Monday, August 8, 2022

Vaccine rollout under Biden struggles to deliver on campaign pledge

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During the election campaign, Joe Biden vowed to “move heaven and earth” to improve the distribution of coronavirus vaccines in the United States, repeatedly criticizing his predecessor for failing to come up with a deployment plan.

But now that he’s president, Mr. Biden is not promising a significant increase in the immunization rate, leaving some wondering if the strategy its officials unveiled this month is radical enough.

“The Biden administration said they didn’t inherit any national distribution strategy, but if so, how did we come to 1 million vaccines per day, and why are we still targeting this? number?” asked Leana Wen, professor of public health at George Washington University. Ms Wen praised the administration’s new plan, but added, “We should aim for at least 2 million doses per day, if not 3 million.”

The United States was the first country in the world to allow two vaccines, but it has fallen behind in the international punch-to-gun race.

According to figures of the United States Centers for Disease Control and Prevention, the country administered 26.2 million doses, making it the fifth fastest around the world to immunize people per capita. The United States is ahead of all EU countries, where supplies have been limited, but behind Israel, the United Arab Emirates, the United Kingdom and Bahrain.

Mr Biden has pledged 100 million vaccines will be given in his first 100 days in office. But this level would be reached even at the rate realized during Donald Trump’s last days in power.

Some members of Mr Biden’s team have now warned that the public shouldn’t expect a drastic change in the vaccination rate anytime soon.

“We inherited 57 different distribution strategies, some working and some not, and that’s what we had to work with,” said a senior administration official, referring to the plans adopted by them. different states and territories.

The centerpiece of the Biden plan is better coordination between federal and state governments, largely after the Trump administration left to the states to decide how to get vaccines from distribution centers to local communities. CDC data shows that just over 50 percent of the vaccine doses that have been distributed to states have been administered, suggesting that the problem in some places has more to do with logistics than supply.

One important change introduced by the Biden administration is that the federal government will now guarantee a minimum level of supply to states and notify them of the amount to be expected three weeks in advance.

Cassie Sauer, CEO of the Washington State Hospital Association, said, “Our biggest challenge has been predicting what’s to come. Some weeks hospitals would receive 140,000 doses and others 80,000. Often, vaccination sites did not even know whether they were going to receive the Pfizer or Moderna vaccine. “

The Biden administration also pledged to use federal government resources by involving the National Guard in logistics, as well as helping set up mass vaccination sites and delivering doses directly to pharmacies, clinics and community centers.

However, there are no plans to use the National Guard to administer the fire. The federal government is also not going to take over the state distribution process, as some are asking Congress.

The Biden plan will continue to rely heavily on large drugstore chains such as CVS and Walgreens, which have been criticized for slow vaccinations at nursing homes, where they have been hired to lead the distribution effort. Nursing home staff said they struggled to make appointments for residents, while the Mississippi public health official described the companies’ performance as a “fiasco.”

Map of Covid-19 vaccinations by state

West Virginia, which vaccinated more doses per capita than any other state, said it did so by bypassing drugstore chains. “If we only accepted the federal program [with the pharmacy chains], we thought we would limit our ability to distribute and administer the vaccine to the population in need, ”said an official.

Another pillar of Biden’s strategy is to increase the vaccine supply by invoking the Korean War Era Defense Production Act, which allows the government to take over corporate supply chains and redirect supplies.

But officials said they couldn’t just force drug companies to make more vaccines. “People think we can use DPA to get into a factory and just take it back,” the senior administration official said. “But in fact, it’s a much more subtle tool than that.”

Instead, the Biden administration has invoked the law to ensure the federal government is first in line for “low dead volume” syringes, extract six doses of each Pfizer vaccine vial instead of five.

“You can’t ask Ford to make mRNA-LNP vaccines,” said Drew Weissman, professor of medicine at the University of Pennsylvania, referring to the technology used in the vaccines that have been approved. “It requires space and manufacturing capabilities and I suspect Moderna and Pfizer got everything that’s available.”

Finally, Mr Biden’s team reiterated the advice given in the closing days of the Trump administration that anyone over 65 should be eligible for a vaccination. While this triggered an increase in demand, it also raised concerns that the most vulnerable communities, including African American, could be missing.

Data from 17 states suggests black Americans contract and die from Covid-19 in disproportionate numbers, but receive fewer vaccinations. “We are really concerned that people in the suburbs are simply going to poorer areas to get vaccinated because their children are smart and they have cars to take them,” the senior official said. ‘administration.

Members of Mr Biden’s team have warned that the measures they have taken are aimed at restoring order to the distribution system rather than transforming it overnight. Experts said that while the new administration has yet to address all of the issues it faces, just having a federal strategy should make a difference.

Tom Frieden, a former CDC director, said: “We didn’t have a plan before, and now we do. A plan is better than no plan. “


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