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US COVID-19 vaccine strategy pivots to target those 65 and up - CIDRAP

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Operation Warp Speed announced today a major pivot in the US COVID-19 vaccine strategy, one that will see the release of all current vaccines in the national stockpile and a new effort to vaccinate all those 65 and up as quickly as possible.

The changes bring the total number of doses that have been made available for use in the United States to roughly 38 million.

"We are now at an important juncture in the vaccine program where we're ready for a transition," said Health and Human Services (HHS) Secretary Alex Azar during an Operation Warp Speed press conference today.

Similarities with Biden plan

Azar said governors are called to vaccinate people aged 65 and over, as well as those under age 65 who have a health condition that puts them at risk, and to abandon the "phase 1a" delivery model that said only healthcare workers and those in long-term care should be vaccinated initially.

Supply has outstripped demand in those groups, Azar said, and it was time to make the vaccine more widely available. Azar also said he believed the manufacturing pipeline was secure enough to ensure second doses would be available from ongoing production, and need not be stockpiled.

The new effort closely mirrors the plan President-elect Joe Biden's transition team announced last week. The Biden team is expected to offer more details on its COVID-19 vaccine strategy on Thursday.

Both the Pfizer and Moderna vaccines—the two currently used in the United States—require two doses given 21 to 28 days apart. As recently as last week, the Food and Drug Administration (FDA) said it was not scientifically sound to offer only one dose of the vaccine without guarantee of the second dose. Last week Azar emphasized the FDA's view, and called Biden's proposed plan "untenable."

Currently vaccinators are immunizing 700,000 Americans per day, and Azar said by the end of next week the country will be inoculating 1 million per day.

Azar blame states for slow rollout

"We're telling states now to vaccinate their most vulnerable people," Azar said. "This is the fastest way to protect the vulnerable." Azar also said states needed to open more diverse channels for vaccination.

He said HHS will being allocating doses of vaccine to states based on the pace of vaccine administration and by the size of their 65-plus population The allocation change will take effect 2 weeks from today.

"We're giving states a 2-weeks notice to plan and to improve their data if they think it's faulty," Azar said. "This new system gives states a strong incentive to make sure all vaccinations are promptly reported."

Some states have already started to construct mass vaccine centers in an effort to target large swathes of citizens. In California, Governor Gavin Newsom announced plans to turn Disneyland Dodger Stadium, and Petco Park into vaccination sites. The site at Disneyland is expected to be operational by the end of this week.

Throughout much of Operation Warp Speed's press conference, Azar laid the blame of slow vaccine rollout at the feet of governors, and said states have been too stringent and narrow-minded in their approach to distributing vaccine to citizens.

But according to a new analysis from the Kaiser Family Foundation (KFF), at least 30 states have now expanded their phase 1b recommendations to include adults over 65 and are using modified definitions of essential workers. Other states, in contrast, are adding more complex definitions to the tiered distribution plan.

"A person's place in the COVID-19 vaccine priority line will increasingly depend on where they live," KFF said.

CDC: 10 states have variant cases

Though the Centers for Disease Control and Prevention (CDC) told the Washington Post that no single variant, and no variant native to the United States, is driving the uptick in US virus activity, there are at least 72 cases of variant B117 in 10 states, according to the CDC's website.

Yesterday the US recorded 204,652 new COVID-19 cases, and 1,731 deaths, according to the Johns Hopkins COVID-19 tracker. The US total now stands at 22,775,378 million cases, including 379,444 deaths.

In other news, at least three federal lawmakers have tested positive for COVID-19 after last week's insurrection attempt at the US Capitol. Democratic Rep. Pramila Jaypal of Washington said today that she has tested positive for COVID-19 after being locked down with several Republican lawmakers who refused to wear masks, The Hill reports.

On Twitter, Illinois Democratic Rep. Brad Schneider said he had tested positive, and yesterday, Democratic Rep. Bonnie Watson Coleman of New Jersey said she tested positive for COVID-19.

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US COVID-19 vaccine strategy pivots to target those 65 and up - CIDRAP
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