US says all over 65 should get vac­cine now

Hold for sec­ond doses is no longer needed

- Adri­anna Ro­driguez Health · Medical Activism · Anti-Vaccers · Medicine · U.S. News · Vaccines · Health Care · Alternative Medicine · University of Miami · Philadelphia Union · United States of America · U.S. government · United States Department of Health and Human Services · Pfizer · Moderna Therapeutics · Vanderbilt University · Vanderbilt, Michigan · University School · Tennessee · American Hospital Association · Joe Biden · Johns Hopkins University · Hopkins · Elizabeth · Masimo · Competition · Medical Treatments · Alex Azar · U.S. Centers for Disease Control · Vanderbilt University School of Medicine · Nashville · Nashville, KS · Speed

The U.S. gov­ern­ment an­nounced ma­jor changes to vac­cine dis­tri­bu­tion Tues­day, up­end­ing what’s been stan­dard op­er­at­ing pro­ce­dure for the past four weeks in an at­tempt to speed COVID-19 vac­ci­na­tions and move closer to wide­spread im­mu­nity against the coro­n­avirus.

In a me­dia brief­ing, Health and Hu­man Ser­vices Sec­re­tary Alex Azar asked states to ex­pand vac­ci­na­tions to peo­ple 65 and older, as well as others with co­mor­bidi­ties, pro­vided they have some form of med­i­cal doc­u­men­ta­tion. He said re­stric­tions by states on who is el­i­gi­ble to get the vac­cine “have ob­structed speed and ac­ces­si­bil­ity of ad­min­is­tra­tion.”

“There was never a rea­son that states needed to com­plete vac­ci­nat­ing all health care providers be­fore open­ing vac­ci­na­tions to older Amer­i­cans and other vul­ner­a­ble pop­u­la­tions,” Azar said. “States should not be wait­ing to com­plete 1a pri­or­i­ties be­fore pro­ceed­ing to broader cat­e­gories of el­i­gi­bil­ity.”

Azar also an­nounced the gov­ern­ment will re­lease all avail­able vac­cine to states in­stead of hold­ing back doses for sched­uled sec­ond shots. Fed­eral of­fi­cials had been keep­ing vac­cine in re­serve to guar­an­tee sec­ond doses but Azar said in­creased vac­cine sup­ply and the pace of man­u­fac­tur­ing will en­sure ev­ery­one who gets a first dose will get a sec­ond dose on sched­ule.

Both vac­cines au­tho­rized for use were stud­ied in a two-dose reg­i­men, with the Pfizer-BioNTech doses given 21 days apart and Moderna’s 28 days apart.

“Based on the science and ev­i­dence we have it is im­per­a­tive that peo­ple re­ceive their sec­ond dose on time,” Azar said. “That’s what the science says and ig­nor­ing that would be reck­less.”

U.S. of­fi­cials also are ask­ing states to ex­pand the lo­ca­tions where peo­ple can be vac­ci­nated by adding com­mu­nity health cen­ters, phar­ma­cies and mass vac­ci­na­tion sites.

“Hos­pi­tals made sense as the early dis­tri­bu­tion sites when the fo­cus was on

health care work­ers, but they are not where most Amer­i­cans go to get vac­cines,” Azar said. “States should move on.”

He said the fed­eral gov­ern­ment will de­ploy teams to sup­port states do­ing mass vac­ci­na­tions ef­forts. The gov­ern­ment has part­nered with 19 phar­macy chains and is ready to dis­trib­ute vac­cine to their lo­ca­tions, he added.

Crit­i­ciz­ing some states for “heavy-handed mi­cro­man­age­ment,” Azar also an­nounced a change in dose al­lo­ca­tion.

In­stead of al­lo­cat­ing vac­cines based on the num­ber of adults in each state, the HHS sec­re­tary said states will re­ceive vac­cines based on how quickly shots are ad­min­is­tered, and their num­ber of peo­ple 65 and older.

This new al­lo­ca­tion sys­tem will go into ef­fect in two weeks to give states time to pre­pare, Azar said.

“This new sys­tem gives states a strong in­cen­tive to en­sure that all vac­ci­na­tions are be­ing promptly re­ported, which they’re cur­rently not,” he said. “And it gives states a strong in­cen­tive to en­sure doses are go­ing to work pro­tect­ing peo­ple rather than sit­ting on shelves or in freez­ers.”

So far, the vac­cine roll­out has been pri­mar­ily to health care work­ers and nurs­ing home res­i­dents. Of 27.6 mil­lion doses dis­trib­uted, about 9.3 mil­lion have been ad­min­is­tered as of Mon­day, ac­cord­ing to the Cen­ters for Dis­ease Con­trol and Preven­tion.

