As President Joe Biden spent his first full day in office issuing executive actions aimed at containing the coronavirus, his administration scrambled to get a handle on a key unanswered question: How much vaccine is actually available?
Conflicting accounts of supply totals have bedeviled federal and state health officials, complicating the new administration's sweeping pandemic response plan and casting fresh doubts on how long it will take Biden to bring the virus under control.
Just about half of the nearly 38 million Covid-19 shots distributed by the federal government have been administered to date, according to Centers for Disease Control data. That indicates there’s a glut of unused doses around the country.
But states are warning they're running out of the vaccine, with little sense of when more will arrive.
Federal officials are trying to sort out where the reality lies – an urgent effort that comes against the backdrop of Biden’s promise to deliver 100 million shots in his first 100 days in office.
“That is something that we need to really take a close look at,” said Anthony Fauci, Biden’s chief medical adviser. “If it is the case, particularly the thing that would be most disturbing is vaccine laying around.”
Biden has made ending the pandemic a centerpiece of his early presidency, vowing an all-out federal effort to turn the tide of the crisis within the next several months.
But even as he signed a flurry of directives laying the foundation for that response, White House officials have sought to tamp down expectations — blaming the Trump administration for leaving behind a situation that they insisted was far worse than expected, despite months of transition meetings and planning.
"What we're inheriting from the Trump administration is so much worse than we could have imagined,” Jeff Zients, Biden’s Covid-19 coordinator, told reporters Wednesday night. “We don't have the visibility that we would hope to have into supply and allocations.”
Biden officials complained during the transition that their efforts to gather information on the coronavirus response were stymied at times by Trump administration political appointees. Biden aides for weeks were unable to access Tiberius, the central government database used to monitor vaccine distributions, according to one transition official. They were also denied access to certain standing meetings related to the government’s response until a few days before Biden was sworn in.
Yet while few disputed the transition was rocky, officials working on the transition or familiar with its work said it was patently obvious that the Trump administration response was severely lacking, and it should have been no surprise to Biden’s team.
That is particularly the case with the vaccine pipeline, which has been at the center of weeks of finger-pointing between states and the federal government over the slow pace of vaccinations.
Several state officials on Thursday pointed to supply shortfalls as the chief obstacle to their distribution efforts, adding that directives from both the outgoing and incoming administrations that states should widen their eligibility guidelines wound up depleting reserves.
“What you’re seeing now is the very limited supply that everybody knew was going to be the case, but was not understood by the public,” said Chrissie Juliano, executive director of the Big Cities Coalition, which represents metropolitan health departments. “Suggesting that we allow everybody over 65 to get a vaccine in the hope that it would move supply, while it came from a good place, is just not a reality on the ground.”
Health officials have also struggled with extensive data problems that have hampered states’ ability to update the government on its day-to-day vaccine supply, a lag that’s made it difficult at times to convince federal officials that they’re running low – or track where new shipments are being delivered.
Those issues could take weeks to fix, state and federal officials said, and represent the kind of complex effort that could quickly bog down the Biden administration's response.
On Thursday, Biden rolled out a 200-page national strategy to curtail the coronavirus, part of an effort to show a clean break from the Trump administration, which shirked responsibility for vaccine distribution and created a patchwork system across the country.
The president signed 10 executive orders ranging from invoking the Defense Production Act to expedite production of vaccine supplies to directing the Department of Education to give schools guidance on reopening safely.
Health experts applauded the quick steps and the detailed plan, but they also acknowledged there will be delays putting it all into motion. Although the plans have been underway for months, getting huge government agencies to quickly execute — especially without permanent leadership in place — will be difficult.
A key part of the president’s plan to increase vaccinations is federally-supported distribution sites, with the goal of creating 100 sites by the end of February. But state officials warned that if supply did not increase, the plan would only further disrupt efforts already underway to keep up with rising demand.
"Where are they going to get the doses for that?" said Claire Hannan, executive director of the Association of Immunization Managers. “It makes me a little queasy to hear these community vaccination centers and mobile vaccination clinics – all great ideas that are in these plans, but what’s missing is the doses and the resources.”
The federal government further alarmed some state officials on Thursday, when the Centers for Disease Control indicated it would begin counting Pfizer's vaccine vials as the equivalent of six doses -- up from five, according to an email from the agency obtained by POLITICO.
Those vials require specific syringes to extract all six doses, and that type of syringe is in such high demand that the Biden administration said Thursday it may use the Defense Production Act to ramp up its manufacturing.
Biden officials are also likely to run up against strict limits on the nation’s total vaccine supply for the next several months. Pfizer and Moderna have pledged 200 million total doses by the end of March – enough to hit Biden’s initial pledge, but far from what is needed to achieve herd immunity.
And while Biden on Thursday touted his willingness to use the DPA to speed manufacturing, that expanded stash of materials and supplies won't have any immediate impact on the response.
“It’s not a magic wand,” said one former Trump administration official. “They need to explain what they’re going to do with it.”
Biden’s team is still getting high marks for being honest and transparent about the challenges the country faces in eradicating the pandemic, one that Trump routinely dismissed. Fauci, the nation’s top infectious disease expert who repeatedly sparred with Trump officials, also spoke of feeling “liberated” as the Biden administration hsa elevated him and his colleagues.
“The idea that you can get up here and talk about what you know, what the evidence, what the science is, and know that's it — let the science speak,” he said Thursday. “It is somewhat of a liberating feeling."
Yet when pressed to detail exactly how Biden's lengthy blueprints and much-touted executive actions would translate to more vaccinations on the ground, Fauci was far more tight-lipped.
"To do whatever he can to expand the availability of vaccines," he said. "Whatever that is, he's just said he's going to use whatever possibility."
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