Residents of Minnesota have — at least theoretically — two general paths to receiving the COVID-19 vaccine. Qualified applicants can go to state-allocated vaccination providers, which include both public-health agencies and health care facilities, and those outlets have been able to maintain a fairly decent if not appreciably improving rate of vaccinations. Or, the same qualified applicants can sign up for appointments at participating pharmacies, an option that worked quite well … when it worked.

For the past three weeks, however, almost every participating pharmacy in Minnesota has not offered new appointments to anyone. How do I know this? I spend quite a bit of time checking all of the websites for participating pharmacies in the state for new appointments, out of both journalistic curiosity and naked self-interest. My wife received her initial dose of Moderna three weeks ago and will get her second dose in ten days, where Walgreens has reserved it for that purpose.

However, Walgreens’ web portal has offered no new appointments almost ever since she got her shot, and neither has Sam’s Club, Walmart, or Hy-Vee. A portal that tracks inventory and availability called Vaccine Finder shows a number of these stores with stock, but that appears to be pre-empted second doses, as none of the locations are accepting new appointment requests. ThriftyWhite, a small regional pharmacy operating mainly in rural Minnesota, Iowa, and the Dakotas, did apparently get an allocation of a few thousand doses a couple of weeks ago. They have run through almost all of them, and have only 245 openings left available. Those numbers have not gone upward in at least the last two weeks.

When I first wrote about this stall nine days ago, people insisted that it was an artifact of the big Midwestern storm that ravaged Texas most of all. However, as I pointed out at the time, our roads and airports remained open during that time, and a week or more had gone by and the pharmacies still apparently hadn’t received any allocations. Now we’re more than two weeks past that disruption and it looks like the pharmacies in Minnesota still haven’t received more vaccines.

Who’s responsible for those allocations? The Star Tribune mentions it in passing in a report about the state correcting the omission of Type 1 diabetes as a qualifying co-morbidity. Pharmacies get their allocations from the federal government, not the state:

State health officials also announced that 45,200 doses of the newly approved Johnson & Johnson vaccine are being shipped to Minnesota this week. The vaccine is considered easier to work with because it doesn’t need extreme cold storage and requires only one dose to be effective.

“Future allocations of Johnson & Johnson are uncertain for the next week or so, but we are optimistic about the long-term outlook,” state infectious disease director Kris Ehresmann said.

Allocation of COVID-19 doses to Walmart, Sam’s Club and Thrifty White pharmacies will be changed to better meet demand. Those vials are sent by the federal government and are not part of the state’s allocation.

The change comes after reports that pharmacies in northwest Minnesota had many unfilled appointments, while others were fully booked.

If the issue was just about being “fully booked,” these pharmacy chains would have simply expanded vaccinations into more of their locations. Most of these vaccinations are only taking place in a small number of stores. This looks very much like a supply issue, and it may be why Minnesota is only projecting to get to 70% vaccination among its seniors by the end of March when it started the month at 53%.

This leaves two questions. First, where are the federal allocations to Minnesota pharmacies? Those outlets have the infrastructure, the expertise, and the accessibility to conduct mass vaccinations on a scalable and expeditable platform. Second, why is the rest of the media so incurious about this stall? No one can blame it on the weather this week.

Update: ThriftyWhite has added 3600 new appointments to its website about an hour after this post went live. Some of those appear to be expected deliveries of the Johnson & Johnson vaccine. None of the other pharmacies have added any more appointments … yet. I’ll update this post as the day progresses.

Update: I spoke with a pharmacist at one of the other chains, and they acknowledged the lack of new doses over the last few weeks. They expect a big shipment next week of Pfizer vaccines, so we’ll see if that loosens things up.