Last December, people across the globe watched with hope as American nurses and doctors received their first COVID-19 vaccine doses — only to see our country fall flat on its face as the rollout stalled despite the U.S.’ place as an epicenter of international vaccine development. Now that President Joe Biden has taken office, vowing to “listen to the scientists” and “shut down the virus,” things must have turned around, right? Not so fast — while the federal government’s leadership has undoubtedly improved, the Biden administration's goals for vaccination are relatively tame, at least according to many health experts. Under former President Donald Trump, the federal government falsely promised a near-miraculous rollout of the vaccine. We now face the opposite problem — the Biden administration is underselling the vaccine. It’s time to ramp up expectations and engage in a full bore campaign to get doses into arms as fast as the vaccines are manufactured.
The administration’s hesitancy is perhaps understandable, for both political and practical reasons. By under-promising and over-delivering, Biden could get a shot of political popularity if the vaccine arrives sooner than the public expects. The Trump administration’s failures show that false hype and over-promising can cause tremendous damage. Under Trump’s leadership, state and local governments were left with little guidance on how to coordinate mass vaccination, while total production numbers fell far short of lofty expectations. As late as December, Alex Azar ’88, the former Health and Human Services secretary, was claiming that 20 million people would be vaccinated by the end of 2020. The actual figure? Only about a seventh of that target. These failures were a national disgrace, but that doesn’t mean we need to permanently lower expectations or aim below what’s achievable. Just as overselling the vaccine damages public trust, setting underwhelming goals neglects the urgency for people to get vaccinated as soon as possible. Public health leaders are sounding the alarm, worrying again about lack of planning for faster vaccination, even as manufacturing finally begins to ramp up.
A quick look at the numbers reveals just how pitiful some of Biden’s goals are. The administration has pledged to reach for 1.5 million doses a day (a number raised after many criticized their one million vaccines per day target as too conservative). But despite the administration framing their current target as ambitious, the U.S. has actually exceeded 1.5 million vaccines in the daily rolling average since Feb. 10, starting before some of Biden’s biggest measures to support vaccination were even implemented. We’ve already hit the administration’s loftiest expectations without much effort. So when is the new target coming? Unfortunately, the administration has shown no clear signs of adjusting its numbers.
In addition, the administration has taken a conservative line on vaccine rollout timing, with Biden talking about an end of July goal post for full public availability. Meanwhile, Biden’s chief medical adviser Dr. Anthony Fauci took to the interview circuit these past few days, clarifying that full public availability is likely to start in mid-May. So why the discrepancy? Biden’s end of July goalpost marks the time when 660 millions doses (enough for everyone in the U.S. to receive two doses) will have been manufactured. But not everyone will rush to get vaccines as soon as they’re available, and the public needs to start booking their appointments in advance so states can manage demand — full eligibility will open up before every single dose is manufactured. So, the talk of “end of July'' for general availability is confusing at best, and could cause public misunderstanding when vaccine access begins to increase well before July.
What would a more ambitious campaign look like? The national message should be clear: The public should begin signing up for vaccines as quickly as possible, beginning in May, or early June at the latest. In terms of numbers, many public health experts say the daily vaccination goal should be around twice the current level, or about three million shots per day by April and increasing beyond. That’s where production levels are heading; and in fact, they might hit close to five million doses per day by the end of June, as Johnson and Johnson — whose vaccine candidate will likely soon be approved for use in the U.S. — also ramps up production.
The goal needs to be to get people shots as fast as we can make them. As the initial rollout debacle illustrates, we need to start planning in advance to actually make use of the available supply — every day we keep the goal at 1.5 million is another day wasted, when the Biden administration could be rallying states and marshalling federal resources for a far more ambitious target. It’s the United States’ duty to its citizens to get doses into arms as soon as they’re made — vaccines sitting around in cold storage will not do anyone any good. We also should hope to vaccinate as quickly as possible so our extra unused doses can be donated to global vaccination programs such as the World Health Organization’s COVID-19 Vaccines Global Access initiative. It’s in our direct interest to stamp out global spread of the virus, both morally and for the practical reason of avoiding further mutations and potential new variants of the virus.
So, Joe — now is not the time to hedge bets or deliberately lower expectations. The message must be: “Vaccines will save the lives of you, your family and your community — and we aim to open up availability to the public by mid-May.” The powers of the federal government are truly astounding. The government can more aggressively use the Defense Production Act to boost the supply of items like vaccine vials, provide funding for state vaccination programs and launch campaigns to convince the public to get their shots. Just yesterday, Biden held a powerful vigil to eulogize the 500,000 Americans lost to COVID-19, calling on the country to “remember each person and the life they lived.” How better a way to honor their memory than by moving as quickly as possible to vaccinate this country — so that one day, no more lives must be added to the grim toll?
