New Jersey will re-establish some of the large regional vaccination infrastructure closed earlier this year to accommodate an expected rise in demand for COVID-19 shots once booster doses receive federal approval and more government immunization mandates take effect.

But Gov. Phil Murphy warned Monday that no matter how the program rolls out, demand could exceed system capacity from the first.

The state is working to reopen one of its six original vaccination mega-sites within the next week, state health commissioner Judy Persichilli said at the administration’s twice-weekly pandemic briefing. Two other mega-sites will be re-launched after that so that north, central and south Jersey each has its own operation, she said, and some county, local and privately run sites will also continue to offer shots.

The booster burden

The push to reopen these sites — which were scaled back starting in May as demand for vaccinations dipped — comes as state officials await a decision from the federal Food and Drug Administration on how booster shots should be prioritized nationwide. In mid-August the U.S. Department of Health and Human Services called for vaccinated adults to get a booster, noting that immunity from the first series has been shown to wane after six months or so. The department set a date of Sept. 20 to launch the booster program, which must first have FDA approval; additional shots have been available to individuals with serious immune deficiencies since August.

“This is a work in progress,” Murphy said of the plan to reopen some of the state’s six original mega-sites, which depends in part on the FDA’s decision. “But I promise you, we will be ready. And I would also promise you this, we will overbuild, rather than underbuild.”

But no matter what the FDA decides — or how prepared New Jersey is — Murphy said public interest in the shots may outpace the state’s ability to supply them at first. “Out of the chute, no matter what the eligibility is, there will be, at least initially, supply and demand imbalance,” he said. “We’d like certainty (from the FDA) sooner than later, as you can imagine.”

New Jersey was among the states that struggled for weeks with that sort of imbalance earlier this year, when COVID-19 vaccines were first available to the public. The rollout was slowed by shipping delays, staffing limitations and reporting problems, plus technical problems with the online registration and scheduling system, which was quickly overwhelmed by demand.

More than 5.7 million New Jerseyans are now fully vaccinated, according to state data, and some 65,000 immuno-compromised residents have received boosters. But demand for the shots peaked in early April and declined steadily until July, when fewer than 20,000 doses were administered daily throughout the month. The pace of immunizations picked up slightly in August, reaching 25,000 daily shots during a few days, but has declined again in September.

Federal mandates could drive jabs

Government vaccine mandates set to soon take effect could also impact demand for immunizations. New Jersey required employees of health care, elder care, correctional facilities and other communal settings to be fully vaccinated by Sept. 7 or face weekly testing, Persichilli noted, and more than 77% have now opted for the shots.

Workers at state agencies and authorities, colleges and universities and school districts serving pre-school through high school have until Oct. 18 to be immunized or get tested regularly, Persichilli added. Murphy said Monday that child care workers may soon be added to the state’s vaccination mandate list.

“New Jersey has taken action to boost COVID-19 vaccination in our state,” Persichilli said Monday. “In addition to our efforts to make it as easy as possible to get vaccinated and sharing the benefits of vaccination, the state has also established mandates for some groups to help reduce the risk of COVID-19 transmission in our communities.

Recent orders from President Joe Biden could also push up vaccine demand in New Jersey. On Thursday Biden announced that all federal workers would be required to get COVID-19 shots — with no testing option available — and the administration is now drafting safety regulations that would force companies with at least 100 employees to mandate immunizations or face fines. Companies must also provide workers paid time off to get the vaccinations.

Biden’s private-sector mandate impacts some 4,646 businesses in New Jersey, according to state officials, which employ nearly 1.4 million workers. Murphy said Monday the state is waiting for federal guidance on how this mandate would work. He said he spoke with one CEO who runs a company with several large campus-style facilities, plus offices with only a few people. “So when you’re talking about the private sector, when you’re talking about 100-person minimum, the implication is you’re all in the same location,” he said. “Will there be any flexibility?”

State government may not have a specific role in implementing Biden’s vaccination mandates, Murphy said, “but we want to make sure we have the capacity to vaccinate, test and care for individuals.”

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