USA TODAY International Edition

Vaccine rollout to pick up pace

More states aim to open eligibilit­y but need supply

- Courtney Subramania­n and Joey Garrison

WASHINGTON – It was the focus of his first White House prime- time speech last week, and he doubled down on the marker Thursday.

But President Joe Biden’s directive to states to make COVID- 19 vaccines available to all adults no later than May 1 doesn’t create an especially high bar. Former health officials said that wasn’t the point.

The move was part of broader strategy to jolt states into action without rankling Republican governors – who may be concerned about federal overreach – as the country prepares for a surge in vaccine doses.

“It was conservati­ve, but it was supposed to be conservati­ve,” said Kavita Patel, White House health policy director under the Obama administra­tion. “I think the timeline will be moved up again, not by the president of the United States, but by states in conjunctio­n with ( the Federal Emergency Management Agency) and other vaccinator­s – and that’s deliberate.”

Governors of both parties have said their states will have no trouble meeting the May 1 deadline as long as the federal government supplies enough vaccinatio­n doses. National Governors’ Associatio­n spokesman James Nash said no governors have expressed concern that it’s an unrealisti­c goal.

Hours before Biden’s address last week, Wisconsin Gov. Tony Evers, a Democrat, outlined a May timeline for the public to become eligible for vaccines. The next morning, Michigan Gov. Gretchen Whitmer, another Democratic ally of Biden, revealed all Michigande­rs 16 or older will be eligible by April 5 – nearly a month before the president’s benchmark. This week,

Connecticu­t Gov. Ned Lamont, a Democrat, and Iowa Gov. Kim Reynolds, a Republican, moved up overall vaccinatio­n eligibilit­y to the same April 5 date.

Biden adopted an early strategy of setting manageable expectatio­ns in the fight against COVID- 19, notching political victories as he expands on the vaccine production effort set in motion by his predecesso­r.

The president initially pointed to the end of July as when vaccines would be available for all Americans, before moving that timeline up to May. Biden said Thursday the USA is on track to meet his goal of 100 million shots in his first 100 days on Friday

“I’m glad to see that several states are already taking that step to make more and more Americans eligible even before May 1,” Biden said. “Next week, I’ll announce our next goal to put shots in arms.”

The May directive is aimed at empowering states as the Biden administra­tion builds a national strategy absent from President Donald Trump’s approach to the pandemic while striking a balance between federal and state tensions, according to Patel.

“It’s accomplish­ing what we want, which is to open up eligibilit­y way beforehand without the federal government coming in and overtaking state efforts already underway,” she said.

Trump largely relied on states to procure their own testing materials and other critical equipment as COVID- 19 tore through the country last year, which resulted in shortages and some states pitted against each other in bidding wars. Both Democratic and Republican governors complained of the “backup role” Trump said the federal government was playing.

Biden came to office on the promise of nationaliz­ing the response but has faced pushback as some Republican governors defied his guidance on fighting the spread of the coronaviru­s. Texas’ Gov. Greg Abbott ended a statewide mask mandate this month, allowing businesses to operate again at 100% capacity.

‘ A strong signal to states’

This week, Texas opened vaccine eligibilit­y to anyone at least 50 years old, putting the state on pace to meet Abbott’s stated goal of making shots available to anyone who wants a vaccine by spring.

Abbott’s press secretary, Renae Eze, pointed to two factors that have hindered more progress: “a limited vaccine supply and outdated population data from the federal government.”

She said Texas’ weekly allocation of vaccines is smaller relative to other states because the federal government relies on data that doesn’t take into account Texas’ massive growth.

Joshua Sharfstein, a former U. S. Food and Drug Administra­tion commission­er and a professor at Johns Hopkins University, said Biden’s executive order is less about setting a target and more about sending a message to states to prepare for an influx of supply.

State officials have viewed the vaccine rollout with a “week- to- week mentality” as early distributi­on was hampered by logistical hurdles, inconsiste­ncy in data, supply shortages and weather delays, Sharfstein pointed out.

“Now there are really no excuses,” Sharfstein said. “This is a way to get the country moving, and this was a clear statement from the federal government that the vaccine supply is going to be there.”

Kristina Box, Indiana’s state health commission­er in Republican Gov. Eric Holcomb’s administra­tion, called the latest directive a “reasonable goal” during a panel discussion Tuesday at the Forum at Harvard T. H. Chan School of Public Health.

“Hopefully by May, if we truly receive that much vaccine, yes, we can open that up and and allow Hoosiers ( Indiana residents) to decide if they’re ready to be vaccinated,” she said.

States brace for a boost in supply

In a weekly call with governors Tuesday, White House COVID- 19 response coordinato­r Jeff Zients told states to expect to receive more vaccine doses during the first week in April, when Johnson & Johnson anticipate­s a dramatic boost in its doses, according to Democratic Gov. John Carney of Delaware.

The Johnson & Johnson shot is the only one of three vaccines authorized for use in the USA that does not require a follow- up appointmen­t for a second dose, meaning more Americans will be fully vaccinated sooner.

“That allotment will be considerab­ly more than what we’ve been getting, and it will stay at that level for the weeks after that,” Carney said. “So we need to be prepared ourselves to move those vaccines in people’s’ arms.”

Delaware, Biden’s home state, made vaccines available Wednesday to Delawarean­s 50 years or older. Nearly 332,000 people in Delaware, 20% of its population, have received at least one vaccine. Carney said the state is on its way toward meeting the May 1 directive.

The USA averaged 2.4 million daily vaccinatio­ns over the past seven days, according to Andy Slavitt, a White House senior adviser on COVID- 19 response, up from 2.2 million the week before. Nearly 30% of all adults and two- thirds of seniors 65 or older have received at least least one vaccinatio­n shot, according to the Centers for Disease Control and Prevention.

More than 16 million doses, a record allotment, are being distribute­d to states this week, the White House said, totaling 22 million doses including vaccines sent to pharmacies and health centers. Most of the doses are from Moderna and Pfizer. The Johnson & Johnson allotment is likely to add 4 million to 6 million next week.

Biden’s directive doesn’t mean states must ensure all adults are vaccinated by May, but people can at least sign up by then.

“We anticipate having enough vaccine to be able to open up before May 1. That would be my goal,” Florida Gov. Ron DeSantis, a Republican, said last Friday at a retirement community in Port Orange. He lauded his state’s progress vaccinatin­g its large population, asking residents on hand to raise their hands if they’d gotten a shot.

“See, most of them have had it,” DeSantis said. He said he expects the state to make vaccines available to residents 55 and older in March before expanding to all adults in April.

States have generally made vaccinatio­ns available to citizens in tiers beginning with front- line workers, seniors 65 or older and teachers before moving to adults younger than 65 with health conditions before expanding to the general population.

 ?? MARK LENNIHAN/ AP ?? Connecticu­t Gov. Ned Lamont, left, says that by April 5, everyone in the state will have vaccine and appointmen­ts available to them.
MARK LENNIHAN/ AP Connecticu­t Gov. Ned Lamont, left, says that by April 5, everyone in the state will have vaccine and appointmen­ts available to them.

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