We need a science-based plan for vaccine distribution

Outgoing Health and Human Services (HHS) Sec. Alex Azar announced last week the U.S. would soon distribute our COVID-19 vaccine stockpile to try and accelerate the pace of U.S. immunizations. 

We now know this reserve has already been depleted and that every available dose is being taken directly from the production line and put into circulation. 

The threat this aggressive strategy presents to public health safety is extraordinary. Both vaccines approved for use in America today require two shots spaced roughly three to four weeks apart. The stockpile we once had was designed to ensure an ample supply of second shots would exist for those who received the first one.  

On paper it seems like a laudable goal. In practice, there is a serious risk of an already strained supply chain being unable to meet the vaccine demand. Manufacturers may not be able to guarantee production of enough doses to reach eligible second shot recipients in time. Reserving enough vaccines for second doses to be deployed in a timely fashion is sound public practice. 

We all want to speed up the vaccine rollout. President Joe Biden himself announced an ambitious strategy to vaccinate 100 million people in the first 100 days of his presidency. But we must follow the science as we learn about COVID-19 variants and their increased infectiousness. The available vaccines are our best defense — but deploying them based on the clinical trial data is essential. 

Anything that risks a delay in the delivery of a second shot gambles our future. It rests on a belief that, with vaccine production on the rise, the reserve can reach more people. Yet we simply don’t know if manufacturers will have enough time to keep pace and generate more doses for those on-the-clock to receive the second shot. 

The Food and Drug Administration (FDA) itself noted that data from Pfizer’s clinical trials showed its vaccine was just 52 percent effective after the first shot. There is little room for error.

Some public health experts believe we should deliver as many first doses to as many people as possible and give the second dose when supply becomes available. But the clinical trials that benchmarked the high efficacy rates for both the Pfizer and Moderna vaccines were based on specified three- to four-week delivery time windows. It’s unknown whether these same rates can be achieved if we arbitrarily manipulate this timing. 

Any new variable skews the results of the clinical trials upon which the rigorous FDA regulatory review and approval process was based. Moving the goal posts when the research hasn’t examined the potential human health impacts is a highly risky proposition.

Why take chances and change course with a new rollout plan that could potentially spread the delivery of each dose farther apart on a hunch that it should still be effective when there’s no hard data to support it? 

Public health officials must communicate clearly and consistently about the vaccine. Changing strategies midcourse based on unproven theories without the proper research or delivery infrastructure to back it up only magnifies the hesitancy and existing skepticism many already feel toward the vaccine. 

At a time when the circulation of disinformation is at an all-time high — and can lead to dangerous outcomes — we must insist on facts to prevail about COVID-19 and the vaccines working to stop it. To this end, as social media companies take action to flag or remove accounts that promote deceitful political commentary on their platforms, they should take similar steps to block the advancement of COVID-19 hoax claims and vaccine conspiracy theories. Such rhetoric only breeds distrust of the public health system and could further delay our ability to stop the virus.

Bringing our best minds together to figure out how we can make the vaccine available to as many people as we can, in as short a timeframe as possible, is our shared goal. But it cannot come at the expense of risking more American lives. 

We must listen to the science that brought us to this moment. The data shows we have two highly viable vaccines that are proven to be effective as long as they are administered to people under specified timing guidelines. We must trust the process and follow that plan. 

Lyndon Haviland, DrPH, MPH, is a distinguished scholar at the CUNY School of Public Health and Health Policy.