Tuesday’s Operation Warp Speed news conference began with Health and Human Services Secretary Alex Azar acknowledging that vaccine administration has not proceeded with the necessary speed and urgency — a remarkable admission for an administration that has long refused to recognize its botched leadership on the coronavirus pandemic. More than four weeks after vaccine shipments began, some 10 million inoculations have been given from 29 million doses shipped. Despite months to develop and implement a plan for faster distribution, inoculations lag far below the projections of 20 million Americans vaccinated by the end of 2020 — and come nowhere close to distributing 100 million doses as President Trump promised in September.
Even worse than the slow rollout are the reports of vaccine doses being thrown out. Some hospitals and pharmacies have had to discard unused vaccine after people didn’t show up for appointments or when health-care workers and nursing-home residents chose not to be vaccinated. Because of strict guidelines prohibiting distribution beyond these prioritized groups, doses couldn’t be reallocated before they expired. Meanwhile, people desperate to receive the vaccine have lined up overnight in some places, only to be turned away.
The newly expanded vaccine eligibility is broad: anyone 65 and older, and all adults with high-risk medical conditions. This guidance overrides the tiers that were painstakingly decided by a Centers for Disease Control and Prevention advisory committee. On paper, the CDC tiers made sense; they used public health principles to define the workers considered most essential or groups most vulnerable to the coronavirus. But in practice, it has not worked to adhere to a rigid protocol of waiting for one vulnerable group to be vaccinated before opening eligibility to other at-risk groups.
To be sure, logistical problems loom with making more than 100 million people eligible for vaccines when neither the supply nor the infrastructure exists to deliver the shots. States could be overwhelmed as they adjust to the new guidance. People could become frustrated when they cannot immediately get vaccinated. These scenarios, though, are better than wasting any doses of vaccine when every dose represents a potential life saved.
Azar’s second change — expanding distribution sites — will substantially speed up vaccination rates. I’ve argued before that we need to expand access points to wherever it is that people are. Many patients prefer to receive vaccines through their regular doctor or pharmacy, so it helps that Operation Warp Speed plans to increase distribution through community health centers and local pharmacies. Already, Los Angeles, New York, Houston and other cities are converting stadiums into mass vaccination sites where thousands of people can be inoculated every day. I’m thrilled that the federal government agrees with the need for such mass vaccination locations and supports standing up these sites.
Azar also stated that all available doses of the coronavirus vaccine will be released. This parallels plans that President-elect Joe Biden’s team announced last week. Unlike the Biden statement, which has not provided such a clear assurance, Azar was unequivocal that all first doses of the vaccine would be followed by timely administration of second doses. This is how clinical trials for the authorized vaccines were done, and adhering to the clearly defined protocol is critical to maintaining public trust.
The part of the Trump administration’s new strategy I like most is the plan to recalculate how many doses each state receives based on how quickly the states are administering the supply they have. States that have been efficiently distributing doses are showing that they can deliver vaccines with the urgency required. Reward them by sending more doses their way. To prevent exacerbating inequities, states that are laggards should be given federal assistance to improve their infrastructure. But in the meantime, vaccines shouldn’t be given to these states only to sit in storage. This allocation plan also incentivizes states to report inoculations in real time or close to it.
After months of bungled coronavirus responses, the Trump administration has unveiled some much-needed course corrections. Of course, state and local health departments should have been given the resources they requested long ago, and because that didn’t happen, the overall vaccination effort is months behind where it could and should be. Still, these plans deserve praise as a step in the right direction: They’re helping to set up America’s vaccination program — and the incoming Biden administration — for success against the pandemic.