U.S. Vaccine Supply: What to Know

The Four Percent

Demand for vaccines is skyrocketing as the United States grapples with a record death toll from Covid-19 and the threat of new, more contagious variants. After a slow start in December, many states and cities have quickly ramped up vaccine delivery, widening access to larger groups of people and setting up mass testing sites.

But now there’s a new wrinkle: Some mayors and governors say they have run out of available vaccines, and have had to cancel appointments.

The Biden administration has promised to overhaul the country’s faltering vaccine effort, but there’s only so much it can do to increase the available supply.

Here’s what you need to know.

There are simply not enough doses of authorized vaccines to meet the enormous demand. And that is not likely to change for the next few months.

Going forward, Mr. Azar said, the government would shift to a new model: rather than holding onto a reserve of booster shots, each weekly shipment from the manufacturers would include doses for new people as well as second doses for those due for their booster shots. President Biden echoed that policy in announcing his vaccine plan last week.

Federal officials have previously said they were working with states to track who has gotten a vaccine, and when they are due for their booster shots, which is three weeks later for the Pfizer vaccine and four weeks later for the Moderna one.

They have said that each weekly shipment will give priority to people who need their second dose that week, and whatever is left will go to vaccinating new people.

But the plan relies on state and federal governments working together and accurately reporting who has received a vaccine, and what is needed from week to week. Many state governments have complained they do not have the resources to carry out the vaccine distribution plan, and the next few weeks will demonstrate how well the system works.

The incoming Biden administration has vowed to overhaul distribution to the states, providing more transparency to local officials about how much vaccine they can expect, in the hopes of allowing states to better plan.

No, it’s not likely to happen.

Last week, Gov. Gretchen Whitmer of Michigan asked the federal government for permission to buy 100,000 doses of vaccine directly from Pfizer. And on Monday, Mr.. Cuomo wrote a letter to Pfizer asking for the state to buy vaccines directly.

Pfizer and Moderna’s supply has been fully claimed for at least the first quarter of this year, meaning it’s unlikely there will be any spare vaccine to sell to individual states.

In addition, the emergency use authorizations for the Pfizer and Moderna vaccines stipulate that the federal government oversees distribution.

In a statement, a Pfizer spokeswoman said the company “is open to collaborating with the U.S. Department of Health and Human Services on a distribution model that gives as many Americans as possible access to our vaccine as quickly as possible.” But she noted that “before we can even consider direct sales to state governments, H.H.S. would need to approve that proposal.”

A state official said on Tuesday that the governor felt it was important to exhaust all his options, no matter how unlikely they would be to succeed, and pointed to his efforts in March to directly buy ventilators from manufacturers — setting up a bidding war among states that he later criticized the federal government for fueling.

But advisers to the Biden administration have indicated that they are not in favor of such a move. On Monday, Dr. Celine Gounder, a pandemic adviser to Mr. Biden during his presidential transition, said allowing states to reach separate deals would cause more problems than it would solve.

In an interview on CNBC, Dr. Gounder noted Mr. Cuomo’s previous criticism of bidding over ventilators. “I think this kind of an approach to vaccine allocation is going to result, frankly, in the same kind of situation that he, himself, was criticizing last spring,” she said.

Yes, most likely.

At least three other vaccines are in late-stage clinical trials, and the success of any one of them could mean millions of more doses for U.S. residents by this spring.

Johnson & Johnson is expected to announce the results of its vaccine trial any day now, and if it is successful, the first doses could become available in the United States by February. Although early production of the vaccine has lagged, the company has signed a deal to provide 100 million doses of its one-dose vaccine by the end of June.

By March and April, results from trials testing two-dose vaccines by AstraZeneca and Novavax could also be made public. AstraZeneca has an arrangement with the U.S. government to provide 300 million doses, and Novavax to provide 110 million.

What’s more, both Pfizer and Moderna say their factories are ramping up and expanding capacity each week. They have signed deals to supply an additional 100 million doses each of their vaccines in the second quarter of this year.

It’s still not clear, although conservatively, there could be enough vaccines by the summer.

If no other vaccines are authorized, the United States has signed deals with Pfizer and Moderna for a total of 400 million doses to be delivered by summer, or enough for 200 million people.

That’s pretty close to the American population of 260 million adults (the vaccines are not approved yet for children although studies are underway).

But if other vaccines do prove safe and effective — which experts say is likely — millions more people could be vaccinated more quickly, possibly by late spring.

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