Biden Plans to Release Nearly All Available Doses to Speed Up Vaccinations

In a sharp break with the Trump administration, President-elect Joseph R. Biden Jr. intends to release nearly all available doses of the coronavirus vaccine soon after he is inaugurated, rather than hold back millions of vials to guarantee second doses will be available.

The decision is part of an aggressive effort to “to ensure the Americans who need it most get it as soon as possible,” the Biden transition team said on Friday. The vaccination plan, to be formally unveiled next week, also will include federally run vaccination sites in places like high school gyms and sports stadiums, and mobile units to reach high-risk populations.

The president-elect has vowed to get “at least 100 million Covid vaccine shots into the arms of the American people” during his first 100 days in office.

The decision to release the vast majority of vaccine doses set off a sharp debate among public health experts. The two vaccines that have received emergency approval each require two doses, and the Trump administration has so far been holding back about half of its supply to ensure that booster doses will be available for those already inoculated.

Officials at Operation Warp Speed, the Trump administration’s vaccine program, had noted that doses would stop being sequestered after the first few weeks of rollout. But the announcement by the Biden administration sets the clearest benchmark yet for front-loading shots, then distributing them as they become available. And Warp Speed officials on Friday were critical of the president-elect’s decision.

The Food and Drug Administration — whose advice Mr. Biden has pledged to follow — has spoken out strongly against changing the dosing schedule, as some other countries have opted to do, calling such a move “premature and not rooted solidly in the available evidence.” Some public health experts fear that second doses would be delayed by the decision.

But others called it a smart measure and said it was imperative to get as many people vaccinated as quickly as possible — so long as the second doses are not delayed. The Biden team said it was confident that the supply would be enough, and that Mr. Biden would invoke the Defense Production Act if necessary to bolster the supply of second doses.

“The president-elect believes we must accelerate distribution of the vaccine while continuing to ensure the Americans who need it most get it as soon as possible,” said T.J. Ducklo, a spokesman for the Biden transition team.

The announcement that Mr. Biden intends to free up extra doses coincided with a letter from eight Democratic governors — including Andrew M. Cuomo of New York and Gretchen Whitmer of Michigan, both of whom have clashed with President Trump — imploring the current administration to release all available doses to the states as soon as possible.

“The failure to distribute these doses to states who request them is unconscionable and unacceptable,” the governors wrote in the letter, which was obtained by The New York Times and sent Friday to the secretary of health, Alex M. Azar II, and Gen. Gustave F. Perna, who is in charge of vaccine distribution.

“We demand that the federal government begin distributing these reserved doses to states immediately,” the letter said.

Mr. Biden’s promise of 100 million shots in arms is an ambitious one, and the Trump administration’s rocky rollout — which Mr. Biden called “a travesty” on Friday — has not made his task any easier. As of Thursday, the Trump administration had shipped more than 21 million vaccine doses, and millions more were already in the federal government’s hands.

Yet only 5.9 million people had received a dose. State and local public health officials, already overwhelmed with rising infections, have been struggling to administer the vaccine to hospital workers and at-risk older Americans while most people remain in the dark about when they might be protected.

The biggest problem so far has not been a lack of vaccine, but the difficulties that state and local governments face in distributing the doses they have. Capacity and logistics, not shortages, are keeping vaccines from being administered.

Dr. Leana S. Wen, an emergency physician and public health expert at the George Washington University School of Public Health, said she was surprised and concerned about Mr. Biden’s new strategy.

“This is not the problem we’re trying to solve right now,” Dr. Wen said.

Officials at Operation Warp Speed were also critical.

Speaking at a news briefing on Friday, Dr. Stephen M. Hahn, the F.D.A. commissioner, urged states that have used only a small part of their supply to begin vaccinating lower-priority groups, while still observing government guidelines. Most states are still prioritizing frontline health care workers and older Americans in group residential settings.

Expanding the targeted groups “will go a long way toward using these vaccines appropriately and getting them into the arms of individuals,” Dr. Hahn said.

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