According to four people familiar with the matter, senior officials working with the White House coronavirus task force and Operation Warp Speed are urging states to dispense some of their excess COVID-19 vaccine doses. who wants it.
The plan is already underway, and federal officials are already talking to states about it. If pushed further, the shift in distribution could end months of debate and strategies about who should get the vaccine first. But officials argue that this first-come, first-served approach is one of the few ways to make sure millions of vaccine doses don’t go off the shelf. To date, 24 million doses have been assigned to states, of which about 28 percent of those doses have been administered.
President Donald Trump once said that 100 million doses would have been prepared by the end of 2020. More recently, officials said they would have administered 20 million doses by then. That did not happen. In mid-December, states began reporting a series of problems: dosing was delayed, and vaccination reporting systems were shut down. And as the New Year approached, the administration still hadn’t hit its mark.
While government officials, citing everything from slowness of production and quality control to allocation scheduling conflicts, have admitted there was a slight delay in getting the first batches to the states, they have repeatedly told their local counterparts that distribution will soon be back on track. would be on the right track. Internally, however, federal officials have become concerned in recent days that there are issues at every step in the supply chain that could further slow vaccination coverage. A surprising number of health and frontline workers do not show up or refuse to receive their vaccinations. (According to an Los Angeles Times reporta hospital in Northern California has vaccinated less than half of its staff.) Refrigerators have broken, spoiling dozens of doses. And states are struggling to find enough individuals to administer the vaccines.
“If the number of cases and deaths rises sharply after the December holidays and the vaccine distribution plan is not on track, we will be in big trouble,” said a senior official.
As part of the talks about how to rapidly improve distribution, officials in working group meetings, in inter-institutional phone calls and at a Camp David summit Tuesday suggested that states should distribute the vaccine – doses that are about to expire – to all individuals who want it. to get. vaccinated. These people would get the vaccine, even if they are not primary care health workers, essential workers, over 75 years old. No formal decision has been taken to make recommendations in this vein, officials said they are not against states following this course of action and have communicated to some local officials that they should embrace the idea. Alex Azar, Secretary of Health and Human Services, and other top Operation Warp Speed officials gathered at Camp David on Tuesday to discuss the next two weeks of the vaccine rollout and transition to the Biden administration.
“We must ensure that the critically ill and most vulnerable people get this vaccine first,” said a senior official. “But after that, if there are doses that just sit in the fridge and expire, we have to get them out of there.”
“We must make sure that the critically ill and most vulnerable people get this vaccine first. But after that, if there are doses that just sit in the fridge and expire, we have to get them out of there.“
– senior administrative officer
Senior officials working on the vaccine distribution process are convinced that the disposal of vaccine doses is not an option and that local officials should allow their distribution to anyone who wants them. The question, officials said, is how states regulate that process and keep track of who has been vaccinated, when to get their second dose, and whether the state has enough doses to ensure that each recipient gets both doses.
There are signs that individual hospitals and pharmacies are already taking a first-come, first-served approach. News broke Monday that the giant Washington, DC pharmacy had given a vaccination to someone walking through the store because the health workers who would be getting their injection failed to show up. In Louisville, a couple got vaccination shots at Walgreens on Christmas Eve after learning extra was available. And a California hospital gave away hundreds of doses to prison and nursing home personnel after the freezer malfunctioned.
“Releasing the vaccine if it is not going to be unused … if it is thawed … we absolutely have to get rid of this stuff,” said Juliette Kayyem, a former assistant secretary in the Department of Homeland Security. “I think local ingenuity is very important. It is to be welcomed. You want agility at a local level with money from the FBI. “
It’s all part of a wider conversation within the administration’s health agencies and among members of the White House task force about why vaccine rollouts have been so bumpy. The vaccination effort was always going to be complicated – it is, after all, the largest such campaign in US history – there was some confusion on the part of the state from the start as to exactly how much federal support they would receive in the delivery process once Operation Warp Speed Sent the vaccine.
For federal government officials working on Operation Warp Speed overseeing the distribution campaign, no one seems to be able to decide why vaccination rates across the country are so low. Some officials said it’s because states aren’t doing their job to get people to sign up and show up for their vaccination appointments. Others say public education about the vaccination process and its efficiency is woefully inadequate.
In addition, each state experiences vaccination distribution differently. Some states experience long lines of individuals showing up for their photos. Other states seem to be struggling to get the vaccines out of the freezer into people’s arms.
Officials within the administration’s major health agencies, including the CDC and HHS, say one of the biggest issues is the lack of an accurate and reliable vaccination reporting system. An official said some states require individuals to register with state and municipal databases after their vaccination to report that they received their shot and that not everyone does. Another official said there is no centralized reporting system that states can use to report their numbers to the CDC. Officials within the CDC wanted to work more intensively to collect, collate and analyze the data, but the White House and other senior health officials have pushed back, a senior official said.
A senior official told The Daily Beast that as part of Tuesday’s hour-long Camp David rally, officials discussed the need for states to dispense the vaccine to individuals outside the primary care health worker population if there are any leftover doses. They also drew up a plan to work with states over the next two weeks to ensure that vaccine shipments are sent to pharmacies rather than health departments or hospitals to make the distribution process easier and more manageable. Operation Warp Speed officials hope to use the partnership with more than 19 pharmacy chains in 40,000 locations across the country to scale distribution by February.
The more pressing question, said a senior government official, is how the Trump administration and incoming Biden team are addressing hesitation about vaccines. If individuals refuse to receive the vaccine – especially front-line workers – it will take months longer to achieve broad immunity through vaccination. To this end, individual members of the Trump administration’s White House coronavirus task force have taken it upon themselves to speak to the media and appear virtually at private events to promote the vaccine’s efficacy.
HHS has also launched a campaign known as “Vaccinate with Confidence” to increase awareness on this topic. The aim of the campaign is to enhance the safety of the vaccine – and the importance of slowing its spread – including through promotional videos and advertisements. A December social media campaign titled “Prepare the Nation” reached users on Facebook, Instagram, Snapchat and Pinterest. Last week, the campaign had 74 million impressions and 7 million video views, according to an HHS presentation by The Daily Beast.