“These milestones are significant achievements, but we have a lot more to do,” said Biden on Thursday. “This is just the ground. We will not stop until we win this pandemic.”
The country still has a long way to go, but the vaccine’s launch looks much less chaotic.
As of Thursday, about 12.3% of people are fully vaccinated in the United States. It is a long way from herd immunity, in which a sufficient number of people were vaccinated or had the disease to have immunity, if herd immunity is possible.
“I think we should be careful when we marry this concept of collective immunity because we don’t really know exactly what this virus is in particular,” Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said an audience in the Senate on Thursday.
“We must be concerned with vaccinating as many people as possible as soon as possible,” Fauci said on Monday.
Launch of the ‘less messy’ vaccine
In January, before Biden took office, even the surgeon general, Dr. Jerome Adams, called the launch of his own administration’s vaccine “a little confusing.” Experts say it is definitely not that anymore, but the process still needs to be worked out.
“It’s better in many ways, but maybe we should call it ‘less messy’,” said Jennifer Kates, the senior vice president and director of global health and HIV policy at the Kaiser Family Foundation.
The supply is coming
An improvement was in the supply of vaccines, said Kates.
In December and early January it was unclear whether the country would have enough doses for everyone.
The Biden government invoked the Defense Production Act to help streamline the essential machines, equipment and supplies that vaccine companies need to produce more doses. He also brokered an agreement under which the pharmaceutical company Merck will help produce the Johnson & Johnson rival vaccine.
“The Biden government has taken a much more, I would say, aggressive approach to addressing the challenge of vaccine delivery as well, by buying more doses, basically ensuring that the United States now has the supply it needs,” said Kates.
States can also better predict how much supply they will get. There are new federal mass vaccination sites, a federal partnership with retail pharmacies and a partnership with community health centers – all the changes in the Trump administration’s approach that have largely left the distribution for the states to resolve.
“They played a much more direct and active role in actually delivering the vaccine and getting injections in the process, so this is a big change,” said Kates.
Now there are also three vaccines authorized. The most recent, made by Johnson & Johnson’s Janssen vaccine arm, requires only a single dose, meaning that more people can be vaccinated completely sooner. Supply has so far been limited, but the company said it will fulfill its contractual obligation to have 100 million doses by the end of May, with more on the way, with another factory about to enter the mix.
Lori Freeman, CEO of the National Association of City and County Health Officials (NACCHO), said supplies to states are expected to remain stable until the end of March, with a major increase in April.
“It will be interesting to see such a significant increase in the supply of vaccines. I worry a little if we will have systems to handle the additional quantity, ”said Freeman.
Vaccines are sought
Freeman says there is not enough workforce to manage this right now, but if public health agencies work with enough partners, it is possible and plans are underway.
Coordination between federal, state and local leaders is the next hurdle that needs to be overcome quickly.
“Without this coordination, if you are simply distributing the vaccine to all possible channels, we will not really understand how we are penetrating certain communities and vaccinating the country,” said Freeman.
She said they are working to find the distribution points that will make the biggest differences quickly, because there are still gaps, like elderly people who are not leaving home.
“There are still a lot of people to think about,” said Freeman. “It’s like the biggest Rubik’s Cube puzzle in the world.”
Taking it to the right people
“The people most affected are not getting the most vaccines,” said Dr. Carlos Del Rio, an infectious disease specialist at Emory University School of Medicine.
“We need to make sure that there is a better relationship between those who got the disease and those who got the vaccines,” said Del Rio.
Overcoming hesitation
To be effective, the country’s vaccination efforts will also have to convince those hesitant to get vaccinated.
Dr Marcella Nunez-Smith, leader of the Biden government’s Covid-19 equity task force, said on Sunday that the government plans to have a national education campaign linked to the expected increase in vaccine supplies.
The effort will involve “trusted messengers, influencers and others to reach everyone,” she told CBS Face the Nation on Sunday.
Republicans will need to be reached.
A March 11 CNN poll found that while 92% of Democrats say they have already received a vaccine or will try to get it, that drops to 50% among Republicans.
Freeman says public health agencies are thinking about how to reach the hesitant. She said that this also has to come from the neighborhood level.
“We need to turn quickly to get the right trusted messengers in each neighborhood to help people on an equal footing to turn the corner on this,” Freeman said.
‘Eligible’ does not mean vaccinated
Freeman said that leaders also need to manage expectations.
“He said that every American would be ‘eligible’ and I thought what does it really mean? What it means is that when you, me, or any of our friends and loved ones, when we are thinking about registering for the vaccine, what that means is that we’ll all be eligible to put ourselves on a waiting list, ”said Freeman.
With even more demand than supply, leaders need to be transparent and tell people that it is still a little difficult to predict when they will actually receive the vaccine.
While all American adults are eligible for vaccination by May 1, the White House will not have enough supplies to meet the government’s goal of having enough vaccine for all 300 million American adults by the end of May.
Reasons for optimism
Del Rio said that while vaccination efforts at the moment are not perfect, he is “quite surprised” that the United States is as far ahead as it is. He sees hope in that.
“The United States does not have an adult vaccination program. We never vaccinated like that. It is totally new and the states were trying to do it without resources and needing to compensate as they went along, ”said Del Rio.
If you think about it, he said, about a quarter of the world’s doses have been administered in the United States.
“It could be better, for sure, but the United States and the states are doing much better than we expected.” And perhaps it is a good sign of what is to come.