WASHINGTON — President-elect Joseph R. Biden Jr., racing against a surge in coronavirus cases and the emergence of a new variant that could significantly worsen the pandemic, is planning a vaccination offensive that calls for greatly expanding access to the vaccine while promising to use a wartime law to expand production.
But his plan is colliding with a sobering reality: With only two federally authorized vaccines, supplies will be scarce for the next several months, frustrating some state and local health officials who had hoped that the release of a federal stockpile of vaccine doses announced this week could alleviate that shortage. Trump administration officials clarified Friday that the existing stockpile would only go toward giving second doses to people who had already received the vaccine, and not to new groups of people.
“The vaccine rollout in the United States has been a dismal failure so far,” Mr. Biden said. “The honest truth is this, things will get worse before they get better. And the policy changes we are going to be making, they’re going to take time to show up in the Covid statistics.”
The president-elect said he would invoke the Defense Production Act, if necessary, to build up vaccine supply. But the team also sought to tamp down expectations. Mr. Biden said his plan “won’t mean that everyone in these groups will get vaccinated immediately, because supply is not where it needs to be.” But, he added, it will mean that as doses become available, “we’ll reach more people who need them.”
The Biden team promised to ramp up vaccination in pharmacies, and build mobile vaccination clinics to get vaccine to hard-to-reach and underserved rural and urban communities, emphasizing equity in distribution.
Mr. Biden spoke of “the tragic reality of the disproportionate impact this virus has had on Black, Latino and Native American people,” adding that “equity is central to our Covid response.”
Like the Trump administration, Mr. Biden called for states to expand the vaccine eligibility groups to people 65 or older.
The administration will also make “programs available for high-risk settings, including homeless shelters, jails and institutions that serve individuals with intellectual and developmental disabilities,” the fact sheet said.
In some respects, Mr. Biden’s proposals echo those of the Trump administration, which also called earlier this week for opening vaccine eligibility to groups to 65 and older, making greater use of pharmacies and moving vaccinations to federally qualified health centers. The Trump administration has also frequently used the Defense Production Act to give vaccine makers priority with suppliers for raw ingredients and other materials.
Mr. Biden unveiled the vaccine distribution plan just one day after he proposed a $1.9 trillion spending package to combat the economic downturn and the Covid-19 crisis, including $20 billion for a “national vaccine program.” The president-elect has said repeatedly that he intends to get “100 million Covid vaccine shots into the arms of the American people” by his 100th day in office.
Time is of the essence. The federal Centers for Disease Control and Prevention on Friday sounded the alarm about a fast spreading, far more contagious variant of the coronavirus that is projected to become the dominant source of infection in the country by March, potentially fueling another wrenching surge of cases and deaths. Some public health experts are worried.
“I think we are going to see, in six to eight weeks, major transmission in this country, like we’re seeing in England,” said Dr. Michael T. Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota and a member of Mr. Biden’s coronavirus advisory board. “If we can set up vaccine clinics faster and more efficiently, how many lives do we save?”
Mr. Biden intends for the federal government not only to develop mass vaccination sites, but also to reimburse states for the use of National Guard troops to administer vaccines. To staff the mass clinics, Mr. Biden promised to “mobilize thousands of clinical and nonclinical professionals.”
The plan’s emphasis on ensuring equitable distribution includes mobile vaccination clinics, as well as using data to target vaccinations in hard-hit areas and in communities that have been disproportionately affected by the virus. The fact sheet also says that officials will focus on places where people live in close quarters, such as jails — which some state plans have failed to prioritize, even though some of the country’s largest clusters of infections have been in prisons.
The vaccine distribution plan is part of Mr. Biden’s broader effort to use the current crisis to rebuild the nation’s crumbling public health infrastructure — long a goal of Democrats on Capitol Hill.
To that end, Mr. Biden has promised to increase federal funding for community health centers and has called for a new “public health jobs program” that would fund 100,000 public health workers to engage in vaccine outreach and contact tracing. Such a corps of trained public health workers would presumably be in place for the next pandemic.
“The details still have to be worked out but, this is really a critical recognition that state and local health agencies need to be shored up in a way that they haven’t been in decades,” Dr. Osterholm said.
Nearly 400,000 people in the United States have died with the virus during the pandemic, and the country has logged more than 23 million infections, according to a New York Times database. Over the past week, there has been an average of more than 240,000 cases per day, an increase of 27 percent from the average two weeks earlier. More than 4,400 deaths were announced on Tuesday, a record.
As of Friday, according to the federal Centers for Disease Control and Prevention, about 10.6 million people had received at least one dose of a Covid-19 vaccine, and about 1.6 million had received the second dose. That is far short of the goal federal officials set to give at least 20 million people their first shots before the end of 2020.
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