The purchases would increase available supply by 50%, bringing the total to 600 million doses by this summer.
Because both products - one developed by Pfizer and German company BioNTech and the other by Moderna - are two-dose regimens, that would be enough to fully vaccinate 300 million people. An estimated 260 million people in the United States are currently considered eligible to receive a coronavirus vaccine, though Pfizer and Moderna have initiated trials for children as young as 12, the results of which could expand the pool.
The deals promised by President Joe Biden would not immediately speed up vaccinations. But they would greatly boost his chances of returning the nation to some semblance of normalcy by late summer or the fall.
The president said Monday he expects the general public to gain access to shots by the spring - as he seemed to elevate his administration's goal from 1 million vaccinations a day to 1.5 million - though aides said that was aspirational. And Biden drew back Tuesday to his earlier ambition of administering 100 million shots in his first 100 days, insisting it would be a good start.
Biden, in remarks Tuesday evening, said he expected the additional doses to be delivered through the summer.
"This is an aggregate plan that doesn't leave anything on the table or anything to chance, as we've seen happen in the past year," the president said.
He added, in a further effort to distinguish his approach from that of his predecessor, "This is a wartime effort."
The companies were more cautious in public statements, though people knowledgeable about the negotiations said formal deals were imminent because the government was using options built into existing contracts to receive the additional doses. Those people, like several others, spoke on the condition of anonymity to describe internal matters.
Moderna spokesman Ray Jordan declined to comment. Pfizer spokeswoman Amy Rose said the company "has engaged in regular communications with the Biden administration and we stand at the ready to start negotiations should the White House choose to execute their option for additional doses."
Each company has already agreed to deliver 200 million doses to the federal government by the end of June. Pfizer has said it can deliver 120 million of those doses by the end of March, at a price of $19.50 per dose, while Moderna has pledged 100 million by then, with each dose sold for $15.
Manufacturing has steadily ramped up, in pace with those targets. As a result, federal allocations to states and other jurisdictions will increase by about 16% next week, easing shortages that have intensified nationwide without immediately alleviating supply problems.
Jeff Zients, coordinator of the White House's coronavirus response, informed governors of the increase on a call Tuesday afternoon, according to two people who participated and spoke on the condition of anonymity to describe the conversation.
The weekly allocation is forecast to go from about 8.6 million doses to about 10 million. The vaccines are distributed on a population basis among 64 jurisdictions, including 50 states, eight territories and six major cities.
Senior administration officials said the increased supply will come mostly from releasing more doses of Moderna's vaccine. The stepped-up allocations will remain for three weeks, these officials said, as the Department of Health and Human Services provides estimates on that time scale going forward.
The increased allocations and the promise of better forecasts came as welcome news to state and local officials, who have implored the federal government for estimates of available supply so they can plan and set expectations for the public.
Such projections were not possible in December, according to current and former federal officials, because of uncertainty about manufacturing and instability in the supply chain. The government has gained greater understanding of production schedules, especially after directing suppliers to fulfill Pfizer's needs under the Defense Production Act.
Moderna this month raised its global target for the year from 500 million doses to 600 million. Pfizer and BioNTech recently raised their target from 1.3 billion doses to 2 billion.
But precise manufacturing schedules remain difficult to predict, and Zients could not answer questions on Tuesday's call with governors about exact production levels and when he expected significant scale-up, according to one state official who participated. The official said the administration promised more details "sooner rather than later."
Meanwhile, vaccine shortages are having stark consequences throughout the country. Appointments have been canceled en masse as health officers and medical providers confront a sharply limited supply of doses, which are being targeted at medical workers, older people, some front-line workers and other highly vulnerable people. The patchwork of rules about eligibility has deepened confusion about access to the shots.
New information is around the corner about a third vaccine, though its efficacy is not publicly known. Health officials are awaiting data from a trial by Johnson & Johnson, which will probably arrive in the next week.
That data may also suggest how a vaccine performs against one of the virus variants spreading alarm globally, because some of the trial was conducted in South Africa, where a more transmissible variant has been identified. The federal government has already paid $1 billion for the first 100 million doses of Johnson & Johnson's vaccine, which, if it proves effective, would be a boon because it is a single dose.
The effort to buy additional Pfizer and Moderna doses vaccines represents a shift in strategy, as the Biden administration doubles down on two highly effective products authorized by federal regulators. The Trump administration worked to spread its risks over many vaccine candidates.
