U.S. should not hold back doses. Distribute them now.

The Trump administration could deliver a coronavirus vaccine to all at-risk health-care workers and everyone over 75 in December. But the Health and Human Services Department is only shipping out 45% of the available vaccine — a decision that will leave about 22 million Americans without any immunity during the deadliest period since the pandemic began.

The reason for holding back more than half of the vaccine, they argue, is that it is a two-dose regimen and they want to make sure they have second doses available for everyone who gets the first. So instead of pushing out as many doses as possible immediately, they are holding back 55% of available supply — 50% for second doses and about 5% as a “safety stock.” As a result, they will distribute only about 18 million doses this year when about 40 million will be available.

That is insane. We are at the peak of the pandemic. On Dec. 17, 3,406 people died of covid-19 — the highest single-day death toll since the pandemic began. Holding back 55% of your available vaccine during the pandemic’s peak is like holding back 55% of your available ammunition on D-Day, because the troops will need those bullets a month from now when the Nazis are on the run. When soldiers are fighting and dying on the beaches, you give them all the ammunition you can right away — knowing factories back home are churning out more.

We know that the first vaccine dose provides significant immunity. Moderna reported the vaccine was 80.2% effective after the first dose, and experts believe the Pfizer vaccine has a similarly high efficacy rate. So why are we immunizing fewer than half the Americans we could be during the worst period of the pandemic? Today almost 52,000 nursing home residents a week are getting COVID-19, and about 21% of them die. Getting vaccines to nursing homes a month earlier could save more than 40,000 lives alone.

Defenders of saving doses say we don’t know how long immunity lasts from the first dose, so we need to make sure we have second doses available. But there will be 50 million more doses coming in January that can be used for that second dose, and 60 million in February. Moreover, the Institute for HealthMetrics and Evaluation model suggests that by the end of January the pandemic will begin rapidly declining. We need to provide asmuch immunity to asmany people as possible now.

The only reason to hold back doses is to hedge against the risk of a manufacturing failure. But should that happen, we have a much bigger problem as a country than not getting people second doses. Arthur Caplan, a professor and founding head of the division of medical ethics at the New York University School ofMedicine, tells USA Today, “I will accept a bit of risk in terms of supply to get to that goal as long as manufacturers will promise that the second doses are highly, highly likely to be available for those who got the first dose. . . . Vaccinat[ing] as many as possible in the midst of a horrific deadly plague to maximize lives saved has to be our moral priority.”

Everyone should get their second dose. Yet even if there was a slight delay, there is no evidence it would cause any harm.

It may make sense to reserve 5% of the vaccine in case of distribution problems, but 55% is absurd and inhumane. Right now, we have a small window in the next few weeks to save lives during the current wave. That window is closing fast.

It is time for President Donald Trump to step in. If he lets the HHS withhold vaccine doses this month, Americans will needlessly die. He needs to order HHS to release those vaccines — now.