The Centers for Disease Control and Prevention reported on Monday that 2.1 million doses of coronavirus vaccines have been administered in two weeks. While this might sound like an impressive number, it should set off alarms.
Let’s start with the math. Anthony Fauci, the government’s top infectious-disease doctor, estimates that 80 to 85% of Americans need to be vaccinated to reach herd immunity. Both the Pfizer and Moderna vaccines require two doses. Eighty percent of the American population is around 264 million people, so we need to administer 528 million doses to achieve herd immunity.
At the current rate, it would take the United States approximately 10 years to reach that level of inoculation. That’s right — 10 years. Contrast that with the Trump administration’s rosy projections: Earlier this month, Health and Human Services Secretary Alex Azar predicted that every American will be able to get the vaccine by the second quarter of 2021 (which would be the end of June). The speed needed to do that is 3.5 million vaccinations a day.
There’s reason to believe the administration won’t be able to ramp up vaccination rates anywhere close to those levels. Yes, as vaccine production increases, more will be available to the states. And Brett Giroir, assistant secretary for health at HHS, argued on Sunday that the 2.1 million administered vaccines figure was an underestimate due to delayed reporting. So let’s be generous and say the administration actually administered 4 million doses over the first two weeks.
But even that would still fall far short of the 3.5 million vaccinations needed per day. In fact, it falls far short of what the administration had promised to accomplish by the end of 2020 — enough doses for 20 million people. And remember, the first group of vaccinations was supposed to be the easiest: It’s hospitals and nursing homes inoculating their own workers and residents. If we can’t get this right, it doesn’t bode well for the rest of the country.
Here’s what concerns me most: Instead of identifying barriers to meeting the goal, officials are backtracking on their promises. When states learned they would receive fewer doses than they had been told, the administration said its end-of-year goal was not for vaccinations but vaccine distribution. It also halved the number of doses that would be available to people, from 40 million to 20 million. (Perhaps they hoped no one would notice that their initial pledge was to vaccinate 20 million people, which is 40 million doses, or that President Trump had at one point vowed to have 100 million doses by the end of the year.) The vaccine rollout is giving me flashbacks to the administration’s testing debacle. Think back to all the times Trump pledged that “everyone who wants a test can get one.” Every time this was fact-checked, it came up false. Instead of admitting that there wasn’t enough testing, administration officials followed a playbook to confuse and obfuscate: They first attempted to play up the number of tests done. Just like 2 million vaccines in two weeks, 1 million tests a week looked good on paper — until they were compared to the 30 million a day that some experts say are needed. The administration then tried to justify why more tests weren’t needed. Remember Trump saying that “tests create cases” or the CDC issuing nonsensical testing guidance?
When that didn’t work, Trump officials deflected blame to the states. Never mind that there should have been a national strategy or that states didn’t have the resources to ramp up testing on their own. It was easier to find excuses than to admit that they were falling short and do the hard work to remedy it.
Instead of muddying the waters, the federal government needs to take three urgent steps. First, set up a real-time public dashboard to track vaccine distribution. The public needs to know exactly how many doses are being delivered, distributed and administered. Transparency will help hold the right officials accountable, as well as target additional resources where they are most needed.
Second, publicize the plan for how vaccination will scale up so dramatically. States have submitted their individual plans to the CDC, but we need to see a national strategy that sets ambitious but realistic goals.
Third, acknowledge the challenges and end the defensiveness. The public will understand if initial goals need to be revised, but there must be willingness to learn from missteps and immediately course-correct.
I remain optimistic that vaccines will one day end this horrific pandemic that has taken far too many lives. To get there, we must approach the next several months with urgency, transparency and humility.
Leana Wen is an emergency physician and visiting professor at George Washington University Milken Institute School of Public Health.
Previously, she served as Baltimore’s health commissioner.
Leana S. Wen, a Washington Post contributing columnist, is an emergency physician and visiting professor at George Washington University Milken Institute School of Public Health. Previously, she served as Baltimore’s health commissioner.