On Thursday, Dr. Anthony Fauci, the country’s leading infectious disease specialist, made a prediction that was like music to the ears of millions of Americans who are not yet eligible for the COVID-19 vaccination.
“If you look at the projection, I imagine that when we get to April, that’s what I’d call it, to [lack] best writing, ‘hunting season’, ”Fauci told NBC’s“ Today ”program. “That is, almost anyone and everyone in any category can start getting vaccinated.”
April? Less than 50 days to go. The United States’ vaccination campaign began 60 days ago, on December 14. Since then, only 11.3 million Americans – mostly health workers, with a few sprinkled elderly people – have received both doses of the Pfizer or Moderna vaccine. Another 24 million Americans have had their first chance and are waiting for the second.
The news was filled with headlines about the collapse of nomination sites, elderly struggling and governors complaining about a shortage of supplies. In the meantime, we have just started vaccinating Americans aged 65 and over; most essential workers are not even eligible yet.
So, is Fauci offering false hope when he says that “anyone in any category” will be able to apply for vaccination starting in April? Or is your projection realistic?
The answer, if you really look at the numbers, is surprising – and encouraging. It turns out that April is not out of the question.
The first thing to consider is the current rate of vaccination, which is faster than you think. “If you compare now to what we were doing literally a month ago,” said Fauci on Thursday, “the climb has been really considerable.”
He’s right. On January 11, the United States administered an average of 632,000 doses per day. We are now an average of 1.6 million. This is not just a two and a half fold increase. It is also more, now, than the revised target of 1.5 million doses per day that President Biden set two weeks ago, after critics said his previous target of 1 million doses per day was too low.
The next thing to consider is where the supply is headed for. (Hint: it’s going up.) “As we enter March and April, the number of doses available will allow for a much broader approach to mass vaccination, which is actually much faster than what you’re seeing now,” said Fauci Thursday .
Initially, logistical bottlenecks were delaying vaccination; many states were administering less than half the doses they received. But now that some of these nodes have been unraveled, the national share of available administered doses has risen to 68%, with several states eliminating 80 or even 90%.
The offer, in contrast, is what prevents us today; at the moment, the doses administered are consistently exceeding the doses delivered for the first time since launch began. But, as Fauci said, that should change soon. Since Biden took office, the number of doses sent to the states has increased 28 percent to 11 million doses a week, according to COVID-19 White House coordinator Jeffrey Zients. As of Thursday, the administration will increase that number by another 5 percent, with 1 million doses going directly to 6,500 retail pharmacies and another 1 million going directly to 250 community health centers that serve hard-to-reach groups, such as homeless, migrant workers and public housing residents.
Production is also increasing. At first, Pfizer and Moderna promised to deliver 100 million doses each by the end of March. But Pfizer recently added 20 million doses to that promise – then announced that it could send all 200 million doses purchased by the U.S. before the end of May, or two months ahead of schedule, because vaccinators can squeeze six or even seven doses of bottles that should only contain five.
At the same time, Moderna is “asking US regulators to approve what it says is an extremely simple proposal to speed up Americans’ immunization against coronavirus: fill the empty space in their flasks with up to 50 percent more doses,” according to the New York Times. If the change is approved, which could happen this month, it would theoretically allow Moderna to send tens of millions of additional doses by the end of March and another 150 million by June.
To give you an idea, about 68 million doses were distributed in the last 60 days. In the next 50 days – that is, in April – the United States could receive 175 million more.
And that’s not counting the Johnson & Johnson single-dose vaccine, which the Food and Drug Administration is expected to approve this month, with 100 million doses to follow before July. Or the Novavax and Astra Zeneca vaccines, which may also be available in April. Or the fact that on Thursday, the Biden government announced that it had guaranteed other 200 million doses of Pfizer and Moderna to be delivered in “regular increments” by the end of July – bringing the grand total of just these two manufacturers to 600 million doses, or enough to fully vaccinate all adults in America (and more some).
Administering so many additional millions of doses will be a challenge, but Fauci looked confident on Thursday. “I imagine, and in fact, I am quite sure that as we enter and at the end of April, you will see … pharmacies, community vaccination centers, mobile units really accelerating the pace of vaccination,” he said. “Hopefully, when we arrive in early spring, we will see a much greater acceleration of dosage.”
It is important to note here that the US has already shown that it can administer three million flu vaccines per day – double the current daily average for COVID-19 vaccines.
But even if the rate of actual vaccination does not accelerate so much, we must still be on track for the “hunting season” in April. The numbers add up. There are approximately 54 million seniors in the United States, and the Centers for Disease Control and Prevention classifies about 30 million Americans as essential workers. In all, the combined number of people who are likely to be eligible for vaccination before the “hunting season” – a group that may also include non-elderly people with “high-risk medical conditions” – is about 182 million, according to the CDC.
But the problem is this: not all eligible Americans will actually get vaccinated – especially as more and more younger workers become eligible. Based on the latest screening survey by the Kaiser Family Foundation, most Americans say they do not want to be vaccinated as soon as possible, and 31% of essential non-medical workers say they plan to wait and see how the vaccine is working on others before roll up your sleeves. Among Americans aged 18 to 29 – and among blacks, who have long suffered from medical discrimination – that figure rises to 43 percent. It is 37% among Latinos.
According to a respected forecast, the current US trajectory suggests that at least 100 million Americans will have started vaccination by April 1 – more than enough to cover all the elderly, frontline workers and high-risk individuals who say they plan to be vaccinated as soon as they can. This is assuming that the rate of vaccination never exceeds 2 million doses per day.
The end result, as former FDA commissioner Scott Gottlieb recently explained, is that soon, “perhaps in April, the supply will begin to exceed demand” – and then “the challenge will not be how to ration a scarce resource, but how reach patients reluctant to be vaccinated. ”
At this point, it would not be a surprise if state and federal leaders decided that it was time to keep the ball rolling, opening vaccination “to just about anyone in any category”. This is especially true if, as Gottlieb predicts, the monthly vaccine supply reaches 100 million doses by the end of March.
Not that the vaccination itself is immediate for anyone, as Fauci noted on Thursday. “From then on,” he said, “it would probably take several months, just logistically, to put vaccines in people’s arms.” Hesitation, however, would continue to pose a challenge, especially if cases continue to decline, the elderly are protected from serious illness and the most reluctant Americans begin to ask themselves, “Why bother?”
Still, Fauci remains optimistic. “Hopefully, when we get in the middle and late summer,” he said on Thursday, “ [will] we have accomplished the goal we are talking about – that is, the vast majority of people in this country have been vaccinated. “
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