Experts warn of vaccine stumbles 'out of the gate' because of Trump officials' refusal to consult with Biden's team

"Everyone was completely responsive to any question," said Lawrence Summers, director of the National Economic Council under President Barack Obama. "They talked to us about major decisions."

That smooth handoff is in stark contrast to what is happening now as President-elect Joe Biden prepares to assume power during a double-barreled crisis involving a lethal virus and its economic fallout that experts say demands close cooperation. Instead, as the coronavirus overwhelms U.S. hospitals and kills more than 3,300 people a day on average, the Trump administration has balked at providing access to information and failed to consult with its successors, including about distributing the vaccines that offer the greatest hope of emerging from the pandemic.

For more than a month, the Biden team pressed to attend meetings that offered "real-time information on production and distribution of vaccine" - important details for the president-elect's advisers debating ways to bring the pandemic under control, said a transition official, speaking on the condition of anonymity to discuss private interactions.

While health agencies' career staff have been helpful, it was not until this week that Biden officials were allowed to attend meetings of Operation Warp Speed, the administration's initiative to accelerate vaccine development and distribution. They were also not invited to the two Warp Speed sessions this weekend when Trump officials decided on sweeping changes to try to speed up the sluggish vaccine rollout. Nor were they briefed on those changes in advance.

While some of those policies mirrored Biden plans, others raised red flags among the president-elect's advisers. One is a recommendation to offer vaccines immediately to tens ofmillions under 65 who have high-risk medical conditions - a change the Biden team fears could overwhelm state supply and already stressed sign-up systems, while creating unrealistic expectations for those eager to get inoculated.

Another new policy, involving the controversial question of whether to penalize slower-moving states, was to take effect the week after Biden becomes president. State officials say they are uncertain about whether to take the new policy seriously or to brush it off because it seems to lack support from the incoming administration.

But on Thursday, Conn. Gov. Ned Lamont, a Democrat, tweeted that federal officials had notified the state that it would receive an additional 50,000 doses next week "as a reward for being among the fastest states" to get shots into arms. West Virginia, which is moving at the fastest clip based on Centers for Disease Control and Prevention data, did not get any additional doses, said Holli Nelson, a spokeswoman for the state's National Guard. An HHS spokesperson did not immediately respond to a request for comment.

The Biden transition official also said it took the transition team several weeks to get access to Tiberius, a data system that would have helped officials understand earlier "where vaccine is going, which states are ordering, when it is moving."

"Look, we are still prepared to meet our goal of 100 million shots in 100 days," the official said, referring to a commitment Biden made in early December. "But it would have been a lot more helpful if we'd had access to real-time information."

On Thursday afternoon, another senior Biden official described "uneven cooperation" from the Trump administration. He spoke on the condition of anonymity before Biden's speech Thursday night calling on Congress for an additional $400 billion to fight the pandemic, including $20 billion for a national vaccination program.

The lack of coordination has alarmed public health officials and experts on presidential transitions, especially as a more contagious virus variant first identified in Britain spreads across the United States and the Centers for Disease Control and Prevention projects as many as 477,000 covid-19 deaths by Feb. 6.

The dearth of coordination "means we are stumbling out of the gate with the vaccine," said Douglas Brinkley, a presidential historian at Rice University. "We are failing at a government level on distribution because there is no game plan. There is a chaotic Trump one and a learning-curve Biden one."

The decision to urge states to immediately vaccinate a much larger pool of people - about 81 million between the ages of 16 and 64 with high-risk medical conditions- was "absolutely inappropriate," said Michael Osterholm, a member of Biden's covid-19 advisory board and director of the Center for Infectious Disease Research and Policy at the University of Minnesota.

"When you make a recommendation that . . . far exceeds the number of doses that are available for the foreseeable future, that's not helpful," Osterholm said. "It only creates confusion, frustration and, frankly, a lack of trust in the system."

At least 11.1 million people have received one dose of the vaccine in the U.S.

Health and Human Services Secretary Alex Azar and other Warp Speed officials said they made the decision to dramatically increase eligibility because too many doses are sitting in freezers and they have greater confidence in a reliable supply of vaccines.

