- Nov 4, 2020
President Joe Biden and his top advisers have derided the Trump administration’s playbook for distributing coronavirus vaccines, but so far have made only modest changes to the plan that’s meeting their target pace of more than one million shots a day.
Biden has said vaccine distribution was in “worse shape than we anticipated.” White House Chief of Staff Ron Klain said a Trump administration plan “did not really exist.” Adviser Cedric Richmond said they “didn’t leave a plan.” Xavier Becerra, Biden’s choice for health secretary, said it was like taking over a plane in a nosedive.
But while Biden’s approach to the virus -- frank warnings about the pandemic, mask mandates on federal property -- is a reversal from Trump’s policies, his administration’s distribution of vaccines so far looks little different from that of its predecessor. Before Biden was sworn in, vaccines already were being delivered at a pace to meet his goal of 100 million doses in his first 100 days as president.
The new administration has said they’ll order new doses, but will do so by exercising options in contracts negotiated by the previous administration, which thought it premature to do so. They say they’ll use the Defense Production Act, which Trump used repeatedly. Rather than a total overhaul, they have otherwise made course corrections and modest shifts.
Biden’s ability to sharply change direction is inherently limited. The sheer magnitude of the distribution efforts would make any major changes costly and risk backsliding, even if temporarily. Some aspects of the program don’t offer much wiggle room to begin with, while the trickiest parts are yet to come -- and entirely on Biden’s shoulders.
Any efforts by Biden to shape the program also were undercut by Trump, who delayed the transition as he disputed the results of the election and refused to concede. Trump’s team said more than 300 transition briefings were held with health officials, though Biden officials have said the information exchange was limited until just days before the inauguration.
Partisan RhetoricSome officials who led Trump’s efforts have objected to what they see as partisan sniping from Biden’s team, warning that it’s hurting morale among career staff who are working on the vaccine rollout.
“The transition is happening less well than I, and my team, had been hoping,” said Moncef Slaoui, chief scientific adviser to Operation Warp Speed, the joint effort between the Department of Health and Human Services and the Department of Defense to develop and distribute vaccines in record time. Biden’s team dropped the name, in hopes of boosting confidence in the shots, and forced out Slaoui.
“The team doesn’t understand why the Operation is being criticized as it is. It is so unfair and unjustified,” Slaoui said. “If it wasn’t for this Operation, we may not have as many vaccines as we will now.”
“We certainly are not starting from scratch,” Fauci said last week. “It’s taking what’s gone on, but amplifying it in a big way.” Biden, too, has given credit to scientists and the Trump administration for getting the vaccine program off the ground. “And that credit is absolutely due,” he said.
Biden’s ApproachThere are differences. Biden is endorsing federally run community vaccination centers and mobile clinics, and is aiming to provide states with a three-week supply preview. They have moved to boost the number of people available to administer it, although Trump officials said the shortage is in vaccines, not vaccinators. Biden has pledged to let science lead the way and made briefings public, in stark contrast to Trump, who sidelined health advisers in favor of those who reinforced his own view.
Biden has also pressed to address equity -- saying that communities of color have been disproportionately hurt by the virus and can’t be left out in the response. Vaccinations could get more complicated as months stretch on, supply grows and the easier groups to access -- including health care workers and long-term care residents -- are fully vaccinated.
But the biggest pieces of the distribution effort remain unchanged, undercutting claims from some Biden advisers that they inherited no plan. Many of the most stubborn bottlenecks don’t stem from the federal government’s decisions: Companies simply can’t produce vaccines fast enough and supplies are scarce; even if distribution goes smoothly, the administration of doses gets backed up at the local level.
“What we’re seeing here is them marching through the playbook of Operation Warp Speed,” added Michael Pratt, a former Health and Human Services official under Trump. “Something cannot simultaneously be a dismal failure and have already accomplished the ‘ambitious goal’ you set.”
Nearly every industrialized nation has been beset by vaccine delays. The European Union has moved to restrict vaccine exports. The U.S. has administered 8.3 doses per 100 people, trailing the U.K. and Israel yet outpacing Germany, Canada, France and the EU overall, according to Bloomberg’s Vaccine Tracker.
The war of words has ramped up since inauguration day. Slaoui said he’d been told by the Biden administration that he would remain as a consultant, only to later read in news reports that he had been asked to resign. He said he asked Zients about the reports and was told that he should resign.
“I accepted to do it that way at their request,” Slaoui said in an interview. “There’s two ways to look good, you either look good because you do great things, or you look good because you make others look bad. I hope that the new administration doesn’t get into that game.”
Biden has kept other key Trump personnel in place, including General Gustave Perna, who co-lead Operation Warp Speed alongside Slaoui, focusing on distribution.
Biden has bristled at questions about whether 100 million doses in 100 days -- a target he set before vaccinations began -- is too modest a goal. The U.S. reported more than one million daily doses for the first time on Jan. 13, and the rolling daily average topped one million on Jan. 23, Biden’s third full day in office. Two days later, Biden revised his goal, saying he thinks 1.5 million daily doses was achievable in the first 100 days. The U.S. has only so far hit that mark once: inauguration day.
“It is really incorrect to say there was no plan -- because we’re already achieving 1.3 million doses in arms per day, which exceeds the first goal President Biden had,” said Brett Giroir, who led the previous administration’s efforts to ramp up testing.
A key unknown remains. Late-stage efficacy data from Johnson & Johnson is expected any day now for its single-dose vaccine that’s more easily stored, and is expected to be quickly brought to market without the missed delivery timelines of the Pfizer Inc.-BioNTech SE shots. If the J&J vaccine is authorized, Biden’s team could quickly hit 2 million total doses a day, a former Trump official said.
Biden on Tuesday announced the U.S. would exercise options for an additional 100 million doses each from Pfizer and Moderna Inc., a move that puzzled Trump officials. The doses will cost roughly $3.6 billion and won’t be ready until summer. “I would have waited to see what the J&J vaccine does before talking about deals for additional doses,” Slaoui said.
Biden said that doesn’t bother him. “I hope you’re all asking me by the end of the summer that: You have too much vaccine left over. You have too much equipment left over. That’s not my worry,” he said this week. “I hope that becomes the problem”
Biden announced that shipments to states would rise for the next three weeks -- to 10 million doses from about 8.6 million. The administration hasn’t said where the extra doses are coming from, but Trump officials said Moderna had been scheduled to bring more production online under agreements made before Biden took office.
One pillar of the Biden response is use of the Defense Production Act to prioritize certain materials and supplies. Trump’s administration used it regularly, but there’s always a tradeoff -- pushing something to the front of the line can displace other crucial production. Biden administration officials have declined to detail how they’re using DPA.
Slaoui said the DPA was used 18 times to support vaccine manufacturing. “There’s nothing new about that,” he said.