- The Biden administration has upped its initial COVID-19 vaccination goal to 200 million doses administered in the first 100 days of his term.
- The White House also outlined a four-part plan to increase the availability and access to vaccination sites.
- Currently, 46 states are track to open vaccine eligibility to all adults by May 1.
- The vaccine rollout, however, is continuing to play out very differently in individual states based on available supplies and local vaccine hesitancy.
The White House has set new goalposts in the race to get more Americans vaccinated against COVID-19 as cases are rising again.
On March 29, President Biden laid out a four-point plan to administer 200 million vaccine doses within the first 100 days of his term.
Key points of the plan include:
- Providing vaccination sites within 5 miles of the homes of 90 percent of Americans by April 19.
- Doubling the number of pharmacies where eligible people can get a vaccine.
- Opening 12 more federally run mass vaccination sites across the country.
- Funding transportation options for older adults and people with disabilities so they can access available vaccination sites.
All of this comes on top of the president directing states to open up vaccine eligibility to all adults by May 1.
The White House COVID-19 Response Team says about half the states are expected to meet that target by April 15, 2 weeks ahead of schedule.
So far, 46 states and the District of Columbia have said they plan to make the May 1 date.
Experts say the vaccine rollout has improved on the federal side.
“My colleagues at the state health department tell me that delivery of vaccines is becoming more regular and predictable, which makes it easier to plan clinics,” said William Schaffner, MD, professor of preventive medicine and infectious diseases at Vanderbilt University School of Medicine.
But other states are anticipating disruptions.
Potential roadblocks on the vaccine timeline
In California, the Federal Emergency Management Agency (FEMA) is shutting down two “megapod” vaccination sites.
By April 11, the FEMA-run mass vaccination sites in Oakland and Los Angeles will close after their planned 8-week run.
“We really need these federal programs to continue for several more months,” said Jeffrey Klausner, MD, MPH, professor of preventive medicine at the Keck School of Medicine of the University of Southern California.
“They were chosen for their easy access to transportation centers where people could take trains, buses, subways. It’s been highly effective particularly for reaching underserved communities who may not have cars,” he told Healthline.
And he said it’s not reasonable to think neighborhood pharmacies can fill the gap.
“Maybe a pharmacy can do 50 or 75 doses a day, not the thousands you can do at these mega sites,” he added.
California is opening up vaccine eligibility to residents over 50 years old by April 1, then to everybody 16 and over by April 15. There's expected to be a surge of people signing up, and demand will far outpace supply.
At a March 30 afternoon briefing, Barbara Ferrer, PhD, MPH, public health director for Los Angeles County, warned: “We’re going to need to ask folks to be patient while our supply continues to increase.”
Some states have more vaccine supply than demand
As of March 31, the Centers for Disease Control and Prevention (CDC) says more than 195 million vaccines have been delivered. But the number of doses administered is just north of 150 million.
Two of the first states to roll back mask mandates, Texas and Florida, are among the bottom tier of states when it comes to the percentage of vaccine doses administered versus what they have received in terms of supply.
Of the 28 states that are slated to open eligibility by mid-April, 17 have below average adult vaccination rates, according to USA Today. Many also lag behind other states when it comes to fully vaccinating older adults, one of the highest-risk groups.
Some experts believe those states have opened up their eligibility because of waning demand.
“There are rural areas where supply exceeds demand. They have vaccines in the refrigerator and they can’t give them away,” Schaffner told Healthline.
“In part that’s because many people in states like mine [Tennessee]… deeply red… still view COVID through a political prism,” he added. “They believe it’s exaggerated, it’s not that bad, it’s going away. They’re going to be very hard to persuade.”
“That kind of vaccine hesitancy is something that could prolong the public health emergency of the pandemic,” said Amesh Adalja, MD, senior scholar at the Johns Hopkins Center for Health Security and adjunct assistant professor at the Johns Hopkins Bloomberg School of Public Health.
Overcoming vaccine hesitancy
The current pace of vaccinations is about 2.5 to 3 million a day, likely enough to meet the president’s adjusted goal of 200 million shots in arms within his first 100 days in office.
Biden also set a goal for being on a path to get “close to normal” by July 4.
But to do that, experts say it will require convincing the reluctant to get the shots.
“At the moment the virus is still ahead of us, but we need to keep vaccinating to get ahead,” Schaffner said.
“We’re going to have to reach out to young adults in their 20s, 30s, and 40s to come in and get vaccinated,” he said. “They know they are less severely affected.”
But Schaffner said the coronavirus variant first detected in the United Kingdom, B.1.1.7, is more contagious, more likely to produce serious illness, and is spreading rapidly.
“We see the case rates going up and the hospitalizations in some parts of the country, and they are being dominated by the younger age groups,” Schaffner added.
“We will need to combat vaccine hesitancy proactively with facts and education,” Adalja told Healthline.
“The faster we can vaccinate, the more resiliency we will have against the variants,” he explained. “The vaccine, even against problematic variants, is able to prevent serious disease, hospitalization, and death.”