Trump Administration’s Vaccine Shifts Come With Risks, New Challenges

Stat: U.S. Plan To Expand Covid-19 Vaccine Access Likely Sets Up New Debacles
As health authorities across the country struggle to get Covid-19 vaccination programs up and running, outgoing Health and Human Services Secretary Alex Azar threw a new wrench into the works on Tuesday, telling states to expand priority access to tens of millions of additional people immediately. But it will be several months before there is enough vaccine available to meet that kind of demand. (Branswell, 1/12)

Politico: Trump’s Abrupt Shift On Covid Shots May Sow More Chaos
CDC Director Robert Redfield downplayed the impact of the new policy, saying the advisory board’s guidance never guaranteed that everyone in those groups would be immunized before moving on to lower-priority groups. And the federal health official said the administration’s intention is not to skip over essential workers. ... But flooding the system with more vaccine alone won’t work without setting up more vaccination sites and providing more material support, experts say. “In order for us to efficiently move doses into arms, a strong understanding of how many doses to expect this week, next week, and the following weeks is needed,” Claire Hannan, the executive director of the Association of Immunization Managers, wrote in an email. (Ollstein and Roubein, 1/12)

The Washington Post: Biden Team Sees Risks In Trump Decision To Widen Vaccine Pool 
Advisers to President-elect Joe Biden are balking at a decision by the Trump administration to dramatically increase the number of people eligible for the coronavirus vaccine, believing the changes could overwhelm states and create unrealistic expectations for millions of Americans waiting for shots. At issue are changes to the vaccine rollout announced Tuesday by the Trump administration. Officials instructed states to begin vaccinating tens of millions of people with a high-risk medical condition putting them at increased risk of dying from the coronavirus, along with all adults 65 and older. Including both those groups immediately adds another 100 million people potential seeking shots, bringing the total to about 184 million and intensifying demand on already stressed sign-up systems. (Sun and Stanley-Becker, 1/12)

The Trump administration officially announced the policy change Tuesday —

The Washington Post: Trump Administration Reverses Stance, Will No Longer Hold Back Second Shots Of Coronavirus Vaccine
The Trump administration announced sweeping changes to its vaccination rollout on Tuesday, including making all of the coronavirus vaccine supply immediately available, urging states to provide shots to anyone 65 and older and warning states with lagging inoculations that they could lose some of their shots to speedier places. The steps, part of an effort to accelerate a delayed and disjointed rollout, depart from the administration’s original strategy, and come just days after President-elect Joe Biden announced plans to release nearly all the vaccine supply. (Sun, McGinley, Stanley-Becker and Goldstein, 1/12)

NPR: Trump Administration Makes Big Changes To Speed COVID-19 Vaccine Rollout
The call is accompanied by a change in how vaccine doses are allocated to states. Currently, doses are given to states based on their total adult populations. Starting in two weeks, vaccines will be distributed to states based on the number of over 65-year-olds who live there — and by the pace of vaccine administration reported by states. "[This new allocation system] gives states a strong incentive to ensure doses are going to work, protecting people rather than sitting on shelves or in freezers," Azar said at the press briefing, "We need doses going to where they'll be administered quickly and where they'll protect the most vulnerable." (Simmons-Duffin and Huang, 1/12)

In other news about the vaccine rollout —

The Wall Street Journal: Health Officials Scramble To Provide Booking Systems For Covid-19 Vaccines 
After a week of unsuccessful attempts to book an appointment for a Covid-19 vaccine, Katie Solovey’s parents turned to her for help. The 34-year-old’s parents spend their winters in Siesta Key, Fla., part of Sarasota County, which is using Eventbrite Inc.’s ticketing platform to schedule vaccine appointments. The platform is familiar to Ms. Solovey, but not to some older people including her parents, who are in their 70s, she said. Her father was also using a first-generation iPad on a shaky wireless connection, making it hard to enter all the information required before the system timed him out. (Deighton and Alcantara, 1/12)

STAT: CDC’s COVID-19 Vaccine Guidelines Prioritize People With Type 2 Diabetes Over Type 1. Why?
The CDC’s interpretation of risk differs from the decision made by U.K. health officials to include both type 1 and type 2 diabetes in its list of conditions that pose higher risk after Covid-19 infection. The CDC responded with a statement that reiterates the guidelines and current evidence used to write them. “This list is a living document that will be periodically updated by CDC, and it could rapidly change as the science evolves,” Kristen Nordlund of CDC’s public affairs office wrote Monday. States are free to create their own priority lists, and in Tennessee, for example, people with both types of diabetes are classified together as at higher risk than the general population. (Cooney, 1/12)

KHN: Hospitals’ Rocky Rollout Of Covid Vaccine Sparks Questions Of Fairness 
Last week, after finishing inoculations of some front-line hospital staff, Jupiter Medical Center was left with 40 doses of precious covid vaccine. So, officials offered shots to the South Florida hospital’s board of directors and their spouses over age 65.But that decision sparked outrage among workers left unvaccinated, including those at one of the hospital’s urgent care clinics, or who believe the hospital was currying favor with wealthy insiders before getting all its staffers protected, according to a hospital employee who spoke on the condition of not being named. (Galewitz, 1/13)

KHN: Feeling Left Out: Private Practice Doctors, Patients Wonder When It’s Their Turn For Vaccine 
Dr. Andrew Carroll — a family doctor in Chandler, Arizona — wants to help his patients get immunized against covid, so he paid more than $4,000 to buy an ultra-low-temperature freezer from eBay needed to store the Pfizer vaccine. But he’s not sure he’ll get a chance to use it, given health officials have so far not said when private doctor’s offices will get vaccine. “I’m really angry,” said Carroll. (Appleby, 1/13)

KHN: Are You Old Enough To Get Vaccinated? In Tennessee, They’re Using The Honor System 
In December, all states began vaccinating only health care workers and residents and staffers of nursing homes in the “phase 1A” priority group. But, since the new year began, some states have also started giving shots to — or booking appointments for — other categories of seniors and essential workers. As states widen eligibility requirements for who can get a covid-19 vaccine, health officials are often taking people’s word that they qualify, thereby prioritizing efficiency over strict adherence to distribution plans. (Farmer, 1/13)