Biden’s Covid team grapples with a basic question: Where’s all the vaccine?

Several state officials on Thursday pointed out that supply shortages were the main obstacle to their distribution efforts, adding that both outbound and inbound administration guidelines that states should expand their licensing guidelines were running out of reserves.

“What you are seeing now is the very limited supply that everyone knew would be but was not understood by the public,” said Chrissie Juliano, executive director of the Big Cities Coalition, which represents metropolitan health departments . “It is just not a reality locally to suggest that we allow anyone over 65 to have a vaccine in the hopes that they would relocate supplies even though they come from a good place.”

Health officials also faced extensive data issues that hampered states’ ability to keep the government informed of their daily vaccine supplies. This delay has sometimes made it difficult to convince federal officials they are running out – or keep track of where new shipments are being delivered.

These issues could take weeks to resolve, state and federal officials said, and they could be the kind of complex effort that could quickly stall the Biden government’s response.

On Thursday, Biden launched a 200-page national strategy to contain the coronavirus. This was part of an effort to show a clean break with the Trump administration, which had shunned responsibility for distributing vaccines and created a patchwork system across the country.

The president signed 10 executive orders ranging from invoking the Defense Production Act to accelerate the production of vaccines to instructing the Department of Education to instruct schools to reopen safely.

Health professionals welcomed the quick steps and detailed plan, but also acknowledged that there will be delays in implementation. Although the plans have been underway for months, it will be difficult to get large government agencies up and running quickly – especially without constant guidance.

An integral part of the president’s plan to increase vaccinations are government-supported sales locations with the goal of creating 100 locations by the end of February. However, state officials warned that the plan would only further disrupt efforts already underway to keep up with rising demand if supply did not increase.

“Where do you get the cans from?” said Claire Hannan, executive director of the Association of Immunization Managers. “It makes me a little queasy to hear about these community vaccination centers and mobile vaccination clinics – all great ideas that are in these plans, but what’s missing is the doses and the resources.”

The federal government further alerted some state officials Thursday when the Centers for Disease Control announced they would count Pfizer’s vaccine bottles as the equivalent of six doses – out of five, according to an email from the agency received from POLITICO.

These vials require special syringes to extract all six cans, and this type of syringe is so popular that the Biden government said Thursday it could use the Defense Production Act to ramp up their manufacturing.

Biden officials are also likely to face strict limits on total vaccine supplies in the country over the next few months. Pfizer and Moderna have pledged a total of 200 million doses by the end of March – enough to keep Biden’s initial promise, but far from what it takes to achieve herd immunity.

And while Biden announced on Thursday his willingness to use the data protection agency to expedite manufacturing, this expanded inventory of materials and supplies won’t have an immediate impact on response.

“It’s not a magic wand,” said a former Trump administration official. “You have to explain what you’re going to do with it.”

Biden’s team still gets high marks for being honest and transparent about the challenges the country is facing in eradicating the pandemic that Trump routinely dismissed. Fauci, the nation’s leading infectious disease expert who has clashed with Trump officials on several occasions, also spoke of feeling “liberated” when the Biden administration elevated him and his colleagues.

“The idea that you can get up here and talk about what you know, what the evidence is, what the science is, and know that it is – let the science do the talking,” he said Thursday. “It’s a liberating feeling.”

However, when Fauci had to delve into how Biden’s lengthy plans and much-touted executive action would lead to more vaccinations on the ground, he was far tighter.

“To do everything possible to increase the availability of vaccines,” he said. “Whatever that is, he just said he would take every opportunity.”

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