A federal recommendation that states expand eligibility for the coronavirus vaccine appears to have been premised on inaccurate claims about expanded vaccine availability by high-ranking Trump administration officials. That could add even more chaos to a U.S. vaccine rollout already characterized by dysfunction, with particular harm to frontline workers and the elderly, who may now face much stiffer competition from lower-risk Americans for a place in line.
On Tuesday, federal officials and the CDC recommended that states open up vaccine eligibility to anyone over the age of 65 or younger residents with added risk factors. The same day, Health and Human Services Secretary Alex Azar announced that Operation Warp Speed would release a stockpile of doses that had been held as insurance against supply-chain disruptions. Also on Tuesday, U.S. Surgeon General Jerome Adams said that “we have enough [vaccine] in reserve that we can just start pushing those doses out there.”
Many states have already expanded eligibility to anyone over 65. But states including New York, Oregon, and Connecticut focused on vaccinating health workers and nursing home residents, following prior CDC guidelines. They opened the doors to those over 65 only after Tuesday’s recommendations and the accompanying promise that more supply was on the way.
But according to reporting today from the Washington Post, the promised vaccine reserves simply aren’t there. Despite the statements from Azar and Adams, Operation Warp Speed director Christopher Sharpsten told the Post that the existence of any federal vaccine reserve was a “false rumor.” After Azar’s public statements, some state health officials reportedly heard directly from Operation Warp Speed officials that their allocations would not in fact increase. But others did not find out until days later when they received unchanged weekly distribution plans.
Response from state officials has been scathing. In a statement posted on Twitter, Washington Gov. Jay Inslee said, “The Trump admin. must answer immediately for this deception.” Oregon Gov. Kate Brown, whose state was among those who followed the recommendation to expand access, wrote: “I am shocked and appalled that they have set an expectation on which they could not deliver, with such grave consequences…Oregon’s seniors, teachers, all of us, were depending on the promise of Oregon’s share of the federal reserve of vaccines being released to us.” A spokesperson for the Oregon Health Authority described the reversal as “having the rug pulled out from under us” in an interview with Fortune.
The push to expand eligibility was itself a response to a vaccine rollout that has been criticized as too slow and restrictive, in part because every state has been expected to develop its own plans, with little federal assistance. The incoming Biden administration had already signaled that it planned a similar eligibility expansion.
But without expanded supply to match, the changes have likely made the already disheartening situation even worse.
In a since-deleted statement, the New York Health Department said that appointments were fully booked for the next 14 weeks, just hours after the state had expanded eligibility. The agency pointed out that the looser requirements meant 7 million New Yorkers were now eligible to be vaccinated, but only 300,000 new doses were being delivered from the federal government each week. The statement was posted on Wednesday but replaced Thursday with less specific language.
States may respond to the revelation of missing supplies by reversing their expansions of eligibility. But short of that, the head fake by the Trump administration will have the worst effects on groups including frontline and essential workers and those over 75, who would have otherwise been eligible and wouldn’t have had to compete with the much larger group now in the running.
“When you open it up this way, often the people who are best poised to take advantage of the new prioritization are those who have the resources, have the time, and tend to have higher income,” says Josh Michaud, associate director of Global Health Policy for KFF (formerly the Kaiser Family Foundation). “People who don’t have the information networks, who don’t have the time and patience to go through and figure all this out, they get left behind.”
The situation also highlights the lack of transparency about vaccine supply in general. “From the outside looking in, we have very little visibility into how many doses Operation Warp Speed thinks they’ll be getting,” says Michaud. “This has been shrouded in secrecy,” leaving states more dependent on statements from officials—whether they’re true or not.
Additional reporting provided by Sy Mukherjee.
