While the US has undergone a dramatic shift in terms of COVID-19 policy with the Biden administration, substantial flaws in the previous administration’s plans for mass vaccination have hindered the country’s speed in distributing the vaccine. 

The lack of vaccine infrastructure in order to efficiently vaccinate the general public, easy access to signing up for the vaccine (especially for senior citizens), and wide disparities in terms of the communities that are receiving the vaccine meant that the vaccine rollout was shaky at its start, though it has considerably improved over the past month. 

Though President Biden has pledged to vaccinate 100 million Americans during the first 100 days of his presidency, federal officials believe that a million shots a day would not suffice to vaccinate the entire US population quickly enough, and have suggested two million would be the appropriate goal to aim for. The good news, however, is that the daily vaccination rate has surpassed two million shots during the past three weeks. In total, the US has distributed about 148 million vaccine doses and administered about 113 million of those doses (CDC COVID Data Tracker). 

However, though experts have praised the uptick in vaccinations in recent weeks, they have also stated that vaccination capacity is not as high as it should be. Indeed, many have warned that being complacent now could mean widespread infections with the COVID variants, which are expected to peak during the spring, similar to the pandemic’s first wave during the spring of 2020. Administering the vaccine to as many people as possible in the next months will be critical in tamping down the spread of new strains of the virus, which have been found to be far more contagious than the original.

To make matters worse, Republican-led states have recently begun to quickly rescind important public health measures. In states like Florida and Texas, mask mandates at the county and state levels were lifted over the past month and people, leading to concerns about COVID cases rising in such states. 

An executive order signed by Texas governor Greg Abbott stated that “no person may be required by any jurisdiction to wear or to mandate the wearing of a face covering”, but “businesses may require employees or customers to wear masks”. Governors like Abbott and Florida’s governor Ron DeSantis have cited a decline in the number of people testing positive for COVID, but many federal and local health officials have still urged people to keep wearing masks as more contagious variants of the virus surge.

In an interview with ABC’s Good Morning America, Dr. Anthony Fauci, the nation’s leading infectious disease expert, called Florida’s full reopening of bars and restaurants “very concerning,” fearing it will spark more coronavirus outbreaks.

In addition, the nature of the vaccine has served to cause delays in the vaccine rollout. The two vaccines currently being administered, Pfizer and Moderna, both require their vaccines to be stored at sub-zero temperatures (-20℃/-4℉) on average), and as such, need to be transported in massive refrigerators. Furthermore, the two-shot nature of the vaccines necessitates reserving large chunks of the vaccine supply for those who have received one dose of the vaccine, which has led to logistical problems for many hospitals, though systems have put in place after an initial confusion. 

There may be some welcoming news to confront the vaccination challenge: the FDA recently announced that the Johnson and Johnson (J&J) vaccine has been approved to be used in hospitals around the country. The J&J vaccine will not need to be stored at frigid temperatures, reducing a demanding constraint on the other two vaccines, and will also be administered in one shot rather than two. Health officials have suggested that the J&J vaccine will be well-suited to deliver shots to American citizens in remote/rural areas.

The Biden administration has also sought to provide relief for hospitals by providing funding to expand vaccination centers to include stadiums, pharmacies, and mobile clinics. The president has also moved to use federal disaster relief funds (from agencies like FEMA) to help out states and local communities to handle vaccination costs. Biden has also invoked the Defense Production Act in order to ramp up production of necessary materials for vaccination, like syringes, needles, etc. The stimulus bill recently passed in Congress has allocated $350 billion in order to help hospitals and local governments, which have received deep budget cuts over the past few years, with vaccine distribution, coronavirus testing, contact tracing, and genomic sequencing.

However, health officials have said that the US is already close to peak manufacturing capacity and that the federal government has already locked in and purchased as many doses that can be reasonably manufactured in such a short timeframe. From late spring to summer, though, Pfizer has promised to increase their global production target for 2021 to two billion doses from 1.3 billion doses. Pfizer also recently reported that efficient syringes could be used to extract a sixth dose from its vials, which could greatly help boost the vaccination rate over the next few months. President Biden also stated recently in an Address to the Nation that there will be enough vaccine for every American adult by the beginning of May and that the general public can expect some degree of normalcy by July 4.

Northwest Community Hospital (NCH) directors of pharmacy, Mital Desai and Jason Alonzo, shared some hospital data as well as their thoughts on some of the vaccination challenges the US is experiencing as a whole in the context of our local communities.     

Alonzo began by discussing some data of vaccinations administered by NCH. 

“So far, we’ve given around 4,500 first doses. 2200 other people have received both doses, so about 6700 people in total have received at least one. We’re also feeling better because we received an unexpected boost with the extra Pfizer dose,” Alonzo said. 

Alonzo also mentioned that healthcare workers at NCH, physicians, EMS workers (in the fire department), healthcare workers unaffiliated with the hospital, and local dentists/hospital administration staff at smaller practices have all begun to receive the vaccine.  

Desi and Alonzo also discussed the COVID variants and their potential to affect the hospital’s operations.

“So we personally haven’t experienced the variants, but we just heard Northwestern did, so it is definitely circulating in our community,” Desai said. “We do anticipate that it’s already here. We aren’t actively running any assays in order to sequence the variant, which is usually a Northwestern task.”

“In all of the variants, the vaccine has produced some quality of response. During testing, we saw that the vaccine wasn’t as robust in treating the virus, but it still is effective,” Alonzo said.

Finally, the pharmacy managers addressed vaccine hesitancy, and while they are both hopeful in resolving this issue, it still remains a major obstacle in achieving herd immunity in the community as well as in the US overall. 

“I’ve met with many people and talked with them about their fears. In general, there needs to be a lot of work done nationally and locally in addressing vaccine hesitancy. Even though I feel comfortable with the vaccine, not everybody gets their information about the vaccine from credible sources. So hopefully, we can get more and more people to talk to their physicians about any concerns they have about the vaccine,” Alonzo said.

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