A senior Trump official denied there was any effort to keep Biden in the dark about Warp Speed activities. The official, who spoke on the condition of anonymity to discuss internal deliberations, said that while Biden officials only recently have been invited to Warp Speed meetings, they have been regularly briefed on what has been discussed.

The official said it was not appropriate for the Biden team to take part in making decisions because the United States has "one government at a time." He added that when Biden becomes president, "they can change everything if they want."

Tensions between incoming and outgoing administrations aren't unusual - for example, the post-election period between Democrat Harry S. Truman and Republican Dwight D. Eisenhower in the early 1950s was especially acrimonious. But it's hard to imagine a transition more fraught than this one, with a president raging against the election results as a deadly pandemic rages out of control.

"It's a very bad TV show that I would stop watching because it is so unbelievable," said Howard Markel, a medical historian at the University of Michigan.

The transition initially was stalled when the General Services Administration, headed by a Trump appointee, refused to recognize Biden's victory and provide funding to his transition team. The GSA administrator reversed course on Nov. 23.

But even when Trump career officials were told they could talk to the Biden team, they were permitted to share only publicly available information, said an administration health official who spoke on the condition of anonymity to discuss internal matters. "After that, we could share nonpublic information, but it had to be cleared first."

Even if the Trump forces did not want to cooperate with Biden in some areas, there should have been a free flow of information on vaccine issues, said the Trump health official, who compares the current crisis to a war. "The pandemic should have been a DPZ - depoliticized zone," he added.

Brinkley shared that view. "Operation Warp Speed should be deeply bipartisan" with a constant exchange of information, he said. "The fact that has not been happening with Trump is because he's called it a fraudulent election. Why would I give data to somebody who is a fake president-elect?"

Max Stier, president and CEO of the Partnership for Public Service and an expert on presidential transitions, described handoffs of power as a relay race in which runners have to pass the baton. "You run side by side as fast as possible so you can win," he said. "You don't want it to be a start-and-stop strategy, you want it to be a smooth handoff.

"Because your decisions might only last for another week, there should be an alignment" with the incoming administration, he added.

Despite the challenges, Biden and his team have scooped up extensive information about coronavirus vaccine production and distribution from long-standing contacts in pharmaceutical companies and federal agencies. And they have gotten information through back channels from career staff working "off the clock" and using personal email accounts.

Jeffrey Koplan, a former director of the CDC, said it was "shocking" that members of the outgoing administration hadn't involved Biden's team in their decision-making.

"It's not rocket science - it's been done before," said Koplan, who was head of the CDC under both Bill Clinton and George W. Bush.

There also was much more discussion and cooperation in prior transitions on a range of health issues, said Nicole Lurie, who is advising the Biden team, participated in the Obama transition and later served as Obama's assistant secretary for preparedness and response at HHS.

"I knew the person who had been in the role before me, we had a period of overlap, and there was just a lot of information-sharing," Lurie said. "It's nowhere near as complicated as it is now."

While the Bush-Obama handoff is often cited as a model, a well-functioning transition has been regarded by leaders of both parties as an important goal until very recently, according to former administration officials and historians.

Through most of the 20th century, outgoing and incoming presidents were occasionally antagonistic, such as in the transition between Herbert Hoover and Franklin D. Roosevelt in the early 1930s, Brinkley said. Yet even in those times, it was thought that "the crown jewel of American democracy is the smooth transition. You go out for political combat for two years" until the election, followed by a seamless transition, he said.

Partisanship intensified in the 1990s, he said. But even after the 2000 election, which was contested for more than a month before being decided by the Supreme Court, Bill Clinton's staff provided the George W. Bush team with intelligence data on al-Qaida and other terrorist groups. That occurred before it was clear that Bush - not Clinton's vice president, Al Gore - would be the next president, Brinkley noted.

Recalling the drawn-out election battle, Summers, who in 2000 was Clinton's outgoing treasury secretary, said: "We didn't think what happened was fair or legitimate. But it didn't occur to anyone to not concede, or to not work with the transition once the Supreme Court ruled."

Said Brinkley, "It used to be seen as anti-American not to have a smooth transition."