Likely the biggest immediate challenge of the Biden administration is improving the vaccine rollout. His new COVID-19 team has said it aims to administer 100 million shots for 50 million Americans in the first 100 days of office. It’s a plan some are still challenging
“I invoke the Mike Tyson principal. Everyone has a plan until they are punched in the mouth and it feels like we're being punched in the mouth. The rollout has been extraordinarily slow and sluggish,” said an expert during a debate with the Journal of the America Medical Association (JAMA).
Vaccine experts debated with JAMA about the possible benefits and consequences of getting all the doses available into more Americans, resulting in a delay of the second dose.
The concern wasn't necessarily how protected people would be if they delayed getting the second dose by a few weeks. In trials, both vaccines produced higher immunity responses after the first dose than the flu shot overall. The concern was more around the mixed messaging and Americans’ perception.
“What worries me is that there are people who are going to hear this and say, you know, ‘I’m 80-90% effective. That’s not that much different than 95%. I got my dose, I’m good. I hadn’t suffered with that first dose, why bother getting the second dose?’ That worries me,” said an expert.
“That they see this as yet another curve ball and like you told me masks didn't work, then you told me they did, then you told me I needed to clean my mail and now you're telling me I don’t, and I’m just so confused I’m just not going to get vaccinated,” said an expert.
There are also concerns the system for determining who is next to get the vaccine is too complex, actually creating more opportunities for inequity.
“Who is going to be able to figure their way around the system? Who is going to game it or who is going to have the resource and the wherewithal to get to the front of the line? It’s going to be the well-to-do, it’s going to be the privileged. Exhibit a is the tax code,” said an expert.
One proposed idea is that after nursing homes and health care workers, we move to an age system, where we start with 75 and up, 65 and up, 55 and up. And then possibly a lottery after that based on the last number of your birthdate.
That takes the burden of requiring proof of preexisting conditions and essential worker status off those giving vaccines, so they can speed up administering them.