Just how many doses of the Johnson & Johnson vaccine did Emergent Biosystems spoil in its confusion between that line and its AstraZeneca production? At the moment, it’s unclear, but the impact appears to be huge. The CDC has warned states to expect an 80% reduction in allocations of the single-shot COVID-19 vaccine next week, which will complicate plans to expand eligibility to all adults:

Deliveries of Johnson & Johnson’s Covid-19 vaccine doses throughout the U.S. are expected to plunge by more than 80% next week, according to state officials and federal data, as J&J grapples with manufacturing challenges.

The federal government has allocated just 700,000 doses of J&J’s vaccine to U.S. states, territories and certain cities and federal agencies next week, compared with 4.9 million doses that were allocated for this week, according to information posted online by the Centers for Disease Control and Prevention.

The expected sharp decrease will complicate states officials’ mass vaccination plans at a time when they are counting on a greater supply of doses to help immunize the growing number of people becoming eligible.

Eighty percent? Emergent reported that 15 million doses had been spoiled, but also that they had produced well over 100 million that hadn’t been impacted by the failure. Late last night, however, the Baltimore Sun reported that the scope of the failure was more significant, although they expected a much lower impact on allocations. The FDA has still not authorized Emergent’s production, it turns out:

Maryland health officials expect to see a drastic reduction in the state’s allocation of Johnson & Johnson’s COVID-19 vaccine next week — a shortfall that will lead to a 33% drop overall in the availability of first- or single-dose vaccines compared to this week, officials said. …

The site of the ruined doses, the Emergent BioSolutions plant near the Johns Hopkins Bayview Medical Center, does not yet have approval from the U.S. Food and Drug Administration to distribute its product, and officials have said all the Johnson & Johnson vaccine distributed in Maryland is made in Europe.

But an official with the U.S. Department of Health and Human Services told The Baltimore Sun Thursday that Johnson & Johnson expects to provide “a relatively low level of weekly dose delivery” until the East Baltimore plant gets federal authorization to distribute.

The 33% represents the overall impact on allocations of all vaccines, but that’s bad news in either scope. Every state had been prepared to expand eligibility for vaccinations to all adults over the next couple of weeks, with Hawaii being the final state to set its target date for this month. This drop in supply might not impact eligibility, but it will certainly impact access.

The good news is that J&J continues to produce its own supply in the Netherlands and thinks it can still meet its US targets by the summer deadline. It might even get to it by the end of next month:

A J&J spokesman declined to comment to the Journal about next week’s dip in supply, but said that 100 million does are still set to be delivered to the US for use by mid-year — possibly the bulk of it by late May.

That’s a shame, as our momentum on vaccinations has steadily increased. This chart from Our World in Data demonstrates our success thus far:

The dramatic drop in UK vaccinations is a result of the sudden questions being asked about the AstraZeneca vaccine, presumably. It’s not that they are saturating the population; this chart shows that the UK trails considerably behind the US in terms of total numbers of fully vaccinated residents, at 9% while the US is at 19%. Even so, our level of full vaccination is hardly a place where we’d want to see a plateau, especially one caused by the vaccine that can fully vaccinate in one dose.

The big question now is how long it will take the FDA to deal with Emergent Biosystems and validate the doses it has already produced. Given its track record thus far, it might be a while. Let’s hope J&J can accelerate production in the Netherlands in the meanwhile.