Friday, May 14, 2021

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Biden sets new vaccine goals as White House grapples with its message


WASHINGTON - President Joe Biden declared a new goal Tuesday that 70% of adults will have at least one coronavirus vaccine shot by the Fourth of July as the White House grappled with how to send Americans a complex message: A normal life is within reach if you get vaccinated - but the crisis is far from over, so dont fully relax your guard.

Biden has been accused of sending mixed messages recently by continuing to wear a mask outside despite official guidance that he does not need to, since he is fully vaccinated. The White House is reaching out to scientists and public health experts to understand how the science is evolving as more people get vaccinated and which restrictions they can and cannot relax, according to people familiar with or engaged in the conversations.

"The challenge for the president, and the federal government in general, is you're having to set standards for the entire country and role-model for the entire country, and what might be appropriate in one place is not what's appropriate everywhere," said Celine Gounder, an epidemiologist at New York's Bellevue Hospital and a member of Biden's coronavirus transition task force. "The problem is we don't know necessarily who around us is fully vaccinated."

Beyond aiming for 70% of adults to have at least one vaccine shot by Independence Day, Biden said Tuesday, he wants 60% to be fully vaccinated by the same time, part of an effort to create a nascent sense of normalcy by the holiday.

"The light at the end of the tunnel is actually growing brighter and brighter," Biden said. "We need you to bring it home. Get vaccinated."

The White House also told states Tuesday that coronavirus vaccine doses they choose not to order will become available to other states - the most significant shift in domestic vaccine distribution since Biden took office and part of his effort to account for flagging demand in parts of the country.

To help accomplish that, Biden announced a change in strategy to focus more sharply on hesitant and rural Americans - directing pharmacies to offer walk-in appointments, allocating funding for pop-up clinics and sending more doses to rural health clinics, among other moves.

To meet the new benchmarks, the country will need to dispense 100 million shots over the next 60 days, beyond the more than 200 million that have been administered so far. But this next phase will require reaching Americans who are far from traditional health-care facilities or are skeptical that getting vaccinated will do them any good.

Still, Biden's goals are well within reach given the current pace of vaccinations. The president has developed a pattern of announcing goals that may appear ambitious at first but end up being achieved with relative ease, such as his early pledge, made with much fanfare, to administer 100 million shots in his first 100 days - a goal he more than doubled.

About 150 million Americans have received at least one dose to this point, according to figures compiled by The Washington Post.

Biden said he will focus on three areas in the coming weeks: vaccinating adolescents between 12 and 15, if the Food and Drug Administration determines the vaccines are safe for them; making it more convenient for everyone to get vaccinated, especially those in rural and hard-to-reach locations; and persuading individuals who are hesitant to get vaccinated.

"We know there are millions of Americans who need a little bit of encouragement to get the shot," Biden said. That persuasion effort, he added, will in some ways be easier than the massive logistical effort it took to produce enough vaccines in the first place, but "in another sense it's harder, because it's beyond my personal control."

Health officials are confident that communities that can achieve a 70% vaccination rate will see sharp declines in individual cases, hospitalizations and deaths, a senior administration official said on a call with reporters Tuesday.

Still, over the past few weeks, some health experts have criticized Biden and the White House, arguing they need to better demonstrate the perks of getting vaccinated, a key step in overcoming hesitancy. After a surge of vaccinations over the past few months, supply has started to outstrip demand as hesitancy has become the Biden administration's most significant hurdle.

About 40% of adult Americans are fully vaccinated, but polls suggest that a significant portion of the population does not plan to get inoculated. In some cases, they believe the vaccines were developed too quickly and may be unsafe; in other cases, they are young adults who do not feel vulnerable.

Biden spoke directly to the latter group Tuesday, warning that even though the virus is especially dangerous to older people, that does not mean younger people are automatically safe.

"We're still losing hundreds of Americans under 65 years of age every week, and many more are getting seriously ill from long stretches at a time," the president said. "Look, even if your chance of getting seriously ill is low, why take the risk when you have a safe, free and convenient way to prevent it?"

For all the progress in beating back the pandemic, cases remain stubbornly high, at about 50,000 new confirmed infections each day - a number several experts said is probably an undercount given lower rates of testing - and about 700 deaths per day.

Ezekiel Emanuel, chair of the University of Pennsylvania Department of Medical Ethics and Health Policy, suggested Biden is trying to send a message to multiple audiences - those who have been vaccinated, those who are considering it and those who are reluctant.

"You've got this balancing act," said Emanuel, who was on Biden's coronavirus transition task force. "On the one hand, 'If he can't stop wearing a mask, then I might not be able to stop wearing a mask, and what's the advantage?' There is a strain of that. The other thing that probably is important is . . . we only have 44 percent of the population vaccinated, so that is a problem."

The administration has begun taking steps to loosen restrictions for those who are vaccinated, including new guidance last week from the Centers for Disease Control and Prevention that vaccinated Americans do not have to wear a mask outside, unless they are in a crowded venue such as a sports arena or at a concert.

But some experts note that there continues to be a patchwork recovery across the country. Several states are still experiencing increases in caseloads, and various pockets of the country have notably low vaccination rates.

Much of the appropriate public health behavior now depends on a person's specific circumstances, experts said. A group of people who are all fully vaccinated can return to their pre-pandemic behavior together, while a vaccinated person in a region of the country with high rates of transmission and many unvaccinated people still needs to take precautions such as wearing a mask.

The task for the administration over the next several weeks, as it works to hit its Fourth of July goal, will be persuading reluctant Americans to get vaccinated while not reopening the country too quickly and risking another surge in cases, experts said.

"We're in an area where it's not going to be guided by precise science. It's going to be guided by science, common sense and politics," said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota and an adviser to Biden's coronavirus task force. "We're going to see flare-ups of cases handled on a state-by-state basis. . . . I don't think we're done at all yet."

Biden also announced Tuesday that millions of dollars from his coronavirus relief package will be made available to support the new vaccination strategies. Nearly $250 million will be allocated to hire workers who will be charged with increasing vaccine confidence and assisting with vaccination appointments in hard-to-reach communities.

The president is also making available $130 million to improve vaccine education and information, particularly targeting health disparities in underserved communities. An additional $250 million will be allocated to assist state outreach efforts, and more than $100 million will be sent to approximately 4,600 rural health clinics.

But experts say the United States cannot fully return to normal until vaccine is widely available globally, because variants of the virus will continue to circulate and can be imported into the Unites States unless more people are inoculated. Numerous outside groups and liberal lawmakers have pushed the Biden administration to ramp up its commitment to help other countries obtain vaccine doses.

Biden nodded to the issue at the end of his comments Tuesday, noting that his administration has committed 60 million doses of AstraZeneca vaccine to other countries, calling it a "significant humanitarian commitment."

The AstraZeneca vaccine is not currently being used in the United States and faces an FDA safety review. But if the United States defeats the virus, Biden said, it will export the versions of vaccine it is currently using internally.

"As long as there's a problem anywhere in the world - even if we solve it here - we're going to move as quickly as we can to get as many doses of Moderna and Pfizer as possibly can be produced and export those around the world," Biden said.

Published : May 05, 2021

By : The Washington Post · Tyler Pager, Yasmeen Abutaleb