President Biden may have prematurely raised hopes when he said he expected that in the spring, any American who wants a COVID-19 vaccination should be able to get one.
Still, he didn’t go as far as to identify which month, leaving open the possibility that “spring” means on the cusp of summer, in mid-June. Nonetheless, the White House quickly tamped down that expectation.
“Everybody won’t be—won’t be eligible this spring, as you all know, even as the CDC continues to provide updated guidance,” White House press secretary Jen Psaki said Tuesday. “But [Mr. Biden] would certainly defer to health and medical experts and obviously the guidance of Dr. Fauci on when we may be at the pace of reaching herd immunity.”
The White House clarified that 100 million vaccinations in the first 100 days of Mr. Biden’s presidency is still the official target, as originally planned, after Mr. Biden expressed hope that 150 million COVID shots could take place in his first 100 days. And the 100 million-in-100-days target is one the nation’s top infectious disease expert, Dr. Anthony Fauci, seems to agree is realistic. “Once you get rolling and get some momentum, I think we can achieve 1 million a day or even more,” he told the Associated Press earlier this month.
At a rate of 1 million shots per day, it would take the rest of 2021 to vaccinate roughly 70% of American adults. That could be in the range of herd immunity, the point at which the rate of transmission of the disease slows down, although scientists aren’t yet sure what percentage of the population must be inoculated to reach herd immunity against COVID-19.
The White House also has not yet said when younger Americans without preexisting health conditions who aren’t essential workers can expect to get their shots.
The administration has been taking steps to ramp up vaccine production, announcing late Tuesday that it’s planning to purchase an additional 200 million Pfizer and Moderna vaccine doses, which it hopes will be available in the summer, though the goal of 100 million doses in 100 days isn’t contingent on the approval of any new vaccines.
Experts in public health and medical supply chains say a number of factors will be decisive in speeding distribution of the vaccine to the general population — in essence, adults under 65 years old who don’t have underlying health conditions and aren’t essential workers.
“Everybody needs to recognize that scaling up to 400 million doses of a vaccine that we didn’t have a year ago is going to take some time,” said Dr. Julie Swann, department head of Industrial and Systems Engineering at North Carolina State University. “I do not expect that the general public will have access in the late spring unless we have several fortuitous things that happen between now and then.”
The main components involved in meeting the vaccination goal are supply, distribution and administration, says Prashant Yadav, a senior fellow at the Center for Global Development and Affiliate Professor of Technology and Operations Management at INSEAD. And they’re “equally important and not a given,” he said.
Yadav thinks that vaccine production would need to run almost “perfectly” to keep in step with the demand but still believes vaccinations could be available to the general public in May or early June. But March or April, he said, is “highly unfeasible.”
Dr. Bruce Y. Lee, professor at the CUNY Graduate School of Public Health and Public Policy and executive director of Public Health Informatics, Computational, and Operations Research, told CBS News that he’s concerned about the “multiple bottlenecks” in the vaccine rollout. Distribution and administration has been slower than expected.
Identifying where the bottlenecks are in the supply chain and will reveal whether a spring timeline is “reachable or aspirational,” he said.
“It’s not just the sheer number of vaccines that matter,” Lee said. “It matters who actually gets them,” Lee said.
Residents could be vaccinated at a faster pace if states ignore prioritization guidelines, but that would be counterproductive to the goal of protecting the most vulnerable, Lee said. There have been anecdotes about line cutting by wealthy Americans, and in other cases, people who are not on the highest priority lists are receiving shots because of the pressure not to waste the highly perishable doses.
“Because the reconstituted Pfizer vaccine must be used within hours or be disposed of, several doses were administered to non-front line healthcare workers so that valuable vaccine would not be thrown away,” Redlands Community Hospital spokesperson Nikyah Thomas-Pfeiffer said in a statement.
And keeping up the million-shots-a-day pace may become more difficult, said Lee and others, noting that vaccinations started with “low-hanging fruit” in places like hospitals and long-term care centers. When eligibility to get the vaccine opens up more widely, some populations may be harder to reach, depending on where they live and what their socioeconomic circumstances are. It will take more effort to reach U.S. residents who don’t speak English or have regular access to health care, Lee noted.
State governments are beginning to feel the pressure to vaccinate less vulnerable populations, Lee said, in particular, from large employers who want to vaccinate their employees, so they can return to work safely.
The Biden administration must conduct its own review of where the bottlenecks are in the vaccine distribution, Lee said. It is beginning to address this, announcing new vaccine allocation schedules this week that will give states more advance information about their vaccine shipments, enabling them to better plan their distribution.
The federal government can also get more people vaccinated more quickly by establishing or supporting vaccine sites, said Yadav, which the Biden administration says it’s developing.
Swann said administering vaccines would be more efficient if each state had a website where people could sign up to get their shots, rather than going through local health departments. But there are currently just a handful of states with a centralized vaccination registration system or wait list, according to a recent review by the Wall Street Journal.
New Jersey has a statewide registration system. In California and New Jersey, residents can pre-register to be notified when it’s their turn, but that doesn’t necessarily place them in a line to receive the vaccine. South Dakota doesn’t have a statewide waitlist, but the it does direct residents to local health care providers where they can find a wait list.
“Eventually, I think we will have enough vaccine for all Americans who want one, and for additional boosters if they are needed,” Swann said. “New processes take time, but the supply will increase.”