Thursday, Jan 21, 2021
Focus on the big picture

US shifts to speed COVID vaccination as cases rise

AP, 13 Jan 2021
The Trump administration has unexpectedly shifted gears to speed the delivery of vaccinations. The required second doses of the Pfizer-BioNtech and Moderna shots will not be held back, and states should begin to vaccinate lower priority groups. (Jan 12)


Now, Health and Human Services Alex Azar has announced two major changes. First, the government will no longer hold back required second doses of the Pfizer-BioNTech and Moderna vaccines, practically doubling supply. Second, states should immediately start vaccinating other groups lower down the priority scale, including people age 65 and older, and younger people with certain health problems.

Dr. Graham Snyder the Medical Director of Infection Prevention and Hospital Epidemiology at the University of Pittsburgh Medical Center, who is not part of "Operation Warp Speed," says this change may mirror what's happening in other parts of the world.

"Perhaps the public health strategies as we've seen elsewhere around the world to get one dose in people to get a partial vaccine to people, even if that means delaying the second dose may be prudent from a public health perspective and offering some protection to more people rather than complete two-dose protection to a smaller group of people," said Snyder.

"The question that follows, what's the best way to protect those who are vulnerable, those people who are an older age groups, is it better to give them the vaccine and protect them directly, or is it better to give vaccine to the people who are taking care of them to prevent them from being exposed? That's not the question that we'll be able to answer very easily. But with this change from the federal government's approach, they're clearly prioritizing getting vaccine to those who are vulnerable," Snyder went on to say.

The move better aligns the outgoing administration with the new Biden-Harris team. On Friday, President-elect Joe Biden said he will rapidly release most available vaccine doses to protect more people. He said he supported immediately releasing vaccines that health authorities were holding back out of caution, to guarantee they would be available for people needing their second dose.

As of Monday morning, the government had distributed about 25.5 million doses to states, U.S. territories and major cities. But only about 9 million people had received their first shot. That means only about 35% of the available vaccines had been administered.

Initially, the shots were going to health care workers and nursing home residents. Those 75 and older were next in line. But problems arose even in vaccinating that limited pool of people. Some hospital and nursing home workers have been hesitant to get the vaccine. Scheduling issues created delays in getting shots to nursing homes.

Some states, have or are planning to open up mass vaccination centers, aiming to inoculate thousands of people a day in a single location. In Florida, Gov. Ron DeSantis opened up vaccinations to people 65 and older. In other states, local health authorities have started asking residents 65 an older to register, in anticipation the vaccination campaign would be expanded.

Each state has its own plan for who should be vaccinated, based on recommendations from the federal Centers for Disease Control and Prevention. The CDC recommendations give first priority to health care workers and nursing home residents.

But the slow pace of the vaccine rollout has frustrated many Americans at a time when the coronavirus death toll has continued to rise. More than 376,000 people have died, according to the Johns Hopkins database.

Snyder says experts will need to continue to monitor the rollout.

"Fundamentally you need four things to get people vaccinated. You need the vaccine itself. You need a place to give the vaccine, and then you need this. You need the electronic infrastructure to schedule to do all the scheduling, communication that includes education about who should and shouldn't get the vaccine, side effects and monitoring. What we have seen so far has been varying models of who provides that. It's OK to have a hybrid model but what we need from the government is clear communication about how to make sure we are aligned with all four of those elements."

The Pfizer-BioNTech vaccine requires a second shot about three weeks after the first vaccination. Another vaccine, this one produced by Moderna, requires a second shot about four weeks afterward. One-shot vaccines are still undergoing testing.

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