President-elect Joe Biden’s ambitious proposal to rapidly accelerate COVID-19 vaccinations with new investments and a national strategy is a welcome change from the Trump administration’s more hands-off approach to vaccine distribution that led to a patchwork of state-level vaccine policies and priorities, public health experts and state officials said.
In Massachusetts, where the vaccine rollout has been at times slower than anticipated, Biden’s initiative could mean additional resources for the cash-strapped local public health departments charged with doling out vaccines to their communities. Additional support from the federal government could allow these agencies to hire more staff, open vaccination sites, and mount outreach and educational campaigns.
“Something like [Biden’s vaccine initiative] could really give them the chance to scale up, just as pharmacies, hospitals, and others are looking to scale up,” said Dr. Paul Biddinger, medical director for emergency preparedness at Mass General Brigham and chair of the state’s COVID-19 advisory group. “I think, given the scope of what we’re trying to do and the time frame, we really need every part of our vaccination administration system to be operating at maximal capacity.”
Many state leaders, including Governor Charlie Baker, also hope that the incoming Biden administration will communicate more effectively about the availability of vaccine doses, allowing them to get shots into arms promptly.
Biden has pledged to administer 100 million doses in his first 100 days of office, a lofty goal that would require speeding up the current pace of inoculations dramatically. Despite initial promises by the Trump administration to vaccinate 20 million people by the end of 2020, as of Friday, about 10.6 million Americans have received one or more shots, according to the Centers for Disease Control and Prevention, while roughly 31 million doses have been distributed.
Adding to the challenge for Biden, the Trump administration on Friday disclosed that the federal government has relatively few vaccines in reserve, dashing the hopes of some states that Operation Warp Speed, the program that oversees vaccine distribution, could increase their vaccine shipments.
Baker said Friday that Massachusetts had been hoping for more vaccines, but “no one at the federal level ever said to me to expect more, OK?”
In a prime-time address Thursday evening, Biden introduced his American Rescue Plan, a $1.9 trillion emergency legislative package to tackle the coronavirus pandemic and revive the economy. The plan calls for a $20 billion investment in a national vaccination program.
In a second speech Friday afternoon, Biden laid out the details of his vaccine distribution plan, which includes creating mass vaccination centers, deploying mobile vaccination clinics in underserved urban and rural areas, and reimbursing states for use of the National Guard to support these efforts.
Calling the vaccine rollout to date “a dismal failure,” Biden vowed to boost vaccine production and the supplies needed to make them using the Defense Production Act. He echoed the Trump administration’s appeal earlier this week to begin vaccinating more people 65 years and older, in addition to essential workers, like teachers, first responders, and grocery store workers. He reiterated an earlier pledge to release almost all available doses of the vaccines, rather than holding back roughly half of the stock, as the Trump administration has done, in order to guarantee that people get the second of the two-shot vaccines.
He also promised transparency to state and local officials and the public about the nation’s vaccine supply and administration’s decision-making.
Two vaccines have been granted emergency authorization for distribution. But, given the difficulties in the rollout so far, Biden and his advisers sought to tamp down expectations, even as the death toll continues to rise.
Biden said his plan “won’t mean that everyone in these groups will get vaccinated immediately, because supply is not where it needs to be.” But, he added, it will mean that as doses become available, “we’ll reach more people who need them.”
Dr. Howard Koh, a professor at Harvard’s T. H. Chan School of Public Health and former assistant health secretary at the US Department of Health and Human Services under President Barack Obama, said the Trump administration’s failure to coordinate a national strategy to the pandemic has overstretched state and local officials in every aspect of their response, from testing and tracing to getting enough personal protective equipment for health workers.
The Biden plan, Koh said, represents an important shift in addressing the COVID crisis.
“We’ve had not one plan, but 50 states going in 50 different directions, so simply articulating a united effort for the United State is major statement for how the new administration will lead in getting the country back on track,” Koh said.
“Each state does want autonomy and flexibility in normal times, but these are not normal times and states need the support and backing and reinforcements of federal efforts especially in the worst pandemic in the century,” he added. “I know that coordinating federal, state, and local efforts in any crisis is absolutely paramount. That just has not happened until now.”
Massachusetts has received approximately 539,000 doses and administered about 279,000 of them, as of the end of the day Thursday, according to the state’s COVID-19 Response Command Center. Nearly 33,000 people in the state, about half a percent of the population, have been fully vaccinated with the two-dose regimen. The vast majority of doses have been administered at hospitals, where front-line clinicians were given top priority.
Speaking to reporters Friday, Governor Baker said the state has been hamstrung by a lack of information from the federal government on upcoming vaccine shipments. He said he also has raised supply chain issues with the incoming Biden administration.
“One of the things that I and others have expressed to the incoming administration is they really need to find a way to create more clarity and visibility for us around what exactly is coming in the pipeline going forward, so that we can create capacity to actually execute on delivering shots in the arms,” Baker said.
“There’s not a lot of visibility into how far ahead you can look with respect to what you can expect to get [in terms of doses] from the vaccine program,” Baker added. “And that means we’re sort of working on a one-week window into what happens next.”
Also Friday, Biden tapped Dr. David Kessler, a former Food and Drug Administration commissioner, to helm his administration’s COVID-19 response, replacing Operation Warp Speed’s Dr. Moncef Slaoui. Kessler, a graduate of Amherst College and Harvard Medical School, led the FDA under Presidents George H. W. Bush and Bill Clinton.
Koh said he has worked with Kessler on tobacco regulations, and praised Kessler as an “experienced and highly respected public servant.”
“I respect him and I want to support him in any way I can,” Koh said. “I think we need his leadership right now.”
Material from The Washington Post was used in this report.