WASHINGTON — Amid Michigan’s worst-in-the-nation coronavirus surge, scientists and public health officials are urging the Biden administration to flood the state with additional vaccine doses.
So far, though, their plea has fallen on deaf ears. Instead, the federal government is sticking to a vaccine-allocation strategy that largely awards doses to states and territories based on their population. As a result, most jurisdictions are still receiving similar per-capita vaccine supplies, regardless of how many people there are getting sick — or how many excess vaccine doses they have.
Experts have cast a surge in Michigan’s vaccine supply as a critical tool in combating the state’s most recent Covid-19 crisis. The state is currently recording nearly 7,000 new cases per day, just shy of its all-time peak in December. Hospitalizations and deaths, which tend to lag a few weeks behind increasing case counts, are also on the rise.
“I would be surging a lot of vaccines to Michigan right now,” said Ashish Jha, the dean of the Brown University School of Public Health. “To me, this is a no-brainer policy, and I would be curious to hear why the Biden team hasn’t done this.”
During a media briefing on Wednesday, White House officials acknowledged that Michigan’s situation is dire. They gave no indication, though, that they would send additional vaccines there to help quell the surge, when STAT asked. They argued that it is too early in the national vaccine campaign to begin targeting supply based on case rates.
Rochelle Walensky, the director of the Centers for Disease Control and Prevention, said the agency was working to expand testing capacity in the state, address outbreaks in Michigan’s jails and prisons, and scale up genomic sequencing. The one strategy she did not bring up was scaling up vaccine supply.
“By and large, we are still allocating vaccines based upon population,” Andy Slavitt, one of President Biden’s top pandemic-response advisers, said during the briefing. “Clearly we will get to a place where more targeted strategies will work, but right now I would commit to you that we’re doing both.”
The administration’s fixed position is at odds with public health experts like former Food and Drug Administration commissioner Scott Gottlieb; the physician-researcher Eric Topol; and the Flint, Mich.-based public health advocate Mona Hanna-Attisha.
Some have attempted to quantify what’s at stake more precisely: One modeler, University of California, Berkeley, research programmer Joshua Schwab, projected recently that doubling Michigan’s vaccine allocation for two weeks could help prevent 10,000 hospitalizations and 1,200 deaths.
The state’s Democratic governor, Gretchen Whitmer, first asked President Biden for additional vaccine supplies on March 30. But Jeff Zients, the White House’s Covid-19 response coordinator, rebuffed the request, the Washington Post reported.
“I know that some national public health experts have suggested this as an effective mitigation tool, and I know we’d certainly welcome this approach in our state,” Whitmer reportedly said on a call between governors and Biden administration advisers.
Instead, White House and CDC officials are working with Michigan to leverage its existing vaccine supply and potentially surge shipments within the state.
Despite his resistance to increasing the number of doses Michigan received, Slavitt stressed that the federal vaccine effort is not a one-size-fits-all endeavor.
As examples, he stressed that the Biden administration was now allowing community health centers to order vaccines directly; adding locations to the government’s retail pharmacy partnership “surgically”; and locating federal vaccination sites in the places determined to be most in need.
“I wouldn’t want to give the impression that we are — someone is sitting back and managing this pandemic according to some formula,” Slavitt said. “It’s not true in the least.”
To date, the White House’s population-based system for determining vaccine supply has faced little pushback or criticism, even though states have experienced different rates of Covid-19 spread for months.
Broadly, the federal vaccination effort is viewed as a major success. The U.S. is currently administering roughly 3 million vaccine doses per day. Nearly one-third of the country, and more than three-quarters of all older adults, have received at least one vaccine dose.
Biden announced on Tuesday that he would direct states to open vaccine eligibility to all adults by April 19, almost two weeks earlier than his prior goal of May 1. Many states, including Michigan, had already done so.
Even as the broader vaccination campaign continues to accelerate, however, momentum has built for surging vaccines to hot spots. The debate in Michigan mirrors one in New Jersey, which experts have argued should also receive additional vaccine supply. Federal officials have similarly ignored that request.
Four months into the U.S. vaccination effort, though, vaccine supply is far less tight.
“There are states like Alabama, Georgia, Mississippi, Louisiana, Utah, where throughout much of the day, the vaccine appointments are going unfilled,” Jha said. “What all of us are arguing for is, for the next couple weeks, surge a ton of vaccines to Michigan. And if certain states that have plenty of supply get a 25% lower allotment for two weeks, they probably won’t miss it. Then, get them back to their normal level, and catch them up if they need it.”