Biden under pressure to deliver more COVID-19 shots

President Biden is facing pressure to aim even higher with his administration’s vaccine distribution goals, with experts noting his early push to deliver 100 million shots in 100 days does not differ dramatically from the current pace.

The new administration has trumpeted its vaccine goal as “ambitious” and “bold.” But a vocal group of experts says Biden’s goal is actually far less than what is needed to tame the pandemic, especially with more contagious variants on the rise.

“100 million shots means 50 million people,” said Eric Topol, professor of molecular medicine at Scripps Research, given that the two currently available vaccines require two doses. “That’s totally inadequate.”

A more contagious variant first found in the United Kingdom could be the dominant strain in the U.S. by March, the Centers for Disease Control and Prevention has warned, sending cases spiking even higher and putting further stress on hospitals. That makes faster vaccinations before then even more pressing.

“That is really the urgency that people are not understanding,” Topol said.

Biden officials have emphasized they won’t stop vaccinations if they reach the goal before the 100 days, so it is possible the goal will end up being exceeded. However, experts say the aim still matters and the prevailing focus should be on delivering vaccines 24/7.

Partly, the new administration is trying to set expectations that the pandemic will not immediately turn around and seeking to portray the Trump administration as having left it with little to work with on the vaccination effort.

“What we’re inheriting is so much worse than we could have imagined,” Jeff Zients, Biden’s coronavirus response coordinator, said on a call with reporters on Wednesday.

Anthony Fauci, the government’s top infectious diseases expert, told reporters Thursday that the new administration is “amplifying” what the Trump administration did through a more active federal role, but “we certainly are not starting from scratch.”

The Trump administration drew criticism from experts for placing too much responsibility on states for the “last mile” of getting shots into arms without enough federal support and for not providing clear enough information about how much vaccine each state would be getting and when.

Still, despite the problems with the initial rollout, the pace of vaccinations in the U.S. had already climbed to close to the goal Biden set of 1 million shots per day even before his administration took over. The U.S. was averaging 911,000 shots per day on Jan. 19, according to data compiled by Our World in Data, just shy of Biden’s desired mark.

“Don’t let the media and Democrat politicians spin this differently,” Rep. Steve Scalise (La.), the House Republican whip, tweeted on Thursday. “Biden’s Vaccine Plan is Trump’s Vaccine Plan. The United States was already on track for 100 million doses in 100 days.”

Paul Offit, a vaccine expert at Children’s Hospital of Philadelphia, said the U.S. could need around 250 million people to be vaccinated to reach herd immunity, when enough of the population is immune that the spread of the virus will decline dramatically.

“For a two-dose vaccine, that’s 500 million doses, so when you talk about giving a million doses a day, we’re probably better off with about 3 million doses a day if we can get there,” he said. “A million doses a day is not enough to get there quickly.”

Biden grew defensive on Thursday when asked by a reporter if 100 million shots in 100 days is enough, given that the U.S. is already almost on pace to reach that goal. 

“When I announced it, you all said it’s not possible,” Biden said. “Come on. Give me a break, man. It’s a good start, 100 million.”

White House press secretary Jen Psaki on Friday said there is always room to exceed the goal but noted an array of headwinds, including vaccine hesitancy, and supply problems. 

“If we surpass that, that’s great,” she said. “We’re going to continue working after day 100 as well.”

The Biden administration is taking a number of steps to ramp up federal support for the vaccination effort, regardless of the set goal. Biden signed an order to more fully use the Defense Production Act to require companies to increase manufacturing of vaccine supplies.

One area of focus is increasing the supply of special syringes that can extract an extra dose of vaccine that is in some vials, thereby increasing the number of doses available.

The administration also plans to use Federal Emergency Management Agency to set up federally run vaccination sites, with the goal of 100 sites in the first month. 

There are also questions about how many doses of vaccine will be available. Pfizer and Moderna have each committed to having 100 million doses for the U.S. by the end of March — twice as much as needed to fulfill Biden’s goal — though it is possible manufacturing problems could reduce those numbers. 

Officials hope that a third vaccine, from Johnson & Johnson, could be authorized in the coming weeks, which would provide additional supply.

But Biden administration officials said they are still trying to get a handle on what the supply situation is and do not have exact projections from manufacturers.

The new administration is also seeking to improve communication with state leaders, who have complained the Trump team did not give them information on their allocations far enough ahead of time to properly plan.

The clock is ticking, said Marc Lipsitch, an epidemiologist at the Harvard T.H. Chan School of Public Health, given the spread of more contagious variants.

“They emphasize the real need to continue accelerating the rollout as much as possible,” he said. “Because to some degree it’s a race between a more contagious virus and our ability to protect people.”