WASHINGTON – In a sharp break with the Trump administration, President-elect Joseph R. Biden Jr. intends to release nearly all available doses of the coronavirus vaccine soon after its inauguration, rather than withholding millions vials to ensure that the second doses are available.
The move is part of an aggressive effort to “ensure that Americans who need it most get it as quickly as possible,” Biden’s transition team said on Friday. The vaccination plan, which will be officially unveiled next week, will also include federally-run vaccination sites in places like high school gyms and sports stadiums, and mobile units to reach high-risk populations. .
The president-elect has vowed to bring “at least 100 million Covid vaccines to the arms of the American people” during his first 100 days in office.
The decision to release the vast majority of vaccine doses has sparked heated debate among public health experts. The two vaccines that have received emergency approval each require two doses, and the Trump administration has so far withheld about half of its supply to ensure that booster doses will be available for those already inoculated.
Officials of Operation Warp Speed, the Trump administration’s vaccination program, had noted that doses would stop being sequestered after the first few weeks of deployment. But the Biden administration’s announcement sets the clearest benchmark yet for front-loading plans and then distributes them as they become available. Warp Speed officials criticized the president-elect’s decision on Friday.
The Food and Drug Administration – whose advice Mr Biden has pledged to follow – has spoken strongly against changing the dosing schedule, as some other countries have chosen to do, calling such a move “premature and not firmly anchored in the available evidence. “Some public health experts fear the second doses will be delayed by the decision.
But others called it a smart move and said it was imperative to get as many people vaccinated as possible as quickly as possible – provided the second doses are not delayed. The Biden team said they are confident the supply will be sufficient and that Mr Biden will invoke the Defense Production Act if necessary to boost the supply of second doses.
“The president-elect believes we need to speed up vaccine distribution while continuing to ensure that Americans who need it most get it as quickly as possible,” said TJ Ducklo, spokesperson for the transition team. by Biden.
The announcement of Mr Biden’s intention to release additional doses coincided with a letter from eight Democratic governors – including Andrew M. Cuomo of New York and Gretchen Whitmer of Michigan, both of whom clashed with President Trump – imploring the current administration to release all available doses to States as soon as possible.
“Failure to distribute these doses to states that request them is unacceptable and unacceptable,” the governors wrote in the letter, which was obtained by The New York Times and sent to Health Secretary Alex M. Azar on Friday. II, and General Gustave F. Perna, responsible for the distribution of vaccines.
“We demand that the federal government immediately begin distributing these doses reserved for the states,” the letter said.
Mr Biden’s promise of 100 million gunshots is ambitious, and the Trump administration’s difficult deployment – which Mr Biden called a ‘parody’ on Friday – has not made its task any easier . As of Thursday, the Trump administration had shipped more than 21 million doses of the vaccine, with millions more already in the hands of the federal government.
Yet only 5.9 million people had received a dose. State and local public health officials, already overwhelmed by the rise in infections, are struggling to administer the vaccine to hospital workers and elderly Americans at risk, while most people are unsure when they might be. protected.
The presidential transition
The biggest problem so far has not been the lack of vaccines, but the difficulties states and local governments face in distributing the doses they have. Capacity and logistics, not shortages, prevent vaccine delivery.
Dr Leana S. Wen, an emergency physician and public health expert at the George Washington University School of Public Health, said she was surprised and concerned about Mr Biden’s new strategy.
“This is not the problem that we are trying to solve at the moment,” said Dr Wen.
Those responsible for Operation Warp Speed also played a critical role.
Speaking at a press briefing on Friday, Dr Stephen M. Hahn, commissioner of the FDA, urged states that have only used up a small portion of their supply to start vaccinating lower priority groups , while respecting government directives. Most states still prioritize frontline health care workers and older Americans in group residential settings.
Expanding the target groups “will go a long way in helping people use these vaccines appropriately and get them into the hands of people,” said Dr Hahn.
Biden’s advisers haven’t discussed the rest of their vaccine distribution review plan; they say more details will be released next week. Mr. Biden has always promised a much more muscular federal response than Mr. Trump’s leave-it-it-yourself approach, and he has laid out his vision in public appearances and interviews with local radio stations while campaigning earlier this week for Georgia. Democratic candidates for the Senate.
“Our plan will focus on gunshots, including launching a fundamentally new approach, establishing thousands of federally-run or federally-supported community vaccination centers of various sizes located in locations like high school gyms and NFL stadiums, ”Mr. Biden said in an interview with WFXE-FM in Columbus, Georgia.
“And,” he continued, “they can be led by federal staff, contractors, volunteers, including FEMA, you know, the emergency management group, the Centers for Disease Control, the US Army, National Guard.
A person familiar with Mr Biden’s vaccination plan said it would take time to establish mass vaccination sites. Mr Biden himself said on Friday that the vaccination effort would be the “greatest operational challenge we would ever face as a nation” – a challenge that would cost “billions of dollars”.
Joshua M. Sharfstein, a former senior FDA official who is now a professor at the Johns Hopkins School of Public Health, said mobile units would be especially important for reaching people in rural areas, as well as underserved populations, where transportation or lack of interest was a barrier to vaccination.
“We need to make the vaccine readily available to people who are excited to get it now, and we need to reach out to people who are at particular risk but still have questions or are unable to make it to sites. vaccination, ”he told me. “If we are just vaccinating the people who are excited to be vaccinated, we will be missing the people who really need to be vaccinated and who deserve special access.”
The dosage regimen, however, is a major complication. Booster injections for Moderna vaccine should be given four weeks after administration; for the vaccine manufactured by Pfizer-BioNTech, the interval is three weeks. World Health Organization officials on Friday issued recommendations that the interval between the administration of two doses of Pfizer vaccine could be doubled to six weeks. But the FDA has not approved such a change.
Mr Biden, who received the vaccine nearly three weeks ago, will receive his second dose on Monday, his spokesperson Jennifer Psaki told reporters on Friday.
With the virus raging across the country and more than 367,000 Americans already dead from Covid-19, some experts have expressed hope that the early deployment of the vaccine would help bring the pandemic under control.
But there is not yet enough data to know what effect the vaccine has on the transmission of the virus. And without knowing the vaccine’s effect on transmission, it’s impossible to predict whether vaccinating more people will reduce the number of cases.
The models describing the impact of front-loading first doses are intriguing, said Olivia Prosper, a mathematical modeler at the University of Tennessee.
But while “they raise a lot of food for thought and a few hypotheses to test,” it is still premature to use them to inform public policy, she said. The models also have their limitations, she noted, as most do not take into account the country’s multilevel immunization strategy, which prioritizes those with high exposure and high risk for the first vaccines.
Sheryl Gay Stolberg reported from Washington and Katherine J. Wu from New York.