Americans need COVID-19 vaccinations now — here’s how Biden can ramp up the process

The advisers of President-elect Joe Biden have been developing plans to speed up COVID-19 vaccine distribution. One idea the transition team has announced is to release available doses immediately rather than holding back half to ensure second doses are available. While this could potentially delay some people from getting a second dose, the risk is worth it. 

Americans have been warned this summer there will be a vaccine shortage. Health care officials were instructed to abide by a strict prioritization schedule and this created a “shortage mentality” that’s slowed the distribution of available vaccines. Of the 30.6 million doses of coronavirus vaccine distributed to health care facilities thus far, an abysmal 36 percent — about 11.1 million — have been administered. Releasing all available doses will help expedite this process.

To meet his goal of administering 100 million vaccine doses in his first 100 days in office, Biden will need to do more than releasing all available doses. Hospitals are already overwhelmed with a surge in coronavirus cases and have limited capacity to administer vaccines. With little federal support, overworked and under-resourced public health departments have been slow to deliver vaccines.

So how does Biden accomplish this important goal?

Give all health care facilities vaccines: Part of the holdup is that vaccines are being distributed to specific locations: certain pharmacies and hospitals. But people should be able to get a shot anywhere they interact with the health care system. Dentists, clinics and doctors’ offices should all be given vaccines to distribute if they have the capacity and necessary freezer equipment. While this may decentralize the distribution effort, it will greatly increase the number of shots getting into arms.

Scale what’s working: Even with the slow rollout, there have been clear examples of success: West Virginia has inoculated almost all of its nursing home population. That’s leaps and bounds better than the national average: 4.7 million doses have been distributed to long-term care facilities but only 1.2 million residents have been vaccinated. It’s an abysmal showing considering that people in long-term care facilities are dying disproportionately from COVID-19. West Virginia didn’t rely on the large pharmacy chains to distribute the vaccines to nursing homes; it used local and independent pharmacies in the areas they were serving. If this continues to prove more successful, other states should take note.

Use the National Guard: The National Guard has been running effective testing operations in many cities across the country including in Washington, D.C. Some of the existing infrastructure could be repurposed for vaccinations. Biden has promised to use an all-government effort to combat the COVID-19 pandemic and using the National Guard to help administer shots falls under that umbrella.

Consider expanding eligibility: Some states, like Maryland and Florida, have found vaccinating by priority group to be too cumbersome and expanded eligibility to more groups. Florida is vaccinating just by age, resulting in long lines and overwhelmed vaccine sign-up websites. Maryland has said that it will move on to lower priority groups without the higher groups being fully vaccinated. While Florida’s model may prove to be too chaotic, especially in cold northern regions where waiting in line may not be feasible, it is important that no vaccine go to waste. Some vaccines have been disposed of because hospitals could not find more health care workers to vaccinate and did not want to face potential punishment for vaccinating people beyond the first priority group. Loosening eligibility without making it a free-for-all could help speed up vaccinations.

Send states funding fast: Though the federal government has dedicated some funding to help states with distribution efforts, the money arrives too slowly. Through the end of 2020, states only received $350 million for vaccine distribution, just more than $1 per resident of the country. The new COVID-19 and economic relief bill Congress passed last month included $8 billion for vaccine distribution. But that money has been slow to reach local governments. The Biden administration should prioritize getting this funding into the hands of states so they can increase the number of people on the ground administering the vaccine. 

The federal government pumped money into Operation Warp Speed to expedite the development and shipment of vaccines, but it lags with the last mile of vaccine delivery. Federal support for rapid vaccine development and implementation of these new therapies must go hand-in-hand to achieve a full recovery for both public health and the economy. With COVID-19 cases surging and more vaccines in the pipeline, the need to expedite vaccine administration has never been greater. These five steps can make that happen.

Arielle Kane is the director of Health Policy at the Progressive Policy Institute. Her research focuses on what comes next for health policy to expand access, reduce costs and improve quality.