Enlarge /. Alex Azar, Secretary for Health and Human Services on December 14, 2020 in Washington, DC.
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The Trump administration's Operation Warp Speed is shifting gear on COVID-19 vaccine distribution to expedite the country's sputtering rollout – and using plans similar to what the team of President-Elect Joe Biden last saw Week announced.
Warp Speed officials said in a news conference Tuesday that they will now increase the number of cans available to states and jurisdictions and the current strategy of withholding half of the available cans for use in the second round of the Reserve vaccinations with two doses. Members of the Biden transition team announced a similar plan last week, saying the president-elect "supports the immediate release of available doses and believes the government should stop withholding vaccine supplies so we can get more shots in the arms now." Americans can get. "
When asked if Warp Speed officials had discussed the plan with Biden's team – which will take over next week – Health and Human Services Secretary Alex Azar said it did not. "We at Operation Warp Speed Board made the decision," said Azar. He also repeatedly stressed that changing the Board's plans is always part of the intentions of its members.
"While we will certainly notify the Biden team of these changes, as you know we are working with one government at a time," Azar told reporters.
In addition to releasing more doses of vaccine, Azar also said he and his colleagues will urge states to expand the groups that are eligible to receive vaccines. In particular, they will now urge states to open up vaccination to anyone over 65 and anyone under 65 who has a documented underlying disease that makes them more susceptible to COVID-19.
This is a significant shift in recommendations to states overriding nuanced prioritization schemes established by expert bodies on public health, including the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention. The change is also likely to generate criticism given the size of these groups and the breakdown of the prioritization. But Secretary Azar seemed to justify the postponement by citing the slow rollout so far – which he totally blamed states for.
Nearly 28 million COVID-19 vaccine doses have been distributed to states and jurisdictions, according to CDC data, but only 9.3 million people reportedly received their first dose.
"In some states, persistent micromanagement of this process has resulted in vaccines reaching larger sections of the population at risk faster," said Azar. At another point, he said some governors had "overreacted" to prioritization recommendations.
Azar went on to say that it was never the federal government's intention for states to halt vaccination of certain vulnerable individuals until all members of higher priority groups have been vaccinated. Many federal officials – including CDC Director Robert Redfield, who also spoke at today's briefing – have repeated this point, advising state officials to vaccinate as many people as possible, even if it means giving up prioritization in order to get every vaccine dose in the refrigerator consume.
As Redfield pointed out on several occasions today, the slow adoption of vaccines may not be as sluggish as it seems. Some of the vaccination counts reported to the CDC can experience significant delays in reporting. Historically, healthcare providers have had 30 days to report vaccination numbers to the CDC – not the current 72-hour reporting time. Additionally, interoperability issues have prevented some vendors from reporting in a timely manner.
"I think a lot of this is being reported," Redfield said of the slow progress in vaccination. However, the CDC is now doing a "deep dive" to really understand the issues in each jurisdiction.
More locations, fewer cans?
To overcome these unknown obstacles to vaccination, Azar said Warp Speed will also urge states to set up new vaccination sites, such as pharmacies, community health centers and mass vaccination sites.
Most recently, Azar said they would change the distribution of the doses to individual states. Currently, each state has access to an allocation of vaccines based on the state's population. Going forward, state grants will be "based on the state-reported pace of administration and the size of 65-year-olds and above in each state," Azar said.
The plan of basing allocations on the size of each state's population at risk actually fits in with Operation Warp Speed's original plan. However, these plans were changed at the last minute to "keep things simple".
Further adjusting the allocations based on the efficiency of group vaccination adds an additional, less straightforward level to calculating the allocations. But Azar defended penal states for slow rollouts.
"If you are not using a vaccine that you have the right to get, we should adjust to states using that vaccine. It is common sense," Azar said. "We want to notify you," he added, referring to the earlier ones discussed reporting. "So get your data in order."
According to Azar, the government will announce the states two weeks before the new allocation strategy comes into effect. With the Biden administration taking office next week, however, it is unclear whether this change will even come into force.