But this also hands the new administration a big opportunity. Getting this right could help restore faith in the federal government’s ability to address massive problems at precisely the moment when Biden will be making a political case for large public programs on other fronts.
To get a sense of how the Biden team will approach this immense logistical undertaking, I talked to Jeff Zients, the President-elect’s choice for White House coordinator of the pandemic response.
Above all, the administration intends to attempt what Zients described as a “whole of government response” to getting the vaccine out, one that will deploy federal power in numerous areas to make it happen.
“Everything is on the table,” Zients told me. “We’ll use every lever we have."
How far the administration actually will go in this regard, and how successfully it will do so, of course remains to be seen.
As of this week, only 4.5 million people have received the first dose of the vaccine, out of 15 million doses distributed. That’s far short of the 20 million that were supposed to receive shots by the end of the year.
Various accounts have described all kinds of bottlenecks: The federal government has largely left it to states to distribute the vaccines it sends them, and states are pushing decisions down to local hospitals and health departments, creating snafus.
The federal government has not offered rules for distribution, only guidelines, and some hospital systems are dealing with contradictory and differing state rollout schedules. Delays in reporting could be lowering the numbers. And states have reported a lack in funding for distribution.
Even some Republicans have criticized the lack of an overarching federal blueprint, with Sen. Mitt Romney of Utah decrying it as “incomprehensible” and “inexcusable.”
According to Zients, the “whole of government” response will contain numerous components.
One is potentially ramping up the use of the Defense Production Act, which empowers the president to require private companies to fast-track contracts, to “accelerate supply impact,” Zients told me.
The DPA might be used to secure more of the vaccine itself, Zients said. Interestingly, he conceded this might be necessary because “"the current plan has the manufacturers Moderna and Pfizer ramping up across time, but it’s not going to be enough to vaccinate a majority of the U.S. population for months."
Zients also said Biden might use the DPA to ramp up availability of supporting equipment like materials and syringes. "We will use the DPA wherever necessary,” he said, adding that it might be used to ramp up production of equipment for testing, another area where the country has lagged.
Zients also allowed that a big problem the government will face is getting the vaccine to “hard-to-reach communities,” and said the new administration would potentially use mobile units, possibly including ones run by the federal government, to reach them.
“We’ll need many of them across the country,” Zients told me, including in “more rural areas.” He added that a ramped up effort to reach people via federal community health centers is also a possibility.
Zients also allowed that the funding in the relief bill that just passed Congress — $8 billion for vaccine distribution and $20 billion for purchasing vaccine to make it available for free to those who need it — is a mere “down payment,” and that they’d need “significantly more funding.”
Of course, this raises the prospect that Senate Republicans might resist the funding needed, potentially cramping the vaccine rollout, despite Biden’s suggestion that they will work with him.
Asked about this possibility, Zients said he was “optimistic” that Congress would supply the needed funding, given “bipartisan support for getting the country vaccinated.”
And he said Republican governors who favor more spending in their own states might be enlisted to help make a public case. He also noted that three coordinators inside the White House would be tasked with “overseeing supply chain management” on vaccinations and testing, coordinating across agencies of government.
Still other ideas, floated in The Post by Leana Wen, include developing vaccination target numbers to call on states to aim for and recruiting an army of vaccinators.
The Biden team said it was premature to say whether such ideas will be considered, and also declined to say whether the new administration would develop its own guidelines for prioritization of the vaccine to replace the ones offered by the Trump team.
Biden has vowed an FDR-style presidency. If there is one area where he can set an early marker down on just how unconstrained the administration will be in terms of realizing that ambition, it’s on the vaccine rollout.
Conversely, an overly constrained or unsuccessful response could result in quick public disillusionment, possibly creating political constraints on many other fronts as well.