Although the COVID-19 vaccine rollout started slow, the U.S. is now administering around 1.6 million doses a day and is one of the leading countries in vaccine distribution. Despite improvements in the process, there are still challenges ahead. New, more infectious strains are increasing the spread of COVID-19 and vaccine hesitancy among the general public has slowed vaccinations. The House Committee on Energy and Commerce will hold a hearing on the status of vaccine distributions on Tuesday, Feb. 23.
This briefing provides background information on the vaccines, an overview of the current status of vaccine distribution and future concerns, and an outline of congressional perspectives and relevant legislation, including:
H.R.349 - Coronavirus Vaccine and Therapeutic Development Act of 2021
H.R.387 - Vaccinate More Americans Act of 2021
H.R.1099 - To Establish a National System for Individuals to Register for COVID-19 Vaccines
S.274 - To Allow States to Provide Medicaid Coverage for Vaccines and COVID-19 Treatments for Uninsured Individuals
This briefing includes:
4 bill summaries
40 additional links
The FDA issued Emergency Use Authorizations (EUA) for two vaccines--the Pfizer-BioNTech COVID-19 Vaccine and the Moderna COVID-19 Vaccine--in December. The companies initially guaranteed 400 million doses to the U.S. Since the end of December, three vaccines still remain in Phase 3 clinical trials and have not been approved.
Given the limited supply of vaccines, the first doses of the vaccines were offered to healthcare personnel and some residents of long-term care facilities. However, logistical challenges throughout December set the campaign to vaccinate the U.S. behind schedule. General Gustave Perna, the head of logistics for Operation Warp Speed, cited several factors for slowing down distribution, including the holiday season leading to more people on vacation and reduced clinic hours, winter weather, and the challenge of storing the doses (the Pfizer vaccine has to be stored in very cold temperatures).
Before his inauguration, President Biden announced his 100-day COVID plan which aimed to administer 100 million vaccines by his 100th day in office. Experts suggest that to reach herd immunity to the virus, 70-90% of the population needs to acquire resistance to the coronavirus, either through vaccinations or infection.
For more information on the COVID vaccine distribution challenges, check out these links:
Status of Vaccine Distribution
As of Feb. 19, the CDC reported that 41 million people have received a dose of a COVID vaccine, with over 16 million receiving two doses. On average, providers are administering about 1.62 million doses per day. With the momentum partially set out by the Trump administration, President Biden will achieve his goal of administering 100 million vaccines by his 100th day in office. With the recent purchase of an additional 200 doses, this sets the U.S. on track to be able to administer first doses to half of the population by early July, and nearly everyone by early December.
Vaccine administration has differed greatly by region. West Virginia has become a leader in vaccine rollout, using 83% of its allotted vaccines. West Virginia’s success is due partially to its decision to opt out of the federal plan. The map below shows the share of state populations that have received one or both doses of the vaccine. The national average is 12.8%, but territories and states such as American Samoa (29.2%), Connecticut (20%), and Alaska (18.2%) have vaccinated nearly a fifth or more of their populations.
Most states followed CDC guidelines to vaccinate healthcare workers first, but now many states have begun to move to the next phases of vaccine administration. The next groups who are beginning to receive vaccinations or be able to pre-register are adults 65+, teachers or other essential workers, and other high risk adult populations.
The Biden administration has taken actions to accelerate distribution and has promised an increase in vaccine doses. However, states say they have yet to see the increase. Governors also recently sent a letter to the White House, asking for more clarity and more coordination between state and federal governments on the use of pharmacies and federally-qualified health centers.
Just as vaccine distribution was ramping up across the U.S., new variants of the virus have been identified globally and in the U.S. The new strains have been found in many U.S. states, with Florida, California, and Michigan with the most cases. Variants from the U.K., South Africa, and Brazil have been found to spread more easily. Early evidence suggests that the current vaccines may not be as successful in offering protections for the new strains.
Another challenge for states distributing vaccines is ongoing supply limitations. States like West Virginia which have successfully managed the distribution and administration of vaccines are beginning to run out of supply.
Finally, data on the demographics of those receiving the vaccine indicates that there are racial disparities in who is getting vaccinated. Studies have shown that COVID has especially impacted Black, Hispanic, and American Indian and Alaskan Native communities. Despite this, some areas have seen more white people vaccinated as vaccinations for Black people fall behind.
As the vaccines begin to be administered to the larger population, there will be even more challenges. Vaccine hesitancy could impact how much of the population is vaccinated. Early on, Governor Mike DeWine of Ohio stated that roughly 60% of nursing home staff members offered the vaccine in the state had declined it. Local governments have launched campaigns in an effort to combat vaccine hesitancy. According to a survey from Kaiser Family Foundation, that about a quarter of Americans probably or definitely would not get a vaccine. These numbers have improved as more people have been vaccinated. Another possible consideration for the future will be redesigning COVID vaccines to protect against the newest variants.
For more information on challenges with vaccine distribution, check out these links:
Congress has been actively monitoring the vaccine rollout. On Feb. 2, the House Committee on Energy & Commerce held a hearing with state government officials titled “No Time to Lose: Solutions to Increase COVID-19 Vaccinations in the States.” The committee will hold another hearing on Tuesday, Feb. 23 with representatives of pharmaceutical companies with COVID vaccines approved for administration or in Phase-3 trials.
The American Rescue Plan Act, the budget reconciliation legislation for COVID relief, currently includes $14 billion to research, develop, distribute, administer, and strengthen confidence in COVID vaccines. The act will also mount a national vaccination program that includes setting up community vaccination sites. The House is expected to consider the bill this week.
According to Rep. Ann Kuster (D-NH), the Coronavirus Vaccine and Therapeutic Development Act would “ensure that the United States will be able to mass-produce and administer COVID-19 vaccines and therapeutics quickly and efficiently.” The bill would authorize $20 billion to expand the funding for COVID vaccines and invest in R&D and expanding manufacturing for COVID vaccines and therapeutics.
According to Rep. Ted Budd (R-NC), the Vaccinate More Americans Act would “allow vaccine providers to administer leftover COVID-19 vaccines to individuals eligible to receive the vaccine in the following phased allocation group, instead of letting those doses go to waste.”
Introduced by Rep. Anthony Brown (D-MD), the bill would create a national website and call center for Americans to find information about their state registration systems. The bill would also provide funding to incentivize states to create one-stop websites to book COVID-19 vaccine appointments.
According to Rep. Michael Bennet (D-CO), the bill would “increase coverage for uninsured Americans receiving COVID-19 related treatment, preventative services, and vaccines through Medicaid.”