Aid groups exhort U.S. not to hoard extra doses
WASHINGTON — A coalition of nongovernmental organizations is calling on President Joe Biden to immediately begin developing plans to share an expected surplus of hundreds of millions of covid-19 vaccine doses with the world, once U.S. demand for shots is met.
Biden has said his primary focus is ensuring that all Americans can get vaccinated, and Thursday he outlined a new goal to deliver 200 million doses over his first 100 days in office. But with all adults set to be eligible for shots
by May 1, and the U.S. set to have enough vaccine for its entire population by the end of July, Biden is being asked to facilitate the delivery of excess doses to the rest of the world — and to do so without putting strings on the shipments or engaging in “vaccine diplomacy.”
In a letter to Biden sent Friday, the groups — 30 nongovernmental organizations including the ONE Campaign, the International Rescue Committee, Catholic Relief Services and Save the Children — call on Biden’s administration to commit to providing excess doses through the World Health Organization-backed covid-19 Vaccines Global Access, or Covax, facility.
“It is estimated that there could be twice as many deaths from covid-19 if rich countries monopolize the first doses of vaccines instead of making sure they are distributed globally,” the groups write. “Vaccine hoarding could cost the global economy up to $9.2 trillion. Wealthy countries will bear half of those costs because of supply chain disruptions and demand shocks.”
They argue Covax would ensure the vaccines are distributed in a way to “maximize equity.” Other countries, such as Russia, China and Israel, have sought to use vaccine sales to bolster their geopolitical positioning.
Biden has moved to have the U.S. contribute financially to the Covax alliance, which will provide vaccines to more than 90 lower- and middle-income nations, but the U.S. has yet to commit to providing any doses. To date, Biden’s administration has approved only the export of about 4 million doses of AstraZeneca’s vaccine, which is not authorized in the U.S. but is in use around the world, to Canada and Mexico.
In the coming months, the U.S. surplus is expected to reach into the hundreds of millions of doses, allowing for what the White House calls “flexibility” in responding to any shortfalls and future developments on the potential need for booster shots and vaccinating children.
The U.S. is injecting an average of about 2.5 million doses each day, and the pace is likely to dramatically rise later this month in conjunction with an expected surge in supply of the vaccines, putting the 200 million-dose goal well within reach.
The nongovernmental organizations want the Biden administration to preempt any contractual or legal issues that U.S. manufacturers would have in providing vaccine and to outline a delivery schedule for when Covax could begin to distribute U.S.-produced doses. They also call on drug companies to share manufacturing expertise and for the Biden administration to support the availability of raw materials for vaccines for doses to be distributed by Covax.
They are calling on Biden to develop a framework for distributing vaccines now, so that once U.S. demand is met, supply can quickly be shifted overseas.
Currently, all vaccines produced in the U.S. are claimed by the federal government under the terms of contracts signed by the manufacturers and the government.
The Biden administration has purchased enough doses of Moderna, Pfizer and Johnson & Johnson vaccines to inoculate 150 million more people than the U.S. population by the end of the year.
The U.S. also has ordered 110 million doses of vaccine, enough for 55 million people, from Novavax, which is expected to file for emergency authorization as soon as next month, as well as 300 million doses, enough for 150 million people, from AstraZeneca.
“Given the optimistic outlook for vaccinating most Americans in the next few months and the huge number of excess doses the U.S. has in its pipeline, the U.S. is uniquely positioned to accelerate the global response to the pandemic by sharing vaccines,” the groups write.
GLOBAL SCARCITY
Whether to keep, modify or redirect those orders is a question with significant implications, not just for the nation’s efforts to contain the virus but also for how soon the pandemic can be brought to an end. Of the vaccine doses given globally, about three-quarters have gone to only 10 countries. At least 30 countries have not yet injected a single person.
And global scarcity threatens to grow more acute as nations and regions clamp down on vaccine exports. With infections soaring, India, which had been a major vaccine distributor, is now holding back nearly all of the 2.4 million doses manufactured daily by a private company there. That action follows the European Union’s decision this week to move emergency legislation that would curb vaccine exports for the next six weeks.
Biden administration officials who are inclined to hold on to the coming U.S. surplus point to unmet need and rising uncertainty: Children and adolescents are still unvaccinated, and no one is certain if or when immunity could wear off, which could require many millions of booster shots.
“We want to, largely, be a part of the global solution here,” Jen Psaki, the White House press secretary, said this week. But she added, “There are still a number of factors that are unpredictable that we need to plan for to the best of our ability, including the variants and the impact and what will be most effective, as well as what will work best with children.”
