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Officials call on states to expand groups getting COVID-19 vaccines

January 12, 2021

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Federal health officials are releasing COVID-19 vaccine doses they had been withholding and are encouraging states to open vaccination to broader groups of people.

“This next phase reflects the urgency of the situation we face,” Health and Human Services Secretary Alex M. Azar II, J.D., said Tuesday. “Every vaccine dose that is sitting in a warehouse rather than going into an arm could mean one more life lost or one more hospital bed occupied.”

Azar said states should start vaccinating everyone 65 years and older and people ages 16 or 18 to 64 (depending on the vaccine) who have documented underlying conditions. The recommendation is a change from the initial recommendations on priority groups made by the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices last month.

“We are telling states today they should open vaccination to all of their most vulnerable people,” Azar said. “That is the most effective way to save lives now.”

Administration of vaccines from Pfizer-BioNTech and Moderna started in December among health care workers and residents of long-term care facilities, and roughly 9 million people have received at least one dose. However, that is significantly behind the 20 million officials predicted by the end of December. Azar blamed reporting lags and states micromanaging who could get a dose. He noted nearly 38 million doses, including 25 million first doses, have been distributed to states.

Officials announced Tuesday they will begin releasing vaccine doses they had been holding onto to ensure there was enough for everyone who received a first dose to receive a second dose. Azar attributed the change to increased confidence in the manufacturing process and was adamant second doses would remain a priority.

“Based on the science and evidence we have, it is imperative that people receive their second doses on time,” Azar said. “That’s what the science says and ignoring that would be reckless.”

Much of the initial vaccination has been performed in hospitals, but Azar encouraged states to expand to pharmacies, community health centers and mass vaccination sites. In two weeks, the government also is changing the way it allocates doses to states. Instead of relying solely on population, it will take into account the percentage of available doses each state has administered.

AAP President Lee Savio Beers, M.D., FAAP, also urged changes to vaccine distribution Tuesday calling it “uneven and haphazard” and saying many pediatricians have had trouble accessing vaccines. She said it is “imperative that robust systems be put in place immediately to make sure no dose is wasted, and that these systems use and expand upon the existing vaccine delivery infrastructure.” She called for federal funding to be released to state and county health departments as quickly as possible and said the AAP also stands ready to help with vaccination.

“Pediatricians, perhaps more than any other medical specialty, understand how to distribute vaccines,” Dr. Beers said. “We do this every day, in every community, in many different types of health care settings."

Future vaccines

Additional vaccines could be available as early as February, according to Moncef Slaoui Ph.D., chief adviser to Operation Warp Speed. He said he expects the Food and Drug Administration to consider emergency use authorization of Janssen’s single-dose COVID-19 vaccine next month, which could be followed by AstraZeneca’s in March.

The Pfizer-BioNTech vaccine is the only one authorized for use in adolescents but is limited to those ages 16 and 17. Moderna is recruiting adolescents ages 12-18 years for trials but so far has only 800, significantly below its goal of 3,000, according to Dr. Slaoui.

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