HEALTH CARE BRIEFING: Jumbled Strategies Slowing Vaccine Rollout

As the U.S. grapples with record hospitalizations and deaths from the coronavirus pandemic, a crucial vaccination rollout campaign is being slowed by inconsistent messaging and myriad state strategies as a new variant of the virus boosts infection rates, public health experts say.

The missteps have put the total number of vaccinations well behind targets set by the Trump administration’s Operation Warp Speed effort. About 5.46 million doses have been delivered in the U.S. since mid-December, or 32% of those that have been distributed across the nation and well below the Trump administration’s goal of 20 million by the end of 2020, according to data compiled by Bloomberg News.

Vaccination rates have ranged widely across states, with South Dakota using 69% of the doses sent to it and Georgia just 22%, according to Bloomberg’s data. “The next couple of weeks are going to be really critical” in how to get the distribution systems up and going more smoothly, National Institutes of Health Director Francis Collins said in an interview with The Washington Post. “It certainly has had a rocky beginning.”

The American Hospital Association urged Health and Human Services Secretary Alex Azar to make a series of moves to speed vaccinations, such as improving coordination among states, quickly answering questions, and clarifying expectations. The AHA’s member hospitals have reported a number of barriers to vaccination in the first weeks, the group said yesterday.

Months of work anticipating the vaccine rollout have been squandered due to a lack of federal strategy, coordination, and significant gaps in planning. Bloomberg’s reporting shows missed opportunities at every level of government, from a hands-off approach in Washington to local hospitals where harried health-care workers were left trying to make last-minute decisions on vaccines without guidance.

Among the issues that have contributed to the rollout’s jumbled start, according to interviews with state, federal and hospital officials: Reductions in the number of vaccines the states were told they would receive, how many doses would arrive, and when they would arrive; complex logistics of storing and administering the vaccines; lack of uniform messaging and education to encourage vaccination; and other issues.

U.S. health officials have vowed that vaccinations will accelerate in coming weeks, with a more coordinated program to administer vaccines in nursing homes and the holiday season coming to a close. But the earliest days might have been the easiest, as pressure intensifies to identify weaknesses and plug them before vying to vaccinate millions more. Angelica LaVito has more.

• Meanwhile, Eight governors are demanding the federal government start distributing Covid-19 vaccines in reserve immediately. The leaders of California, Illinois, Kansas, Michigan, Minnesota, Washington and Wisconsin called on federal officials to release more doses held by the government to states. “The failure to distribute these doses to states who request them is unconscionable and unacceptable,” the governors said in a letter dated Jan. 8. “We demand that the federal government begin distributing these reserved doses to states immediately.” Read more from Elizabeth Campbell.

The Coronavirus Pandemic

NIH Studying Vaccines’ Effectiveness on New Strains: NIH scientists are studying whether Covid-19 vaccines will provide the same level of protection against new strains of the virus as they do against earlier strains, the agency’s lead scientist on coronavirus said.

At the same time, Kizzmekia S. Corbett, scientific lead for the coronavirus vaccines team at the National Institute of Allergy and Infectious Diseases, said she’s “not as alarmed as the media would have us think” by the emergence of the new strains. Read more from Jeannie Baumann.

• Related: LabCorp Gets CDC Contract to Study Variants of Covid-19 Virus

Biden’s Coronavirus Stimulus Plan: Boosted by Democratic control of Congress, Biden is considering asking lawmakers to help suffering Americans in two steps: give them the balance of their coveted $2,000 coronavirus payments, followed by a $3 trillion tax and infrastructure package, Axios reported last night.

• Sen. Chuck Schumer (D-N.Y.) is set to preside over the narrowest possible majority of the U.S. Senate, a task that will require him to keep his Democratic caucus united while luring Republican support for legislation central to President-elect Joe Biden’s priorities. Given the Senate’s 50-50 partisan divide — once the Democratic victors in Tuesday’s Georgia runoff elections are sworn in — control is only assured by incoming Vice President Kamala Harris’s tie-breaking vote. On most legislation, Schumer will need support from 60 senators to cut off debate and move to a vote, under Senate rules. Democrats will have a limited opportunity each year to fast-track a revenue-related bill to pass with just 51 votes. But even with legislation that requires only a simple majority, Schumer must either keep every Democrat on board or win over offsetting Republican support. Read more from Mike Dorning and Laura Litvan.

Testing Sites for Vulnerable to Run Into April: An additional $550 million funding extension announced yesterday means thousands of Covid-19 testing sites in vulnerable areas will continue to operate into April. The program primarily provides testing sites in areas with “moderate-to-high social vulnerability” according to an announcement from the HHS. The effort began in spring 2020. It is run through retail pharmacy chains like CVS Health, Rite-Aid and Walgreens. Read more from Jacquie Lee and Emma Court.

Deaths May Sustain Near-Record Pace: Covid-19 deaths in the U.S. are poised to maintain a near-record pace at least through the month as mounting hospitalizations offset any positive effect from the halting start to inoculations. The U.S. will finish January averaging about 2,600 deaths a day, according to the latest forecast updated by the Centers for Disease Control and Prevention yesterday, a figure based on projections from 36 different models. Altogether, the U.S. is expected to pass 400,000 deaths around Inauguration Day. Jonathan Levin has more.

More Headlines:

• U.K. Aims to Vaccinate at Least 200,000 People a Day by Jan. 15
• Arthritis Drugs Cut Down Covid-19 Mortality, ICU Time in Study
• China Health Expert Defends Delay in Confirming Covid-19 Threat
• China’s Sinovac Vaccine Proves 78% Effective in Brazilian Trials
• South Africa Virus Strain More Transmissible, Not More Severe

What Else to Know Today

Resignations Continue after Capitol Hill Assault: Several members of the Trump administration have resigned following the violent assault on Capitol Hill Wednesday by pro-Trump supporters. Elinore McCance-Katz, HHS Assistant Secretary for Mental Health and Substance Use, resigned, Politico reported, citing a statement from McCance-Katz, Ben Livesey reports.

HIV Bias Suit Against CVS Tests ACA’s Bounds: Californians with HIV and AIDS are taking on their drug plan middleman in a fight over how they get the medications they need to survive. Their proposed class action against CVS Caremark—green-lighted by a federal appeals court last month—is testing the bounds of the Affordable Care Act’s antidiscrimination protections and could open the door to more litigation against powerful pharmacy benefit managers that control how drug benefit plans operate. Read more from Lydia Wheeler.

More Headlines:

• Path to Health Grants Eased for Religious Groups in HHS Rule
• State Medicaid Programs Urged to Target Non-Medical Needs
• Merus Climbs With FDA Expedited Label for Cancer Treatment

To contact the reporter on this story: Brandon Lee in Washington at blee@bgov.com

To contact the editors responsible for this story: Zachary Sherwood at zsherwood@bgov.com; Giuseppe Macri at gmacri@bgov.com; Michaela Ross at mross@bgov.com