The dramatic shift in strategy, which appeared to surprise state health officials, comes as the federal government and states have faced criticism for the slow pace of immunizations, even while some doses have gone unused as states struggle to distribute the shots they already have.
The Trump administration’s decision to release all available doses, rather than reserve half for second shots of a two-dose regimen, comes days after the Biden transition team said it would do so upon taking office. President-elect Joe Biden also said he will release a broader vaccination strategy on Thursday, as he aims for 100 million vaccinations in his administration’s first 100 days.
Azar said the administration no longer feels it needs to hold back doses because “we now have have a consistent pace of production.” He stressed that the administration had always planned to make changes once it had confidence in the supply chain.
Should there be a disruption in vaccine manufacturing, newly available doses would be prioritized for booster shots for people who have already received their first dose, a senior administration official said. People receiving the Pfizer vaccine are supposed to receive their booster shot three weeks later, and the wait is four weeks for those receiving Moderna’s.
As of Sunday, the United States has 38 million coronavirus shots, and about 25 million of those have been delivered to states so far, the official said. About 9 million people have received their first dose as of Monday, according to Centers for Disease Control and Prevention data. That’s far behind expectations set by federal health officials, who aimed for 50 million vaccinations by the end of January, though the pace has quickened in recent days.
Governors have also faced mounting criticism for being too prescriptive over who can get vaccinated, leading to shots sitting on shelves. Many states initially followed federal guidelines to vaccinate frontline health workers and nursing home residents and staff first, but as states had leftover vaccine, more states began expanding eligibility.
In changing how the federal government divides up shots among states, the Trump administration is essentially punishing states that aren’t moving quickly enough or aren’t giving the federal government timely data on how many shots they’ve administered.
“If you’re not using vaccine that you have the right to, then we should be rebalancing to states that are using that vaccine,” Azar said.
The change in allocation strategy will take effect in two weeks, after Biden takes office. However, it did not appear that Operation Warp Speed consulted with Biden’s team ahead of time. The Biden transition did not immediately respond to a request for comment
Marcus Plescia, chief medical officer of the Association of State and Territorial Health Officials, said states did not know in advance about the changes and that they have “significant concern” about the move. He said officials are worried about whether the federal government is pushing aside efforts to ensure the vaccine is equitably distributed.
For months, states warned that they didn’t have enough money to scale up the largest vaccination effort in U.S. history. They pleaded with the federal government and Congress for more funding, so they could create educational campaigns, boost staffing and IT infrastructure and set up mass vaccination sites where people could safely receive shots.
Lawmakers included nearly $9 billion for state vaccination efforts in their year-end coronavirus relief package, but the money is coming too late to speed up the initial phase of vaccinations.
The Trump administration is also planning to accelerate a plan to begin offering coronavirus shots in pharmacies, first reported by POLITICO. The federal government could also deploy personnel to states to do mass vaccinations if requested, Azar said.
The vaccination effort “has been overly hospitalized so far in too many states so we have the vaccine, the demand is there. We need to get these orders,” Azar said.
Brianna Ehley contributed to this report.