Once the Pfizer and Moderna vaccines late last year showed such high efficacy - about 95% - some government experts argued the administration should quickly acquire as much of those vaccines as possible, even if the United States ended up with more vaccine than needed.
That argument has gained currency with the Biden administration, according to people familiar with the government's thinking, partly because of the emergence of variants that appear to be more transmissible and possibly more lethal than the original coronavirus.
Early data shows that the two vaccines may be effective against the British variant of the virus that already is causing infections in the United States. And scientists believe they may possibly be effective against other variants, including ones identified in Brazil and South Africa. The South African variant has not appeared in the United States, but the Brazilian one was recently found in a case in Minnesota.
In addition, the Pfizer and Moderna vaccines, which use a platform known as mRNA to elicit a potent immune response, are the easiest type of vaccine to change to counter threatening new variants.
Biden and his top aides have stressed that vaccine supply is only one aspect of the challenges involved in executing the immunization campaign. The administration is seeking additional resources for state and local health departments and has vowed greater federal coordination of the efforts, including plans to augment the public health workforce and set up mass vaccination sites.
The administration has also pledged to increase transparency for state and local officials overseeing ground-level planning and for members of the public waiting to be vaccinated.
Biden administration officials are also seeking to have more data related to vaccination efforts posted on the website of the Centers for Disease Control and Prevention, according to a federal health official. Ideally, that would include data about manufacturing, supply and allocation to the states. Information about production and supply is not currently publicly available.
The vaccine rollout has been marked by a lack of transparency about stockpiles, short-term rollout schedules and contradictory statements from government officials. Companies producing vaccines have issued broad statements about vaccine goals, based on quarterly projections.
In Pfizer's case, production estimates were recently accelerated by the Food and Drug Administration's recognition of a sixth dose in each vial, which previously had been considered to be "over fill'' beyond the initial five-dose capacity. The change resulted in an instant 20% increase in Pfizer's quota.
The companies said they have been giving more detailed information about vaccine availability to the government, which then relays the information about weekly shipment expectations to state officials.
But the lack of accurate and consistent information has been a major complaint at the state level, as the initial shipments of vaccine have not matched the volume of vaccines local systems are demanding.
The Biden administration appeared to put pressure over the weekend on Pfizer and Moderna to improve the flow of information about vaccine manufacturing and supply. Appearing on "Fox News Sunday,'' Biden's director of the Centers for Disease Control and Prevention, Rochelle Walensky, said, "I can't tell you how much vaccine we have, and if I can't tell it to you then I can't tell it to the governors and I can't tell it to the state health officials.''
Asked to respond to Walensky's concerns this week, Moderna and Pfizer said they have been reporting on a daily and weekly basis the amount of vaccine that will be ready.
"We have and are continuing to work closely with the U.S. government on our production, release and shipping schedules - to ensure Americans receive their first and second doses of the vaccine on time,'' Pfizer said in a statement this week. "We have provided them with a specific schedule, and we foresee no issues in delivering on the commitments we have made."
Jordan, Moderna's spokesman, said the U.S. government is in charge of relaying fine-grained information to states. "The U.S. Government is our customer, and they are free to communicate as they wish," he said.
A former Trump administration official, who spoke on the condition of anonymity to address sensitive matters, said Moderna has been more forthcoming about its vaccine production than Pfizer.
"With Moderna, we always had a pretty clear sense of what was further ahead, and any potential issues, a better ability to accurately predict what was coming," the official said. "With Pfizer, we didn't have as much insight. It was a byproduct of their unwillingness to work as collaboratively with Warp Speed as other companies."
Pfizer did not respond to a request to address the criticism.
Along with other vaccine manufacturers, Pfizer last summer signed an advanced purchase contract with the Trump administration. But the company did not accept research and development money or backing for clinical trials from the government.
Pfizer also opted to distribute its vaccine to states on its own, rather than permit its vaccine to be shipped by national wholesaler McKesson, the government's designated distributor for vaccine and supplies. Its shipments are nonetheless following the federal government's allocation guidance.
Much of Pfizer's supply is obligated to other countries. But the pharmaceutical giant has recently delayed or reduced shipments to Canada and Europe as it retools a factory in Belgium, frustrating foreign governments.
Published : January 27, 2021
By : The Washington Post · Isaac Stanley-Becker, Laurie McGinley, Christopher Rowland