The COVID vaccine has now been distributed for over a month since its initial rollout on December 14. The Trump administration had initially hoped to vaccinate 20 million Americans by the end of 2020, under Trump’s vaccination program Operation Warp Speed, but failed to meet this target. While some 28 million vaccine doses have been distributed to states thus far, only about 9 million have been administered to citizens. The slow rollout of the vaccine is worrisome to many health officials as COVID cases and deaths continue to climb, and more contagious COVID strain runs rampant in the states.
As the nation shifts to new leadership, Biden and his team are preparing to undertake the monumental vaccine distribution task, starting with a new strategy to speed up administration. The question remains as to whether the change in leadership will spur necessary improvements to distribution, and whether Biden’s team is capable of executing its plans quick enough to impact rollout.
Operation Warp Speed
Under Trump’s administration, Operation Warp Speed had some lofty initial goals. The program aimed to distribute and administer 40 million vaccine doses, enough for 20 million Americans to be protected, by December 2020. By the end of January, Trump’s team hoped to vaccinate 50 million people in total. Looking farther ahead, the goal was to have 80% of Americans, or 265 million people, protected by summer 2021. This would require a daily vaccination count of 3 million doses.
However, Operation Warp Speed has lacked in its efforts and failed to meet these targets. Federal leadership’s main goal was to distribute the vaccine to individual states. Yet, insufficient guidance has been given regarding rollout efforts. Instead, blame has been put on the state leadership for the slow rollout because states are expected to keep up with administration goals without a concrete plan in place. While some states have been more successful than others, the responsibility befallen on state health departments lacking resources and funding has hindered many states’ abilities to meet demand. Further, state leadership has been largely heading the pandemic response for many months. The strain from continuous lack of federal support has created a bottleneck for vaccine administration in many regions.
The vaccine under Biden
Biden and his team hope to speed up vaccine rollout by making critical changes to the distribution process. To improve vaccination rates, he plans to release doses that have been in reserve. Instead of holding back stock so that those who have been vaccinated once will receive their final dose, Biden’s team wants to release all available supplies to allow more citizens to receive the first dose. This would aid in his effort to administer 100 million shots in the first 100 days of his presidency. It is a potentially risky move since vaccines require two doses scheduled at certain intervals, and the vaccine rollout to date has been much slower than expected.
“This is going to be the greatest operational challenge we’ve ever faced as a nation,” Biden said, “but we’re going to get it done. But it’s going to take a vast new effort that’s not yet underway.”
However, there has been more backing to this strategy as of late. The Trump administration recently announced its plan to take the same approach, closely following Biden’s tactic. Over the next two weeks, reserved doses are set to be administered to frontline workers, people over 65, and those with underlying health conditions who are eligible for the vaccine. These changes were made during recent meetings on Operation Warp Speed, with health officials struggling to speed up the slow rollout.
The FDA also sees merit in this strategy. Currently, the US withholds about 50% of vaccine stock to save for second doses. According to researchers, by decreasing the reserve stock to 10% for three weeks and administering 6 million doses per week, the resulting increase in vaccinations could mean a 29% decline in COVID cases over the next two months.
Other emerging factors
Recently the FDA addressed other potential strategies to speed up rollout, including stretching the vaccine by cutting it in half or doing away with second doses.
“We have been following the discussions and news reports about reducing the number of doses, extending the length of time between doses, changing the dose (half-dose), or mixing and matching vaccines to immunize more people against COVID-19,” said FDA Commissioner Dr. Stephen Hahn and FDA Vaccine Division Head Dr. Peter Marks.
However, the FDA warns that making such drastic changes to timing and administration of doses could pose a significant health risk and impair vaccination efforts to date.
“At this time, suggesting changes to the FDA-authorized dosing or schedules of these vaccines is premature and not rooted solidly in the evidence,” says Dr. Hahn and Marks.
As the inauguration approaches, Biden and his team are still developing their goals to improve vaccine rollout. The team plans to release more information regarding its strategies in the coming weeks.