President-elect Joe Biden may accelerate distribution of COVID-19 vaccines to U.S. states, a spokesman said on Friday, in an effort to jump-start lagging inoculations that have made little impact on the pandemic one week into the new year.

That move by Biden when he takes office in less than two weeks would be a departure from a Trump administration strategy of holding back a supply to ensure that required second doses of the vaccines are available.

It would also require that Pfizer Inc. and partner BioNTech SE and Moderna Inc., makers of the first two coronavirus vaccines authorized for use in the United States, are able to maintain a consistent supply so second shots could still be administered on schedule.

“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 TJ Ducklo, a spokesman for Biden’s transition.

As of Friday, roughly 6 million people across the United States had received a first injection of the two-shot vaccines, accounting for less than one-third of more than 21 million doses shipped to date, according to the U.S. Centers for Disease Control and Prevention (CDC). Some began getting their second doses this week.

That number falls far short of the 20 million vaccinations the Trump administration had vowed to administer by the end of 2020 as the pandemic spirals out of control with ever-increasing record numbers of infections, hospitalizations and deaths.

“The goal has to be to get vaccine out of freezers and into people’s arms, and I do think that we should get first doses in and rely on the manufacturing process to deliver the second doses in time,” said Dr. Amesh Adalja, a senior scholar at The Johns Hopkins Center for Health Security.

“I would also add that the issue is less about supply but about being able to actually physically administer the vaccine, so this needs to be coupled with the ability to stage vaccination clinics, mass vaccination sites, and train vaccinators,” Adalja said.

The lag has been partly attributed to strict rules by U.S. states controlling who should get inoculated first. Those plans have been complicated by some healthcare workers at the front of the line declining the shots, leaving the doses unused.

The CDC has said healthcare workers and nursing home residents and staff should have priority for the limited supply of vaccines. On Friday, the agency clarified that it was recommending states can also move to its next priority: people over age 75 and essential workers.

New York on Friday became the latest state to expand its vaccination rollout to elderly people, with Gov. Andrew Cuomo announcing that people aged 75 and over could start receiving the shot next week.

New York has recorded over 38,000 COVID-19 deaths, more than any other U.S. state.

In Texas, Florida and Georgia, which are among some dozen states that have either begun or will soon start inoculating the vulnerable elderly, people over 65 are eligible for a shot. West Virginia and Indiana are so far limiting the vaccine to those over 80.

West Virginia leads the country in the pace of first-dose inoculations, having administered 59% of its allotted vaccine supply, according to CDC data.

The pandemic has shown no sign of retreat this week, killing more than 4,000 people nationwide for the second consecutive day on Thursday, or one life lost every 22 seconds, according to a Reuters analysis of public health data.

With a total of over 365,000 deaths, one in every 895 U.S. residents has died of COVID-19 since the pandemic started, according to Reuters calculations. Daily new cases reached a record 272,563 on Thursday.

The latest COVID-19 surge has been compounded by the spread of a new, more infectious coronavirus variant first detected in the United Kingdom that has now been found in at least eight U.S. states.

More than 132,000 Americans were hospitalized due to the coronavirus as of late Thursday night. The total number of U.S. cases since the pandemic began rose to 21.5 million, as strict mitigation measures further taxed the fragile U.S. economy.

The loss of 140,000 nonfarm payroll jobs in December, reported by the Labor Department on Friday, was concentrated in the leisure and hospitality sector. It has been especially hard-hit by the pandemic, with closures of bars and restaurants accounting for three-quarters of the job losses.

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