January 8, 2021

Biden plans to release all available Covid-19 vaccine doses—a big reversal from Trump admin's plan

Daily Briefing

    President-elect Joe Biden's administration will distribute every available Covid-19 vaccine dose the federal government has available once he takes office, according to a Biden spokesperson—an announcement that marks a reversal from the Trump administration, which is currently holding doses intended to serve as patients' second shot in the two-does vaccine regimen.

    The announcement comes amid calls from the American Hospital Association (AHA), state officials, and public health experts to speed up the country's Covid-19 vaccine rollout.

    Public health experts, state officials call on Trump admin to release reserved vaccine doses

    Both of the United States' two authorized Covid-19 vaccines call for patients to receive two doses of the inoculations, with the second dose occurring a few weeks after the first. So far, the Trump administration has released doses of the vaccines that are intended to serve as patients' first shot in the two-dose regimen. The federal government hasn't yet distributed doses intended to serve as patients' second shot.

    Some officials and public health experts have called on the Trump administration to distribute the reserved doses, noting a recent surge in new Covid-19 patients and deaths, as well as the threat of a new, more-infectious variant of the novel coronavirus that's circulating in the United States. For instance, a group of eight Democratic governors in a letter sent to HHS Secretary Alex Azar and Gen. Gustave Perna, COO of Operation Warp Speed, on Friday called on the federal government to release the reserved doses to provide their states with "more vaccines now."

    "The failure to distribute these doses to states who request them is unconscionable and unacceptable. We demand that the federal government begin distributing these reserved doses to states immediately," the group of Democratic governors wrote. They added, "Our states are ready to work around the clock to ramp up distribution, get more shots in arms, and save more American lives."

    California Gov. Gavin Newsom, Illinois Gov. J.B. Pritzker, Kansas Gov. Laura Kelly, Michigan Gov. Gretchen Whitmer, Minnesota Gov. Tim Walz, New York Gov. Andrew Cuomo, Washington Gov. Jay Inslee, and Wisconsin Gov. Tony Evers signed the letter.

    However, the Trump administration has made no indication it would release the reserved doses more quickly than planned. An HHS spokesperson said, "Operation Warp Speed is continuing to ensure second doses are available to vaccine administration sites, at appropriate intervals, as directed by jurisdiction leaders." The spokesperson added, "We would be delighted to learn that jurisdictions have actually administered many more doses than they are presently reporting," and "are encouraging jurisdictions to expand their priority groups as needed to ensure no vaccine is sitting on the shelf after having been delivered to the jurisdiction-directed locations."

    CDC data shows that, as of Thursday morning, the federal government had distributed about 21.4 million doses of Covid-19 vaccines, but just about 5.9 million Americans had received their first dose.

    Biden spokesperson says admin will distribute all available vaccine doses

    On Friday, TJ Ducklo, a spokesperson for Biden's transition team, said Biden's administration will reverse the Trump administration's current policy and instead distribute all of the federal government's available doses of the Covid-19 vaccines once he takes office.

    Biden "believes we must accelerate distribution of the vaccine while continuing to ensure the Americans who need it most get it as soon as possible. He supports releasing available doses immediately, and believes the government should stop holding back vaccine supply so we can get more shots in Americans' arms now," Ducklo said. He added that Biden "will share additional details next week on how his administration will begin releasing available doses when he assumes office on Jan. 20."

    According to CNN, releasing all of the available doses could help accelerate the United States' vaccination efforts, allowing more Americans to receive a first dose of a Covid-19 vaccine. However, the effort also could be "risky," because "vaccine manufacturing has not ramped up as rapidly as many experts had hoped," CNN reports. As such, it's not guaranteed that there will be enough vaccine doses available to provide patients with their second shots if the country's current allotment of doses is depleted from administering patients' first shots—and FDA officials recently emphasized the importance of administering two doses of the vaccines at the currently recommended intervals.

    Still, some public health experts praised Biden's announcement, saying it could help to curb America's worsening coronavirus epidemic. For example, Scott Gottlieb, who previously served as FDA commissioner under the Trump administration, in a tweet wrote, "This is a prudent move that will help expand [Covid-19] vaccine access to more high-risk patients at a time when the epidemic is worsening, and the vaccine can be an important backstop."

    AHA urges Azar to 'expedite' Covid-19 vaccinations with better coordination

    Separately, AHA in a letter sent Thursday urged Azar to take steps to "expedite" Covid-19 vaccinations in the United States, noting that "[i]n the first few weeks of administering vaccines, hospitals have seen a number of barriers to smooth and effective vaccinations."

    For example, states, cities, and other jurisdictions throughout the United States have developed their own vaccination plans, which has made it difficult for health systems serving more than one state to "manage vaccine distribution," AHA wrote, because "their patients live in jurisdictions with different rules about which patients are prioritized and that are at different priority levels."

    In addition, some hospitals throughout the United States have reported receiving fewer vaccine doses than they had requested, while other hospitals have reported receiving more vaccine doses than they could use—without an explanation for the discrepancy, AHA wrote.

    Further, hospitals have lacked clear guidance on "who is responsible for answering" their questions regarding the vaccine rollout. "Hospitals asked for guidance from their jurisdictions, and the jurisdictions may have developed their own unique answer or may have asked for guidance from federal agencies," AHA wrote. However, it remains "unclear" whether federal or state agencies should be responding to questions from hospitals concerning the vaccine rollout, according to AHA.

    "Hospitals are committed to being a central part of the vaccination effort, but hospitals alone cannot do it, especially as we care for burgeoning numbers of critically ill Covid-19 patients, and struggle to maintain sufficient staffing [and] work to have enough personal protective equipment and other resources," AHA wrote.

    To address the issues, AHA called on Azar "to establish a process within HHS … to  coordinate the national efforts among all of the states and jurisdictions and the many stakeholders; answer all … questions expeditiously; establish and maintain effective communication among all involved; and identify and resolve barriers to the rapid deployment of millions of doses of vaccines."

    During a press briefing on Wednesday, Azar said America's vaccine rollout appears to be progressing slower than expected because of reporting lags, the recent holidays, and other factors. However, he said the federal government is taking steps to accelerate vaccinations, including launching a partnership with pharmacies to provide Covid-19 vaccinations earlier than the government had planned.

    "This partnership allows states to allocate vaccines directly to these partners, and these partners can then administer vaccines to particular groups—like those over a certain age or in certain occupations—and eventually to the general public," Azar said. "The plan had been to ramp up this partnership over time ... but to help give states as many options as possible for vaccine administration, we're launching the program this week and states can choose particular partners to send vaccines to now. These partners can provide rapid access to vaccines in settings that may be more convenient and efficient than partners they've used so far, like hospitals" (AHA News, 1/7; King, FierceHealthcare, 1/7; AHA letter, 1/7; Wang, Inside Health Policy, 1/7 [subscription required]; Lim, Politico, 1/7; Frieden, MedPage Today, 1/7; Murray, CNN, 1/8; Gottlieb tweet, 1/8; Gay Stolberg, New York Times, 1/8; CDC data, updated 1/7).

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