(CNN) States across the country say they're running low on coronavirus vaccine supply, with many officials insisting the vaccine delivery numbers reported by the Trump administration don't align with what they are seeing on the ground.
From New York to Tennessee to West Virginia, officials are clamoring for more doses of coronavirus vaccine. And officials in those states said that federal tallies suggesting they have thousands of doses sitting on the shelves don't accurately reflect the supply of vaccine on hand.
The confusion around vaccine supply -- and the gap between what officials said is happening locally and the numbers the Trump administration is reporting -- presents an immediate challenge for the incoming Biden administration.
A source close to the Biden transition team said there is enormous concern among the incoming administration about the accuracy of the numbers that have been released by the federal government. It was only within the last few days that the transition team was given access to Tiberius, the system that shows states how many doses are available to them and allows states to determine delivery locations.
Until then, the team was working solely off numbers they received from manufacturers, unable to cross check and confirm, the source told CNN on Tuesday.
All of this means the Biden team still isn't sure what it will be confronted with when President-elect Joe Biden takes office on Wednesday. Despite frustration, the source said Biden's team has been hesitant to broadcast just how they were left in the dark out of concern that the Trump administration would stop cooperating altogether.
"This is a very confusing time for understanding these numbers and as we talk more and more to the Biden administration, we're learning that they are trying to sort this out as well," Lori Tremmel Freeman, chief executive officer of the National Association of County and City Health Officials (NACCHO), told CNN on Tuesday. "With the change of administration happening at this very moment, they don't appear to totally know yet what vaccine numbers we're talking about and what is the reality."
Trump administration officials, meantime, said they have held hundreds of meetings with the incoming Biden coronavirus team.
"This is a concerted effort by the new team to down-talk where things are, so they could look like heroes when they come in and just carry forward the momentum that we have established," outgoing Health and Human Services Secretary Alex Azar said on Fox News on Monday.
The finger-pointing is of little use to states, which are clamoring for more vaccine and clearer numbers from the federal government about how much is truly available.
"Nobody knows where that number is coming from," Tennessee Department of Health Commissioner Dr. Lisa Piercey told CNN on Tuesday when asked why the federal government's tally of doses distributed in the state is 76,000 higher than the state's count.
"We don't count it on our dashboard until we have it in hand," Piercey said. "We don't want to, you know, get people's hopes up."
A senior administration official told CNN that the numbers from the US Centers for Disease Control and Prevention accurately reflect doses that are distributed or delivered. As of Tuesday afternoon, the CDC's website notes that the term "distributed" refers to the cumulative count of vaccine doses recorded as shipped in the CDC's Vaccine Tracking System.
Yet that has not been the experience in some states.
"The doses distributed means that they've given us a number, we have told them where it needs to go in the system to get sent out, but that does not mean that it's been shipped," said Kris Ehresmann, director of infectious disease epidemiology, prevention and control for the Minnesota Department of Health.
"The doses shipped, that means we've got a FedEx tracking number and it's left the facility," Ehresmann said. "The doses distributed are doses that have been promised to the state, that the state has accepted and given a location where those doses should be shipped. And the disconnect is that those doses haven't necessarily arrived in the state."
And governors in Minnesota, West Virginia and New York have all said in recent days that they are running low on vaccine.
Minnesota Gov. Tim Walz said Monday his state had "a very limited supply."
"The federal government has been giving mixed messages on vaccine availability and guidance, and we need them to step up and get more vaccine to the state," Walz said.
West Virginia Gov. Jim Justice echoed the need for more vaccine in a news conference Tuesday.
"We can't give you a vaccine shot, if we don't have the vaccines," Justice said. "Today, right now -- if they send us vaccines, we will put them in somebody's arm and as soon as we put them in somebody's arm it's going to be saving somebody's life."
There was always going to be a shortage of vaccine in the early months of distribution because production can't keep up with the national demand. But states have repeatedly expressed frustration that they can't get clear answers from the Trump administration about how much vaccine will become available and when.
Hopes of a surge in vaccine shipments fizzled last week after the Trump administration announced a new policy to release second vaccine doses that had been held in reserve, only to later admit that many of those doses had already been distributed.
"This is making our health departments nervous and anxious that those second dose quantities -- thought to be held in protected reserve -- may have actually disappeared somehow. We need rapid transparency and clarity on overall vaccine supply in order to pivot planning and messaging on the ground in communities," Freeman said. "We're just scratching our heads trying to figure out what the truth is."
By the CDC's count, more than 31 million doses of vaccine have been distributed and less than half -- roughly 12.3 million shots -- have been administered, as of Friday.
But states said there's no way half their doses are sitting on shelves or in freezers.
A number of factors could be contributing to the confusion. The CDC's distribution numbers reflect the doses that have been shipped, but that doesn't necessarily mean they have been received yet. The federal totals also include doses that have been earmarked for nursing home residents and those vaccinations have been recorded more slowly, according to health officials.
Some vaccines may have also been distributed to clinics or providers that are moving at a slower pace. In some cases, resource-depleted states have determined it's easier to keep those doses where they are rather than attempt the complicated process of transporting and redistributing them.
"It's not practical for states to consider trying to recall them or move them. It's better for states to support these providers in getting them into arms," said Claire Hannan, executive director for the Association of Immunization Managers.
Unwinding exactly what's mucking up the numbers -- and speeding up the supply of vaccine -- will ultimately be a problem that falls to the incoming Biden administration.
"For example, in Minnesota, we're moving vaccine through as quickly as we can and our numbers for vaccination are far different than what has been described as distributed," Michael Osterholm, a member of Biden's coronavirus advisory board, told CNN on Tuesday. "So that's one of the challenges -- that's where states have been frustrated because they've been getting caught in people perceiving there's a lot more vaccine available than there really is."