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By MICHAEL RUBINKAM 
 Pennsylvania is facing a temporary shortage of booster shots of the Moderna vaccine because providers inadvertently used them as first doses, setting back the state's already stumbling vaccine rollout.
 The error could mean more than 100,000 people will need appointments rescheduled, state health officials said Wednesday.
 About 30,000 to 60,000 appointments for the COVID-19 booster shot will need to be pushed back by one or two weeks, said Alison Beam, the state's acting health secretary. Delivery of another 30,000 to 55,000 initial doses of the Moderna vaccine will need to be delayed, as well, as officials scramble to get Pennsylvania back on track.
 The second-dose shortage does not affect the Pfizer vaccine.
 “People need to be able to know that they’re going to get their second-dose shots” in a timely fashion, even if their appointments need to be delayed, Beam said at a news conference.
 Second doses of the two-shot Pfizer and Moderna vaccines are typically administered 21 and 28 days apart, respectively, but the U.S. Centers for Disease Control and Prevention recently updated its to allow the second dose of the shots to be delayed up to six weeks past the initial dose.
 Pennsylvania has been holding second doses in reserve to ensure they will be available for residents who have gotten the initial shot, but Beam said a “structural issue” with vaccine deliveries emerged at the beginning of January and then festered for weeks.
 Inconsistent vaccine supply, confusion about deliveries and a lack of clear communication between the Health Department and vaccine providers created a “perfect storm,” Beam said.
 The Health Department said that while it’s still determining “root causes,” part of the problem stemmed from vaccine shipments that were not clearly labeled as first and second doses.
 State health officials had told providers they didn’t need to sit on vaccine because second doses had been accounted for in the state’s distribution calculation.
 “So, when providers heard department staff saying things like, ‘There is no need for vaccine providers to hold back any first doses,’ they may have felt pressure to use all of the vaccine they had on hand, when in reality, some of those doses where earmarked for second dose vaccinations,” said Health Department spokesperson Barry Ciccocioppo.
 This week, vaccine providers requested 200,000 second doses of the Moderna vaccine, which approximates the total amount Pennsylvania was allocated by the federal government for first and second doses.
 Beam refused to identify the providers that have been giving vaccine doses intended to be used as booster shots as first doses, declaring: “We're not here to have blamed placed anywhere.” She promised the underlying issues that led to the shortage would be resolved by early March.
 In a news release late Wednesday, Delaware County government officials said pharmacies were responsible for the mixup, but did not identify which ones.
 The booster shortage added to Pennsylvania's vaccine woes.
 Though 1.3 million residents have received at least one shot of a COVID-19 vaccine, the state ranks near the bottom nationally in how efficiently it is vaccinating its population. It is 46th among the states in the number of shots administered per 100,000 people, and 47th by percentage of allocated doses that have been given, according to the latest CDC data.
 Last week, Beam announced a plan to that are administering the vaccine so that more doses go to those that are quickly using their weekly allotments. Under her , hospitals, pharmacies and other providers must administer at least 80% of their allotment of first doses of the vaccines within a week of getting them.
 Sen. John Yudichak of Luzerne County, an independent who caucuses with the GOP, said Wednesday that the Health Department should step aside and yield to private sector logistics experts to come up with an effective vaccination plan. He also called on Democratic Gov. Tom Wolf to appoint a “logistics czar” to oversee distribution.
 “The most vulnerable citizens in this pandemic, those over the age of 65 and those with serious medical conditions, deserve better from Department of Health officials, who are not equipped to execute this monumental and important task,” he said in a statement.
 Health officials have acknowledged there's room for improvement but insist that lack of supply remains the biggest stumbling block to getting more than 4 million currently eligible residents vaccinated rapidly.
 The Montgomery County health department, outside Philadelphia, said it will have to reschedule Moderna booster shots for more than 5,000 people. Neighboring Delaware County canceled first-dose vaccination clinics and said that until supply increases, its vaccination sites would be limited to people receiving second doses.
 Lehigh Valley Health Network, one of Pennsylvania’s largest health systems, said about 1,500 vaccine appointments will need to be rescheduled because of the mixup.
 “Like the people of our community, we are frustrated that vaccine supply continues to be low, and we sympathize with those who were eager to get vaccinated but now have to wait a little longer,” said Brian Nester, Lehigh Valley’s president and chief executive officer.
 Pennsylvania was allocated more than 183,000 first doses this week, though some shipments have been delayed because of severe weather, forcing the cancelation of numerous clinics around the state. 
 Separately, the federal government is sending thousands of doses directly to Rite Aid and Topco stores in Pennsylvania. Philadelphia gets its own supply directly from the federal government.

Mistakes mean Pennsylvania faces shortage of Moderna shots