Senior officials working with the White House coronavirus task force and Operation Warp Speed are pushing for states to start distributing part of their excess doses of the COVID-19 vaccine to anyone they want, according to four familiar people. with the subject.
The plan is already underway, with federal officials already talking to states about it. If enacted, the change in distribution could end months of debate and strategies about who should get the vaccine first. But officials argue that this order-of-arrival approach may be one of the only ways to ensure that millions of doses of vaccines do not expire on the shelf. So far, 24 million doses have been allocated to the states, with about 28% of those doses administered.
President Donald Trump said at one point that there would be 100 million doses prepared by the end of 2020. More recently, officials said they would have 20 million doses administered by then. This did not happened. In mid-December, states began reporting a series of problems – delays in delivering doses, shutting down vaccination notification systems. And as the year went on, the government had not yet reached its goal.
Although government officials, citing everything from slow production and quality control to scheduling conflicts, admitted that there was a slight delay in sending the first batches to the states, they repeatedly told their local counterparts that the distribution would soon be back on track. Internally, however, federal authorities in recent days have begun to worry about problems at every stage of the supply chain that could further decrease the rate of vaccination. A surprising number of health professionals and the front line did not show up for vaccines or refused to receive them. (According to a Los Angeles Times report, a hospital in Northern California vaccinated less than half of its employees.) Refrigerators broke down, spoiling dozens of doses. And states have struggled to find enough individuals to administer the vaccines.
“If we have a big increase in cases and deaths after the December holidays and we don’t have the vaccine distribution plan back on course, we will be in trouble,” said a senior government official.
As part of the talks on how to quickly improve delivery, officials at task force meetings, on inter-agency calls and at a Camp David summit on Tuesday suggested that states should distribute the vaccine – doses that may expire soon – for all individuals who wish to receive inoculated. These people would receive the vaccine, even if they were not frontline health professionals, essential workers, over 75 years of age. There was no formal decision to draw up recommendations in this regard. The authorities said they are not against states seeking this course of action and have informed some local officials that they should embrace the idea. Health and Human Services Secretary Alex Azar and other senior Operation Warp Speed officers met at Camp David on Tuesday to discuss the next two weeks of implementing the vaccination and the transition to the Biden administration.
“We need to make sure that the seriously ill and most vulnerable people get this vaccine first,” said a senior government official. “But after that, if there are doses that are stopped in the refrigerator, expiring, we have to put them outside.”
“We need to make sure that the seriously ill and most vulnerable people are getting this vaccine first. But after that, if there are doses that are stopped in the refrigerator, expiring, we have to put them outside.“
– senior management officer
Senior management officials working on the vaccine distribution process are adamant that allowing vaccine doses to be discarded is not an option and that local authorities should allow their distribution to anyone who wants to. The question, officials said, is how states regulate this process and control who was vaccinated, when they need to receive their second doses and whether the state has enough doses to ensure that each recipient receives both doses.
There are signs that individual hospitals and pharmacies are already taking the first-come, first-served approach. On Monday, the news was that Giant Pharmacy in Washington, DC gave an injection of vaccine to someone who passed by the store because the health professionals who were supposed to receive the injection did not show up. In Louisville, a couple received vaccinations at Walgreens on Christmas Eve after hearing that more were available. And a California hospital distributed hundreds of doses to jail workers and nursing homes after their freezer was defective.
“The release of the vaccine, if it is not used … if it is thawed … we must get rid of this thing entirely,” said Juliette Kayyem, former assistant secretary of the Department of Homeland Security. “I think that local creativity is very important. You should be welcome. You want agility at the local level with money from the feds. “
All of this is part of a broader conversation within government health agencies and among members of the White House task force about why the vaccine was so difficult to launch. The vaccination effort would always be complicated – it is the biggest campaign of its kind in American history, after all – there was some confusion on the part of the state from the start about exactly how much federal support they would receive in the administration process after Operation Warp Speed sent the vaccine.
For federal government officials working in Operation Speed of Warp, overseeing the distribution campaign, no one can decide why vaccination numbers across the country are so low. Some officials said it is because states are not doing their job to get people to register and attend vaccination appointments. Others say that public education about the vaccination process and its efficiency has been woefully inadequate.
In addition, each state is experiencing the distribution of vaccination differently. Some states are facing long lines of individuals showing up for their photos. Other states appear to be struggling to get vaccines from the freezer into people’s arms.
Officials at key government health agencies, including the CDC and HHS, say one of the biggest problems is the lack of an accurate and reliable vaccination reporting system. An official said that some states are asking individuals to sign state and municipal databases after vaccination to report that they received the vaccines and not everyone does. Another official said that 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 on data accumulation, aggregation and analysis, but there was resistance from the White House and other senior health officials, a senior official said.
A senior official told the Daily Beast that, as part of the hour-long meeting at Camp David on Tuesday, officials discussed the need for states to distribute the vaccine to individuals outside the frontline health care population if there are leftover doses. They also devised a plan to work with states over the next two weeks to ensure that vaccine shipments are sent to pharmacies instead of health departments or hospitals, as a way of making the distribution process easier and more manageable. Operation Warp Speed officials hope to use the partnership with more than 19 drugstore chains in 40,000 locations across the country to increase distribution by February.
The most pressing issue, said a senior administration official, is how the Trump administration and Biden’s new team deal with vaccine hesitation. If individuals refuse to receive the vaccine – especially frontline workers – it will take months more to achieve widespread immunity through vaccination. To this end, individual members of the Trump administration’s White House coronavirus task force have taken on the responsibility of speaking to the media and virtually attending private events to publicize the vaccine’s effectiveness.
HHS also launched a campaign known as “Vaccinate with Confidence” to increase education on the subject. The campaign’s goal is to strengthen the vaccine’s safety – and the importance of delaying its spread – in part through promotional videos and advertisements. A December social media campaign entitled “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 obtained by The Daily Beast.