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February 22, 2021

The Biden Vaccine Rollout Is Working

Just a couple hurdles remain for successful global inoculation from
coronavirus

 

President Biden and Michigan Governor Gretchen Whitmer inspect freezers
at the Pfizer vaccine production plant in Kalamazoo, Michigan on Friday.
(Evan Vucci/AP Photo)

The Chief

Back when this newsletter was called Unsanitized, I spent the first
edition of 2021

lamenting the vaccine rollout, which at the time was plagued by a lack
of presidential leadership, delayed funds to states, an over-reliance on
hospitals busy fighting a pandemic, confusion over prioritization, and
even reduced staff during the Christmas holiday. As of January 3, three
weeks into the rollout, only 4.33 million doses had been distributed.

But in the past month, I have been far less concerned with the rollout,
which has been among the best in the world
.
In the 49 days since January 3, the U.S. has delivered 58.8 million
shots, with the seven-day average really moving in a straight line
upward

until Valentine's Day, when that average topped out at 1.7 million
shots per day. Early on, about 30 percent of vaccines shipped had been
delivered; now the number is 84 percent. Only five countries on Earth
have delivered a first dose to a higher percentage of the population
than the U.S. (Israel, the Seychelles, the UAE, Bahrain, and the UK),
and only one of them has a significant population.

Only the icy weather in much of the country stopped the momentum, due to
a combination of people socked in their houses and unwilling to go get
the vaccine, and a delay in shipping roughly 6 million doses. Those
shipments should be made up

this week, and we will get a test as to how much capacity has been built
when states are more flush with vaccine supply, since they'll have
leftovers from last week and the current week's shipment.

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Even with the logistical hazards, the U.S. got 1.3 million shots out per
day over the past week, about at the level of early February, and well
above the original 1 million shots per day
target of
the Biden administration. The delays are unfortunate, and given the
increasing variants could leave the country vulnerable

to higher transmission and more mutations. But if it's just a one-week
blip caused by a nightmare in Texas and difficulties with shipping, and
we get back on track this week, that danger could be muted.

Moreover, the bumper crop of supply this week (because of the make-up
shipments from last week) could be a preview of the near future. Right
now the U.S. is shipping about 10-15 million doses per week. That should
increase

to 20 million per week in March, 25 million in April, and 30 million by
June. If distribution ramps up similarly, you could see 4.5 million
shots delivered daily by summer. The one-dose Johnson & Johnson vaccine
will get a vote this Friday

from the FDA's advisory committee, and although that could be a
complex analysis given the variants, I'd expect approval and immediate
shipping by the weekend. While initial shipments will be small
,
they add to the Moderna and Pfizer rollouts, and of course as a one-shot
vaccine, each one is worth two of the others.

There's some evidence for the idea that the Pfizer vaccine generates a
strong response with just one dose
,
perhaps as good as J&J. The evidence is overwhelming that people who
have contracted the virus only need one dose
.
I'd expect Pfizer to ask for changes on both, which would again
stretch supply to a greater population. (Pfizer is already seeking
permission to store the vaccine in normal refrigerators, after testing
showed it can survive under those conditions for up to two weeks. This
would allow the Pfizer vaccine to be shipped to areas without the
capacity for ultra-cold storage.)

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If you add this up, the U.S. is very well positioned to get the virus
under control by early summer. The public even expects this now
.
The winter of our discontent could be made glorious summer
.
But there are a couple barriers still to cross.

First, we're approaching a time where the binding constraint will be
public willingness to take the vaccine. Without any public education
campaign, a little more than half of the population will take it. But
that's just it, there's been no public education campaign,
explaining that the vaccines are safe and incredibly effective. They all
stop hospitalization and they all stop death
.

It's incredible that the Biden administration is leaving this to a
media given to hype negative stories to explain this to the public. A
handful of public service announcements have rolled out, including an
effective one from Boston Celtics legend Bill Russell
.
But private trade groups or particular executive branch agencies (like
the military
)
have led the way. There's been no real broadcast message from the
White House, on a daily basis, hammering home that these vaccines are
vital and should be taken. There's no need for a public education
vacuum.

The second barrier is getting a global rollout on par with the U.S. This
is in our public health interest, because more virus circulating
increases the potential for more mutations, including some that cannot
be defeated through vaccination. To get the world inoculated, we have to
produce more vaccine and we had to have done it months ago. The Biden
administration pledged $4 billion

to COVAX, the global campaign to vaccinate the world, but that's not
likely to go far.

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There's a very troubling genre of article that attempts to lecture
Americans on why we just can't ramp up production
very
much. This type of article has been written for the last three months in
a row, which in itself proves the problem with it. Nobody doubts that it
takes months to retool factories, secure ingredients, and hire staff.
But we're months from the point when this could have begun. And
we're going to need billions more vaccines for the world. We know it
doesn't take, you know, forever to build capacity; Pfizer started
effectively from scratch and had factories ready to produce its vaccine
within 6-8 months. The best day to replicate that process is four months
ago, and the next-best day, absent a time machine, is today.

This requires two things: money from the industrialized nations of the
world to ramp up production, and open-source intellectual property, so
every country can produce vaccines. We have not come close to the limits
of production, and we have not broken the patents of the vaccine makers
fully during this global emergency. Half a million Americans

have died, and millions more elsewhere. Each day without maximum
vaccines in circulation puts millions more at grave risk. There needs to
be a lot more urgency.

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Don't Believe Me Just Watch

I was on Left, Right & Center again last week, joined by Sen. Angus King
(I-ME), the New York Times' Conor Dougherty, and The American
Conservative's Helen Andrews. Listen here
.

I was on with Ryan Grim on TYT's The Conversation, discussing Biden
and Merrick Garland's Justice Department. Watch here
.

What Day of Biden's Presidency Is It?

Day 34.

We Can't Do This Without You

Today I Learned

* Susan Collins and Mitt Romney both announced opposition

to Neera Tanden to run OMB, and with Joe Manchin opposed, it's hard to
see her getting confirmed. (Axios)

* Chuck Schumer says he's working to find votes

for Tanden. It may be a long search. (Talking Points Memo)

* In case you missed it from us, this likely means that Gene Sperling
will get the nod

to replace Tanden. See also Politico
.
(American Prospect)

* Teacher vaccinations are "not a prerequisite
"
to opening schools. (Washington Post)

* Merrick Garland's confirmation hearing is today; he is pledging
prosecutions

for the Capitol Riot. (Bloomberg)

* The U.S. is negotiating prisoner release

with Iran. (CNBC)

* Biden has vowed to not build more border wall but activists want it
dismantled
.
(HuffPost)

* Goodbye to Trump's high-flow shower head

rule. (NBC News)

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