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US Pivots, Distributing Vaccine According to Demand — Not Population

Vaccine
US President Joe Biden. Credit: White House

The White House announced on Tuesday that it would henceforth redistribute coronavirus vaccines not according to population but according to demand, marking a seismic shift in how the precious doses are allocated to each state.

The move comes as officials realized some states were not ordering all the vaccines to which they were entitled, while other states received less than they desired and could use.

From this point onward, the unordered vaccines will be added back into a federal pool of vaccines so that they will be available to states whose residents are still very much interested in receiving the inoculations.

Pfizer expects vaccine to be available to 12-15 year olds soon

At the same time, Pharma giant Pfizer announced that it expects its own vaccine to be approved by the Food and Drug Administration for use in 12 to 15 year olds very soon. The vaccine is currently being tested in children as young as six months to 11 years.

Tuesday’s announcement is the most meaningful shift in domestic vaccine distribution since the Biden administration came into power.

There is a lack of demand currently in states such as West Virginia, which initially had one of the highest rates of inoculation in the country.

President Biden addressed governors across the nation on Tuesday, announcing his ambitious new goal of giving at least one inoculation to 70% of American adults by July 4, Independence Day — representing another 40 million more people who would have to receive their shot in the next two months.

Biden’s attempt to create herd immunity, a level of vaccination nationwide that would result in a dropping of cases, is patterned after vaccination efforts in Britain and Israel, where infection rates are still decreasing after ambitious inoculation campaigns.

“You do need to get vaccinated,” he stated from the White House, “Even if your chance of getting seriously ill is low, why take the risk? It could save your life or the life of someone you love.”

South still more vaccine hesitant than other areas

But a thorn in the side of the national Centers for Disease Control and state authorities alike is the vaccine hesitancy seen in pockets of the country, enhanced recently by the temporary pausing of the Johnson & Johnson vaccine.

David Kimberlin, a pediatric infectious-disease specialist at the University of Alabama at Birmingham, told the Washington Post “The sooner we get the most people vaccinated not only in our local regions, but around the country, the sooner we will have fewer variants developing and less spread in general.

“Now that there are places saying, ‘Our freezers are full, so please don’t send any more,’ there needs to be an ability to reallocate.”

The ambitious goal means that 160 million Americans would then be fully vaccinated.

As usual, each state will continue to be able to order as many doses as it can according to its population. But the new tweak to the system means that they will no longer be allowed to carry over their unordered doses from week to week, tying up doses that may be used elsewhere where the demand is higher.

Federal Vaccine bank will hold pool of unordered doses

A federal “vaccine bank” will be the repository for the unordered doses, which can then be sent to states who are experiencing a greater demand, allowing them to order 50% more than their normal weekly allocation.

The other states which did not order their entire allotment to which they are entitled can then use their entire share the following week, if there is such a need.

The South has posed a problem in recent weeks, with large amounts of doses going unordered while the vaccine demand remains high in many other areas of the nation.

Arkansas officials declined the state’s entire share of vaccines, according to the Washington Post report. The Republican governor of the state, Asa Hutchinson, told the press that he was in favor of the changes, saying that the doses that had been earmarked for Arkansas “can be used for the urgent needs across the country, where there’s a higher acceptance rate, where there’s a higher demand.”

He admitted that in refusing the precious commodity, he might send a signal to those who are hesitant over taking the vaccine, adding “Maybe that’s a motivator — that if we don’t use the vaccines that are available to us here in Arkansas, then those vaccines might go to Massachusetts, because there’s a higher acceptance rate there,”

Vaccines now given out to all age groups, many on walk-in basis

In a press briefing, he stated flatly “We have to increase our demand for it.”

States are pivoting yet again while many of those who were most eager to receive the vaccine have already done so, and those who are more hesitant remain on the sidelines.

The once lightning-fast pace of inoculations has now slowed, complicated by the recent pausing of the Johnson & Johnson vaccine by the FDA, although the use of the inoculation was resumed after just ten days.

States are beginning to offer the vaccine on a walk-in basis and in mobile units scattered across rural areas of the country.

The weekly average of vaccinations dropped fully 17 percent during the past week, according to data which was gathered and analyzed by The Washington Post — and it has fallen by 33 percent since April 13.

Jeff Zients, the coordinator of the White House coronavirus task force, expressed his satisfaction regarding how quickly the government has been able to get the shots out to those who want them and who are willing to travel to do so.

On May 5, more than 80% of Americans over the age of 65 have now received at least one dose.

“We can better use those doses”

Now, faced with these recent challenges, Zients admits that the country needs to pivot yet again to reach those who are hesitant, saying “there is a need to add more flexibility to the current system.”

In Biden’s speech before the press on Tuesday, he was careful to explain that the states whose residents had shown an unwillingness to accept the vaccine will not be penalized in any way and that they may increase the amount they order the very next week if the need arises.

Reordering the vaccine distribution system “accomplishes what we all want to accomplish,” according to New York Gov. Andrew M. Cuomo (D), the chairman of the National Governors Association.

Cuomo made his remarks during Tuesday’s White House call with governors, according to the Post. “You have state control of your allocation. If a state isn’t using it, then a state that can use it has access to it, which makes a lot of sense to all of us, I think,” he explained.

“I just think we can better use those doses,” Delaware Gov. John Carney (D) stated in the conference call, saying it would be a part of his state’s efforts to provide access to immunization by “intentionally doing that kind of outreach.”

Up to now, throughout the duration of the vaccination process, which began in December of 2020, the White House has adhering closely to the formula based on each state’s population. This even held true despite a fervent appeal from Michigan Governor Gretchen Whitmer (D) to expedite all possible vaccine shipments to her state as it faced a gigantic spike in cases in March and April.

Population-only metric now tossed aside for greater flexibility

Former President Trump had even instituted a reward system of sorts by which states would be rewarded for using up their vaccine doses quickly and efficiently.

However, that tactic was done away with at the time of the incoming administration on January 20, with Biden adopting a population-only metric for division of precious vaccine supplies.

The numbers of doses apportioned to each state even held true as the federal government began its own approach to vaccinations by shunting many thousands of doses to retail pharmacies such as Walgreens and Walmart as well as community health centers and federally-run vaccination centers.

Such pharmacies will now have more doses to distribute where the demand is greater since prior to Tuesday’s decision, 80% of a pharmacy’s vaccine supply had been tied to the population of the state it is in, but now pharmacies will be able to have discretion over as much as 49% of their doses regarding where they are sent.

He added that the FDA may authorize the Baltimore plant which once produced the Johnson & Johnson vaccine before it was shut down for safety violations in a “matter of a week or two.”

This would make possible a significant increase in the number of the one-shot vaccines that would be available in the United States.

The single shot inoculation has always occupied a central place in vaccination campaigns since it does to require the ultra cold temperatures that both the Pfizer and Moderna shots require and it is attractive to those who find making two appointments for shots difficult.

In addition, it has featured in mobile vaccination mobiles that travel to remote areas of the country, which have proved popular with many, even being used in situations where there are no appointments needed and patients can walk up, receive one dose and be done with the entire process.

US Secretary of State Antony Blinken addressed the disturbing spike in infection rates in India, issuing a statement on Wednesday regarding the dire coronavirus situation, saying “The United States continues to deliver on its promise to stand with the people of India amidst the COVID-19 surge.

“Six air shipments funded by the U.S. Agency for International Development have departed the United States, five of which have already landed in India. These flights include health supplies, oxygen and oxygen supplies, N95 masks, rapid diagnostic tests, and medicine. More flights are on the way with the total assistance expected to exceed $100 million.”

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