to snag even with two mass clinics right in town. In Lynchburg, 70 miles south and dominated by conservative Liberty University, open appointments at an old TJ Maxx are easy to find. The disparity has led to in-state vaccine tourism where residents in northern Virginia flock south to snap up shots that would otherwise go unused. The wide availability of vaccines also signals that areas like Lynchburg may be running out of residents willing to get vaccinated.

The Bloomberg Vaccine Tracker shows the percentage of delivered doses that have been used in a state, based on Centers for Disease Control and Prevention data. In late February, with demand for vaccines high, only 19% of doses in the U.S. were unused, a sign that almost every dose delivered was being quickly injected into somebody’s arm. Bloomberg calculated rates of unused doses for this analysis using one-week averages, which are less volatile than day-over-day numbers.

Doses Begin to Pile Up
Now there are warning signs that vaccines are going unused. That’s a concern for epidemiologists who maintain that at least 75% of the nation’s population must be protected before the virus can be truly contained.

Federal officials are in the early stages of rethinking distribution. Vaccines have so far been doled out based on population.

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