After Botching Vaccine Roll Out, Trump Implements Chaotic Distribution Changes That Threaten to Undermine State Efforts

Trump Admin Plans to Flood States With Doses Without Providing Material Support for Inoculation

New Plan “Punishes” States That Have Been Slower to Distribute

Guidelines Could Privilege Wealthy and Well-Connected Over Those Most at Risk

As the coronavirus toll in the United States creeps closer to 400,000 lives lost and as the United States reports a new record for daily deaths — reporting more than 4,300 in just 24 hours — Donald Trump continues to make this crisis worse. 

Following a chaotic rollout of the vaccine, the Trump Administration is now implementing a slew of new rules that threaten to undermine state progress on dose distribution. The administration now plans to release all doses of the vaccine, encouraging states to expand access to those over age 65.  But the plan fails to provide states with material support to deal with a surge in demand and to guarantee that vaccines make it into arms. Trump also intends to “punish” states that have been slower to distribute incolutions, without regard for the impact such punishment will have on the most at-risk communities.

Washington Post: Trump Administration Reverses Stance, Will No Longer Hold Back Second Shots Of Coronavirus Vaccine

• The Trump Administration Announced Sweeping Changes To Its Vaccine Roll Out, Including Making All Of The Coronavirus Vaccine Supply Immediately Available.  “The Trump administration announced sweeping changes to its vaccination rollout on Tuesday, including making all of the coronavirus vaccine supply immediately available, urging states to provide shots to anyone 65 and older and warning states with lagging inoculations that they could lose some of their shots to speedier places.” [Washington Post, 1/12/21]
• The Trump Administration Now Plans To Punish States With A Slower Pace Of Innoculations By Redirecting Vaccine Shipments To Those With A Faster Pace. “It is not clear how, or even if, the outgoing administration’s plan to change state allotments of vaccines will play out. Health and Human Services Secretary Alex Azar told reporters in a briefing that in two weeks, the government would begin ‘redirecting’ shots to states based on the size of their 65-and-older population and the pace of their vaccinations. States doing a poor job of getting shots into arms could see their allotments shifted to those performing better, he said, noting that about 10 states might be affected. The current allocation system is based on a state’s population.” [Washington Post, 1/12/21]
  
• The Trump Administration Has Not Addressed How Expanding Access To Priority Age Groups Would Affect Access For Essential Workers. “Neither Azar, nor other Warp Speed leaders, addressed how expanding the priority age groups would affect access to vaccine for front-line essential workers, from grocery store clerks to bus drivers, who had been in the next group prioritized for vaccination in many state plans. Azar noted that some states, such as Florida and Texas, already are vaccinating those 65 and older, and called it a faster way to protect many of the most vulnerable.” [Washington Post, 1/12/21]
• State Officials Are Denouncing The Plan To Shift Vaccines From “Slower-Acting” States. “State health officials, meanwhile, denounced the plan to move vaccine from slower-acting states as punitive. ‘It is too early to begin to judge how well states are administering this, and a punitive approach isn’t going to help us reach our goal of vaccinating the entire population as safely and quickly as possible,’ said Michael Fraser, who heads the Association of State and Territorial Health Officials.”  [Washington Post, 1/12/21]
• The New Plan Sharply Increases The Eligible Population To 184 Million, Intensifying Demand On Stressed Sign-Up Systems. “The administration’s call to states to broaden access to those 65 and older and those under 64 with high-risk medical conditions sharply increases the potential number of people seeking shots to about 184 million, intensifying demand on already stressed sign-up systems. Under the original CDC recommendations, about 74 million people are in the first priority groups for vaccination: health-care workers; staff and residents of long-term care facilities; front-line essential workers; and adults 75 and older.”  [Washington Post, 1/12/21]
• The Biden Administration Is Concerned That The Immediate Widening Of The Vaccine Pool Could Overwhelm States And Create Unrealistic Expectations. “[Biden’s] advisers said they are awaiting more details [of the plan] but would look unfavorably on a plan that ‘punishes states,’ said two transition officials who spoke on the condition of anonymity because they were not authorized to discuss the plan. They also expressed concern that the immediate widening of the vaccine pool could overwhelm states and create unrealistic expectations for millions of Americans waiting for shots.” [Washington Post, 1/12/21]

