The federal government announced several changes today that it hopes will improve COVID-19 vaccination rates across the country while at the same time rewarding states that are most aggressive in vaccinating their citizens.
The most controversial change is in how vaccine doses are allocated to states. Currently, vaccines are given to each state based on the total adult population. Starting in two weeks, vaccines will be distributed to states based on the number of over 65-year-olds who live there, and more importantly, by the pace of vaccine administration reported by states.
The changes were announced by Alex Azar, Secretary of HHS in a press briefing. “This new system gives states a strong incentive to ensure doses are going to work, protecting people rather than sitting on shelves or in freezers,” Azar said at the press briefing, “We need doses going to where they’ll be administered quickly and where they’ll protect the most vulnerable.”
Another change is encouraging states to immediately make people 65 and older and those with underlying health conditions eligible to receive vaccines. The administration is also urging states to expand vaccination sites to more locations, such as convention centers, pharmacies, and community health centers.
Finally, administration officials announced they would stop holding second doses of the vaccines in reserve, and instead ship more doses to states right away. This change mirrors a plan the Biden team announced last week. Azar suggested that other factors were involved in their decision.
“Because we now have a consistent pace of production, we can now ship all of the doses that had been held in physical reserve,” Azar said. “We’re now making the full reserve of doses we have available for order, [and] we are 100% committed to ensuring a second dose is available for every American who receives the first dose.”
Some public health experts raised concerns that this rapid expansion to additional patient groups and the changes in allocation method could throw more uncertainty into the mix for states. They also worried about confusion in the public since the eligibility criteria have changed multiple times, and the decision about who is eligible to get a vaccine remains with the states.
The country is currently a labyrinth of different stages of rollout and different policies, says Jen Kates, Director of Global Health & HIV Policy at the Henry J. Kaiser Family Foundation, which released an analysis on the subject this week. “There are already cases where states have decided to vaccinate everyone 65 [and older] but do not have a vaccine to do it or they don’t have vaccinators to do it,” she says.
I won’t argue with the public health folks, but the vaccine program has been so restrictive anything that loosens enrollment criteria should help up take.