Federal officials expect 100 million Americans to be fully immunized from COVID-19 by the end of March, authorities said Monday, noting that they are on track to have the capacity to immunize every American by mid-2021.
The federal government, in partnership with distributor McKesson, FedEx and UPS, started delivering its first tranche of Pfizer and BioNTech's COVID-19 vaccine Monday. They plan to send 2.9 million doses to 636 sites across the country by Wednesday, with enough vaccine saved so that each person who gets the first dose can get a second shot three weeks later, HHS Secretary Alex Azar said during a news conference Monday.
"Pending the successful authorization of other vaccine options, we have enough vaccines already purchased to ensure we can meet our goal of vaccinating every American who wants it by the end of the second quarter of 2021," Azar said, adding that the federal government plans to purchase another 100 million doses of Moderna's vaccine—set for emergency use authorization this week—to be delivered in the second quarter.
Allocations are based on each state's adult population. Generally, first doses will be used to immunize front-line healthcare workers along with residents at long-term care facilities, as recommended by the Centers for Disease Control and Prevention. But there won't be enough doses initially for all the people in the CDC's highest tier, and state officials will be left to decide who gets a vaccine first.
The CDC set aside another $140 million Monday to help states' distribution efforts, Azar said, adding that Operation Warp Speed is paying for the vaccines, the ancillary supplies like needles and syringes, and the distributing of the vaccines to jurisdictions. Americans will not face out-of-pocket expenses since insurers will cover cost to administer the vaccine, he said.
"We face very challenging trends around the country as the virus continues to spread, with hospitalizations and deaths near or at record highs in many places and still rising," Azar said. "But today we have hope on the way."
Nursing home, assisted-living and other long-term care residents make up about 40% of the COVID-19 death toll in the U.S. Meanwhile, hospitals are facing shortages of beds and staff to treat the latest surge of COVID-19 patients.
The CDC, states and national pharmacy chains have created a distribution plan to inoculate long-term care residents and staff, with four states prepared to start implementing and scaling that plan this week, officials said.
"We know on Monday, a week from today, over 1,100 long-term care facilities and nursing homes will also begin vaccination," Gen. Gustave Perna, Operation Warp Speed chief operating officer, said during the news conference, adding that they plan to reach more than 70,000 long-term care facilities across the country.
But there are hurdles, Perna said. There has to be locations in these facilities to administer the vaccines, patients need signed consent, the right number of doses need to be on hand to minimize reentry and staff need to be inoculated at the same time, he said.
The government has set aside 500,000 doses in case any obstacles arise, Perna said, adding that they haven't had to dip into that reserve yet. Those issues can range from not spelling an address correctly to natural disasters or transportation accidents, he said.
The Pfizer vaccine needs to be shipped and stored in minus 70 degrees Celsius temperatures, which could present some logistical issues in some ambulatory facilities that administer vaccines, experts said. Another issue is that the Pfizer vaccine ships in 975-dose packages, Azar said during the conference.
While the Moderna vaccine doesn't have the same cold-chain requirements and comes in smaller sizes, it also requires two doses for max efficacy. Providers will have to stock more, maintain inventory for a longer period of time and create a system to track who got doses when, experts said.
Aside from operational obstacles, many Americans are hesitant to take a vaccine.
About half of Americans wanted to get the vaccine as soon as possible, according to a recent survey from the Associated Press-NORC Center for Public Affairs Research. Another quarter were unsure and the remaining respondents were not interested.
"The data demonstrate the efficacy and the safety of the vaccines. It's very important that we increase the number of Americans that accept to be vaccinated based on facts and data and reality because vaccines on the shelf are useless," said Dr. Moncef Slaoui, chief adviser to Operation Warp Speed. "And unless a large majority of us gets vaccinated, we will not be able to control this pandemic."