Politico: Trump’s Abrupt Shift On Covid Shots May Sow More Chaos

• After Leaving States In Disarray, The Trump Administration Plans To “Punish” States That Don’t Administer Vaccines Quickly Enough And Urges Them To Immediately Vaccinae Anyone 65 And Older With High-Risk Conditions. “The administration plans to punish states that don’t move fast enough on vaccinations or that fail to provide the government real-time reports on inoculations. Trump officials also urged states to immediately start vaccinating anyone 65 and over or with high-risk medical conditions.” [Politico, 1/12/21]
  
• But The Plan Fails To Address Inequities, Including Low Uptake In Underprivileged Communities That Have Been Hit Hardest By The Pandemic. “[The Administration’s] moves, however, won’t fix the chaos and inequities that have marked the vaccine rollout so far, including low uptake in underprivileged communities hardest hit by the pandemic, public health experts and some officials representing state health departments told POLITICO. And they could put states struggling to vaccinate hard-to-reach communities farther behind.” [Politico, 1/12/21]
• The Trump Administration’s New Plan Tears Up The CDC’s Guidance, And Could Privilege The Wealthy And Well-Connected Over Essential Workers. “The administration’s moves essentially tear up a game plan crafted by Centers for Disease Control advisers that states have used to make decisions. Some public health experts on that committee said they’re concerned the new system could amount to a free-for-all that favors the wealthy and connected and could shut out essential workers, teachers and other groups that were previously in the first tiers.” [Politico, 1/12/21]
  
• Experts Like Kevin Ault Of The University Of Kansas Medical Center Agree That The New Age Criteria Could Allow The Certain People To Skip Ahead. “‘If you open it up and just base it on age criteria, a lot of people who already have access to good health care can skip to the front and leave other people behind,’ said Kevin Ault, a professor at the University of Kansas Medical Center.”  [Politico, 1/12/21]
• Experts Say Flooding The System With More Vaccine Doses Won’t Improve Distribution Unless There Is More Material Support. “Flooding the system with more vaccine alone won’t work without setting up more vaccination sites and providing more material support, experts say. ‘In order for us to efficiently move doses into arms, a strong understanding of how many doses to expect this week, next week, and the following weeks is needed,’ Claire Hannan, the executive director of the Association of Immunization Managers, wrote in an email.”  [Politico, 1/12/21]
• While The Biden Team Has Proposed Similar Changes, It Has Promised To Provide Robust Federal Support To Ensure The Smooth Distribution Of Vaccines. “Biden’s team late last week had suggested getting more shots out to states and expanding the pool of people eligible to be vaccinated. But it stressed that those changes are just one piece of a complicated puzzle and far from an adequate fix. Biden’s team envisions a more robust role for the federal government and clearer guidelines and more material support for states. It also plans to set up federal vaccination sites, send mobile units into hard-hit neighborhoods that lack health infrastructure and launch a massive education campaign to dispel misinformation about vaccines and prod people to take the shot.” [Politico, 1/12/21]
  
• State Leaders Are Concerned That The Trump Administration’s New Rules Will Disincentivize The Work Of Vaccinating At-Risk Groups Like The Homeless. “State leaders say they’re afraid the Trump administration’s new policies will create more disorder. Some health officials also fear that basing states’ vaccine allocation on their distribution speed will create perverse incentives — leading states, for example, to defer the slower work of identifying and vaccinating undocumented workers, the homeless, rural residents and other at risk groups.” [Politico, 1/12/21]
  
• Adriane Casalotti, Chief Of Government And Public Affairs At The National Association Of County And City Health Officials: “The Harder To Reach Populations Are In So Many Ways The Most Important To Reach Populations.” “‘The harder to reach populations are in so many ways the most important to reach populations, but that wouldn’t show up on the balance sheet of how fast you’re doing this,’ warned Adriane Casalotti, chief of government and public affairs at the National Association of County and City Health Officials. ‘The more people we get vaccinated the faster we get to herd immunity, but if we’re doing that while we’re perpetuating disparities — getting all the easy folks and leaving the harder folks for later — that’s not a just way to go.’” [Politico, 1/12/21]
• States Still Lack The Resources To Effectively Deliver Vaccines Safely Or Equitably. “[Adriane] Casalotti and other officials also stressed that even if they receive more shipments of vaccines, states don’t yet have the resources they need to administer them safely or equitably. ‘We are focused on speed but you have to focus on safety too,’ said Marcus Plescia, the chief medical officer of the Association of State and Territorial Health Officials. ‘That means having the staff to monitor people for allergic reactions after they get vaccinated, and also having enough space at the distribution sites for social distancing. The last thing you want is for someone to get Covid when they’re waiting in line to get the vaccine.’” [Politico, 1/12/21]