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Senior officials working with the White House Coronavirus Task Force and Operation Warp Speed are pushing for states to start handing out some of their excess COVID-19 vaccine doses to anyone who wants them, according to four people familiar with the subject.
The plan is already in motion and federal officials are already talking to states about it. If passed any further, the change in distribution could upend months of debate and strategizing about who should get the vaccine first. But officials say this first-come, first-served approach may be one of the only ways to ensure millions of vaccine doses don’t expire on shelves. So far, 24 million doses have been allocated to states, with about 28 percent 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 happen. In mid-December, states began reporting a series of issues – delayed dose deliveries, immunization notification systems shutting down. And as the new year approached, the administration still hadn’t hit its target.
While administration officials, citing everything from slow production and quality control to allocation planning conflicts, admitted that there was a slight delay in sending the first batches to states. , they repeatedly told their local counterparts that distribution would soon be back on track. Internally, however, federal officials have in recent days started to worry that problems at every step of the supply chain could further slow the vaccination rate. A surprising number of healthcare and frontline workers have either not shown up for their vaccinations or are refusing to get them. (According to a Los Angeles Times report, a northern California hospital vaccinated less than half of its staff.) Refrigerators broke, wasting dozens of doses. And states have struggled to find enough people to administer the vaccines.
“If we have a sharp increase in cases and deaths after the December break and the vaccine distribution plan is not put back on track, we have big problems,” a senior official said. administration.
As part of discussions on how to quickly improve distribution, officials at task force meetings, interagency phone calls, and a Camp David summit on Tuesday suggested states should distribute the vaccine. – doses which may expire soon – to all who wish. inoculated. These people would receive the vaccine, even if they are not frontline health workers, essential workers, over the age of 75. There has been no formal decision to draft recommendations in this vein, officials said they were not against states pursuing this course of action and conveyed to some local officials that they should embrace the idea. Health and Human Services Secretary Alex Azar and other senior Operation Warp Speed officials met at Camp David on Tuesday to discuss the next two weeks of the immunization rollout and transition to the Biden administration.
“We need to make sure that the critically ill and the most vulnerable get this vaccine first,” a senior administration official said. “But after that, if there are any doses left in the refrigerators expiring, we have to take them out.”
“We need to make sure that the critically ill and the most vulnerable get this vaccine first. But after that, if there are doses that are just in refrigerators expiring, we have to get them out.“
– senior administrative official
Senior administration officials working on the vaccine distribution process are adamant that allowing vaccine doses to be rejected is not an option and that local authorities should allow their distribution to anyone who wishes. The question, officials said, is how states regulate this process and track who has been vaccinated, when they should receive their second doses, and whether the state has enough doses to ensure that each recipient receives both doses. .
There are signs that hospitals and pharmacies are already taking the first come, first served approach. On Monday, news broke that the Giant Pharmacy in Washington, DC had administered a vaccine to someone walking into the store because healthcare workers who were due for their injection did not show up. In Louisville, a couple received vaccinations at Walgreens on Christmas Eve after learning there were additional products available. And a California hospital gave hundreds of doses to prison and nursing home staff after its freezer malfunctioned.
“The release of the vaccine if it is not used… if it has been thawed… we absolutely have to get rid of this product,” said Juliette Kayyem, former deputy secretary of the Department of Homeland Security. “I think local ingenuity is really important. It must be well received. You want local agility with money from the federal government. “
It’s all part of a larger conversation within government health agencies and among members of the White House task force on why the vaccine rollout has been so bumpy. The vaccination effort was always going to be complicated – this is the largest campaign of its kind in American history, after all – there was some confusion on the part of the state from the start over the exact amount of the vaccine. Federal support they would receive in the administration process once Operation Warp Speed ships the vaccine.
For federal government officials working on Operation Warp Speed and overseeing the distribution campaign, no one seems to be able to decide why nationwide vaccination numbers are so low. Some officials said it was because states were not doing their job of getting people to sign up and show up for their immunization appointments. Others say that public education on the vaccination process and its effectiveness has been woefully insufficient.
In addition, each state experiences the distribution of vaccination differently. Some states experience long lines of individuals showing up for their photos. Other states seem to have difficulty getting vaccines out of the freezer into people’s arms.
Officials within the administration’s major health agencies, including the CDC and HHS, say one of the biggest problems is the lack of an accurate and reliable immunization reporting system. One official said some states require individuals to log into databases maintained by states and municipalities after their vaccination to report that they have received their vaccines and that not everyone does. Another official said 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 a rejection from the White House and other senior health officials, said a senior official.
A senior official told the Daily Beast that as part of the multi-hour meeting at Camp David on Tuesday, officials discussed the need for states to distribute the vaccine to people outside of the healthcare worker population. first-line if there are doses left. They also came up with a plan to work with states over the next two weeks to ensure vaccine shipments are sent to pharmacies instead of health departments or hospitals to make 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 expand distribution by February.
The most pressing question, said a senior administration official, is how the Trump administration and Biden’s new team are tackling vaccine reluctance. If people refuse to be vaccinated, especially frontline workers, it will take months longer to achieve widespread immunity through vaccination. To that end, individual members of the Trump administration’s White House Coronavirus Task Force have taken the initiative to speak with the media and virtually appear at private events to extol the vaccine’s effectiveness. .
HHS has also launched a campaign known as “Vaccinate with Confidence” to increase education on the issue. The aim of the campaign is to reinforce the safety of the vaccine – and the importance of slowing the spread – in part through promotional videos and advertisements. A December social media campaign titled “Prepare the Nation” reached users on Facebook, Instagram, Snapchat and Pinterest. As of last week, the campaign had 74 million impressions and 7 million video views, according to an HHS presentation obtained by The Daily Beast.
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