Biden inherits big challenges from Trump on COVID-19 vaccines

President-elect Joe Biden and his team are walking a tightrope with their coronavirus vaccine plan, rolling out an ambitious strategy while also tempering expectations as to how quickly it can be enacted.

Biden’s plan, officially announced Friday, is a sweeping proposal aimed at dramatically increasing the federal involvement in the rollout of COVID-19 vaccines.

Biden has pledged to vaccinate 100 million people in his first 100 days in office, and wants the National Guard and the Federal Emergency Management Agency to help by building clinics and helping to administer shots. 

Biden on Friday said that by the end of his first month in office, there will be 100 federally supported centers across the nation. 

He also promised to use the Defense Production Act to increase the supply of critical vaccine components like vials and syringes. 

What is not clear is how Biden will increase the availability of actual vaccines, which remain a fixed and limited quantity.

Biden acknowledged that nothing will change overnight, and his inauguration alone won’t solve the crisis. 

“All these steps will take some time. It may take many months to get where we need to be,” Biden said Friday. “When we’re sworn in next week, we’re going to ask you to keep the faith and keep following what we know works.”

The rollout of vaccines in the waning days of the Trump administration has been choppy and inconsistent, and Biden will need to work to ensure he will not be blamed for the faults of the Trump administration.

Biden will inherit a system of inequitable distribution, months-long wait times for people to find appointments and states that say they don’t know how much vaccine they are getting from one week to the next. 

“The vaccine rollout in the United States has been a dismal failure thus far,” Biden said in a speech Thursday. “This will be one of the most challenging operational efforts we’ve ever undertaken as a nation. We’ll have to move heaven and earth to get more people vaccinated.”

The pace of immunization is much slower than officials promised last fall, with states and federal officials sniping over who shoulders the blame. 

States say they did not receive enough resources when the vaccine rollout began, while Trump officials fault micromanaging governors and rigid adherence to eligibility criteria.

Trump administration officials in recent days have acknowledged the slow pace of immunizations, and have taken steps to try to speed up the process. 

Outgoing Health and Human Services Secretary Alex Azar urged states to prioritize people age 65 and older, as well as anyone between the ages of 16 to 65 with underlying medical conditions. 

Azar also threw a wrench into state planning when he announced a policy that would reward states that administer vaccines quicker.

Allocation to date has been based strictly on a population basis; beginning in two weeks, Azar said states that rapidly use their doses will get a larger allocation. 

The change was a surprise to state officials, and it’s not clear if the incoming Biden administration supports it. They would be in charge of implementing it.

Azar said Operation Warp Speed had not yet spoken with the transition team about the change.

That lack of information sharing between the current administration and the transition team could be one the biggest hurdles to overcome, but experts urged Biden to be transparent about the situation, especially if it means they won’t be able to meet the goal of 100 million shots.

“I would imagine that there’s a lot they don’t yet know because they’re not in office yet. So I think there’s a lot that they have to uncover first, and then communicate to the American people,” said Leana Wen, a public health professor at George Washington University and former Baltimore health commissioner.

But as long as the supply chain is relatively stable, Wen said she thinks 100 million shots is a low bar.

“At that rate, we’re not going to be able to vaccinate 80 percent of the American people until the middle of 2022. We really need to ramp up, way beyond that number,” Wen said.

To aid in his goal, Biden said he plans to release almost all second-dose reserves — something the Trump administration also announced this week. 

“I don’t think it’s impossible to achieve,” said Sandro Cinti, a professor of infectious diseases at the University of Michigan Medical School, said of the 100 million shots goal, especially since the current pace is almost 1 million shots a day. 

“It’s not as if the companies have to make too many more doses of these vaccines” to get to that level, Cinti said. “They’re sitting in warehouses. So let’s ship them out.”