Dr. Wil­liam Schaffner, a pro­fes­sor and in­fec­tious dis­ease ex­pert at the Van­der­bilt Uni­ver­sity School of Medicine in Nashville, Ten­nessee, said he was “stunned” by the pri­or­ity list change.

It has al­ways been clear the Cen­ters for Dis­ease Con­trol and Preven­tion’s vac­cine al­lo­ca­tion guide­lines were de­signed to go in phases, he said, a process that was well-de­scribed in nu­mer­ous doc­u­ments, meet­ings and dis­cus­sions.

When there is in­suf­fi­cient vac­cine to pro­vide it for ev­ery­one, a pri­or­i­ti­za­tion sys­tem is nec­es­sary, he said.

“This was called ‘phased’ be­cause they were in­deed to be im­ple­mented se­quen­tially. Not rigidly so, there was al­ways go­ing to be over­lap. But it was a se­quen­tial plan,” Schaffner said.

While the fed­eral gov­ern­ment fo­cused on mak­ing vac­cines and ship­ping them, he said too lit­tle at­ten­tion was paid to com­mu­ni­ca­tion and the sup­port nec­es­sary for states to ac­tu­ally get doses into Amer­i­can arms.

“Un­til very re­cently, the Congress has not al­lo­cated money for the ac­tual de­liv­ery of vac­cines to in­di­vid­u­als, which is of course the most dif­fi­cult and the long­est part of the whole op­er­a­tion,” he said.

Azar said states “have am­ple fund­ing,” but it hasn’t got­ten de­posited into ac­counts yet. Although $8 bil­lion was al­lo­cated for vac­cine dis­tri­bu­tion un­der the COVID-19 re­lief pack­age on Dec. 27, the first pay­ment isn’t ex­pected to get to states for an­other week or so, said Schaffner.

“It will take time for it to be in­cor­po­rated into bud­gets and to hire peo­ple ev­ery state,” he said.

The Amer­i­can Hospi­tal As­so­ci­a­tion es­ti­mates the na­tion would need to vac­ci­nate 1.8 mil­lion peo­ple a day, ev­ery day, from Jan. 1 to May 31, to reach the goal of hav­ing wide­spread im­mu­nity by the sum­mer. That’s also called “herd im­mu­nity” and would in­volve vac­ci­nat­ing at least 75% of the pop­u­la­tion.

Azar said in Tues­day’s brief­ing states were vac­ci­nat­ing at a pace of about 700,000 peo­ple a day, but ex­pected that to in­crease to at least 1 mil­lion peo­ple a day in the next week to 10 days.

The news comes af­ter the in­com­ing Bi­den ad­min­is­tra­tion an­nounced Fri­day it plans to pri­or­i­tize the first dose and re­lease all the avail­able COVID-19 vac­cines. Tran­si­tion of­fi­cials said it didn’t make sense to hold back vac­cines at a time when more Amer­i­cans are dy­ing than at any point in the pan­demic.

As of Tues­day, the U.S. re­ported more than 22 mil­lion cases and 378,000 deaths re­lated to COVID-19, ac­cord­ing to Johns Hop­kins data.

Bi­den is ex­pected to give a speech Thurs­day out­lin­ing his plan to speed vac­cines to more peo­ple in the first part of his ad­min­is­tra­tion. Azar said the in­com­ing ad­min­is­tra­tion will be briefed on Op­er­a­tion Warp Speed strate­gies.

Con­tribut­ing: El­iz­a­beth Weise and Karen Wein­traub, USA TO­DAY; As­so­ci­ated Press. Health and pa­tient safety cov­er­age at USA TO­DAY is made pos­si­ble in part by a grant from the Masimo Foun­da­tion for Ethics, Innovation and Com­pe­ti­tion in Health­care. The Masimo Foun­da­tion does not pro­vide ed­i­to­rial in­put.

 ?? BRONTE WITTPENN/ USA TO­DAY NET­WORK ?? Of the 25.4 mil­lion vac­cine doses dis­trib­uted in the United States, about 8.9 mil­lion have been ad­min­is­tered as of Mon­day, ac­cord­ing to the CDC.
BRONTE WITTPENN/ USA TO­DAY NET­WORK Of the 25.4 mil­lion vac­cine doses dis­trib­uted in the United States, about 8.9 mil­lion have been ad­min­is­tered as of Mon­day, ac­cord­ing to the CDC.

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