Vaccine manufacturers and some top federal officials say decisions about what to do with extra orders must be made within weeks, or the uncertainty could slow production lines. The manufacturing process can take up to 10 weeks, and changes for a foreign market need time. The regulatory rules that govern vaccine shipments present another hurdle, as does the limited storage life of the drug substances that make the vaccine.
All these variables threaten to complicate what has been relatively smooth sailing for the Biden administration. Thanks in part to the federal government’s determined assistance over many months, vaccine manufacturers have been steadily increasing their output, and states have snapped up new doses as fast as the government could deliver them.
Where to go from here is a matter of intense debate.
Clinical trials to determine which vaccines work for the nation’s adolescents and children are continuing and most likely will not neatly wind up at the same time. By the end of spring, for example, Moderna and Pfizer are hoping for interim results on how their vaccines would work for the nation’s 30-some-million adolescents. But Moderna, at least, does not expect results for children younger than 12 until after the school year starts in the fall.
The administration could hang on to doses from those two manufacturers while it awaits findings, only to discover later that another vaccine whose trials began later — say Johnson & Johnson’s — is a better option.
If one or more of the three authorized vaccines turn out to provide only brief protection against covid-19, scores of millions of more doses could be required for booster shots. But when that answer will come is also uncertain.
Federal health officials have discussed canceling or reducing some orders from Moderna and Pfizer in return for the promise of a fresh supply this fall of either pediatric doses or shots of a new vaccine that has been reconfigured to work against the fast-spreading variants.
There is some push for that from the manufacturers, whose vaccines are coveted by other high-income countries. But it also would deprive federal officials of the power to decide which nations get the surplus doses, as well as the humanitarian and diplomatic credit it would reap from sending the vaccine to countries in greater need.
For all these reasons, senior officials say, the administration is leaning toward keeping the doses it has ordered, then at some point directing the excess to other nations in bilateral deals or giving it to Covax.
MASS FEMA SITES TO CLOSE
Meanwhile, the Federal Emergency Management Agency plans to stop operating two mass vaccination sites in California next month.
The sites in Oakland and Los Angeles opened in February for an eight-week pilot program that concludes April
15. The sites will switch from the Pfizer to the Johnson & Johnson vaccine, which requires just one shot, during the final two weeks of operation so people do not have to sign up for a second dose elsewhere.
State and county officials said they would have liked the program to continue, though it provided a small fraction of California’s overall shots. Each site has the capacity to vaccinate at least 6,000 people per day ,but they have been administering up to 7,500 shots per day, according to the state Office of Emergency Services. Since the sites are federally managed, those shots are separate from California’s overall weekly allocation, which is now about 1.8 million shots per week.
Gov. Gavin Newsom announced Thursday that the state will allow everyone 16 and older to be eligible for the vaccine starting April
15. Right now, people 65 and older, younger people with certain health conditions and farmworkers, teachers and several other occupations are eligible. The state is expecting a much greater supply of doses soon.
The two sites combined have administered half a million doses, with about 67% going to underserved communities and minority groups, according to the Office of Emergency Services.
Frank Mancel, a spokesman for FEMA, said while the sites may keep operating in some fashion, the special allocation of doses will not continue after April 15. The closure of California’s sites does not mean sites will be opening elsewhere, he said.
Separately, the Internal Revenue Service announced Friday that masks, hand sanitizer and disinfectant wipes can qualify as medical expenses for tax deductions or can be paid for with money from tax-advantaged health accounts.
“The purchase of personal protective equipment, such as masks, hand sanitizer and sanitizing wipes, for the primary purpose of preventing the spread of coronavirus are deductible medical expenses,” the agency said.
Taxpayers can qualify for the deduction if they have medical expenses that exceed 7.5% of their adjusted gross income and they itemize on their tax returns. Generally, only a small percentage of taxpayers itemize and an even smaller portion meet the threshold for medical deductions.
For the vast majority of taxpayers who take the standard deduction instead of itemizing, the IRS also is offering tax relief. They can use tax-favored health accounts — health flexible spending arrangements, Archer medical savings accounts, health reimbursement arrangements or health savings accounts — to pay those costs.
The masks and hand sanitizer add to a long lists of medical costs that can come with tax benefits. Payments for false teeth, reading or prescription eyeglasses, contact lenses, hearing aids, crutches and wheelchairs all count toward the write-off and can be paid for by many health accounts.