US officials express concern over possible shortage of COVID-19 vaccine

Production might not meet upcoming needs as cases top 25m across country

Boston Globe – January 25, 2021

People waited to receive the coronavirus vaccine in Charleston, W.V. on Jan. 21, 2021.KRISTIAN THACKER/NYT

WASHINGTON — The United States needs to move faster to immunize the public against the coronavirus, but efforts to accelerate beyond President Biden’s goal of 100 million shots in 100 days may be hindered by the lack of vaccine doses, according to Rochelle Walensky, the new director of the Centers for Disease Control and Prevention.

Four other Biden officials also tried on Sunday to manage public expectations about vaccine distribution, as frustration grows among Americans over long lines, canceled appointments, and other daunting issues.

The officials also tried to smooth over confusion about President Biden’s goal of 100 million shots. Dr. Anthony Fauci, the nation’s top infectious disease specialist, called the figure “a floor, not a ceiling,” on the CBS program “Face the Nation.”

“I think that the supply is probably going to be the most limiting constraint early on, and we’re really hoping that, after that first 100 days, we’ll have much more production,” Walensky said on “Fox News Sunday.”

The updates on the problems with the vaccine distribution come as the nation surpassed 25 million confirmed cases of COVID-19 since the pandemic began. The milestone, reported Sunday by Johns Hopkins University, is a grim reminder of the coronavirus’s wide reach in the United States, which has seen far more confirmed cases and deaths than any other country.

The United States accounts for roughly one of every four cases reported worldwide and one of every five deaths. As officials push to boost inoculation efforts, scientists are challenged by trying to understand the coronavirus variants. Fauci said the variant first detected in the United Kingdom is more deadly and spreads faster.

“We need to assume now what has been circulating dominantly in the UK does have an increase in what we call virulence to cause more damage, including death,” Fauci said on CBS News’s “Face the Nation.”

President Biden on Monday will formally reinstate travel restrictions on non-US travelers from Brazil, Ireland, the United Kingdom, and 26 other European countries that allow travel across open borders, according to two White House officials.

The officials, who spoke on the condition of anonymity to discuss the order, also confirmed Sunday that South Africa would be added to the restricted list because of concerns about a variant of the virus that has spread beyond that nation.

Biden is reversing an order from President Trump in his final days in office that called for the relaxation of the travel restrictions as of Tuesday.

The decision to reverse the order is not surprising, but the addition of South Africa to the restricted travel list highlights the new administration’s concern about mutations in the virus.

The South Africa variant has not been discovered in the United States, but the variant originating in the UK has been detected in several states, including Massachusetts.

On Saturday, the United States reported more than 1.3 million newly administered doses of coronavirus vaccines, the fifth day in a row the country has topped 1 million daily doses, according to data tracked by The Washington Post.

That pace suggests that the country already is on track to meet the Biden administration’s 100-day goal. The target was criticized by some who said it was unrealistic when he announced it in December, but it now seems less ambitious because of increased manufacturing certainty and a ramped-up inoculation pace in the last days of the Trump administration.

Biden defended the vaccination goal Thursday. “When I announced it, you all said it’s not possible. Come on, give me a break, man. It’s a good start.”

On the CBS program, Fauci clarified that Biden was talking about doses, not fully vaccinated people. Within those 100 days, he said, some 67 million people might have received the second of their two required vaccine doses, with another 37 million having gotten just the first dose.

By Inauguration Day on Jan. 20, nearly 36 million doses of the Pfizer and Moderna vaccines had been distributed to state and local governments. However, only about 16.5 million shots had been administered.

Along with Fauci, the four officials included Dr. Vivek Murthy, the president’s nominee for surgeon general; Xavier Becerra, his nominee for secretary of Health and Human Services; and Ron Klain, Biden’s chief of staff. In appearances on the Sunday talk shows, each deflected questions about whether Biden’s goal was too ambitious or too modest.

Instead, Klain said that the vaccine distribution infrastructure inherited from the Trump administration needed to be fortified and that many bottlenecks had to be cleared. “We need more vaccine, we need more vaccinators, we need more vaccination sites,” Klain said on the NBC program “Meet the Press.”

Public health officials are eagerly awaiting late-stage trial results for the one-dose vaccine under development by Johnson & Johnson, with help from Beth Israel Deaconess. On the ABC program “This Week,” Murthy said that while the 100 milliondose goal could be achieved with the vaccines from Moderna and Pfizer, he was hopeful about adding the Johnson & Johnson vaccine.

Klain batted away the possibility that frustrated governors would purchase vaccine for their own states directly, rather than relying on the federal government. “I don’t think that’s possible,” he said, because the emergency authorization for the vaccines means that federal oversight is required.

Murthy said that the government also wanted to increase research on virus treatments. And he mentioned dispatching mobile vaccine units to remote communities. Until now, vaccines have been given mainly to captive populations including nursing home residents and health care workers, or in urban settings.

Fauci said the inoculation pace of recent days may be difficult to maintain as more vaccinations occur outside controlled settings and more broadly in communities.

In her interview on “Fox News Sunday,” Walensky said health officials are increasing their surveillance and study of variants and are monitoring their effect on the vaccines. She called their emergence a signal that “we need to get more vaccine out there.”

Referring to supply constraints, Walensky said the Biden administration is working with manufacturers to address problems and increase production by March.

“One of the biggest problems right now is I can’t tell you how much vaccine we have, and if I can’t tell it to you, then I can’t tell it to the governors, and I can’t tell it to the state health officials,” Walensky said.

That lack of data, she said, is making it harder for state leaders to plan distribution.

In the days before she took over at the CDC and in the few days since, Walensky has repeatedly said the goals for vaccination and the decisions about when to expand the groups eligible for it must square with the amount of vaccine doses available.