WASHINGTON – The Trump administration, which has seen rising Covid-19 fatalities, ordered states on Tuesday to immediately start vaccinating all Americans 65 and over, as well as tens of millions of adults with conditions who have this Risk of dying from coronavirus, higher is infection.
The federal government will release all available doses of the vaccine instead of reserving about half for second doses, said Health Secretary Alex M. Azar II. States should start allowing pharmacies and community health centers, which are largely ill-served, to help the populations Manage shots.
The announcement came as Covid-19 deaths in the pandemic soared to their peak and the new administration of Joseph R. Biden Jr. has pledged a far more aggressive nationwide vaccination effort.
And it came with a stick: states will lose their allocations, said Mr Azar, if they don’t use up cans quickly. From two weeks onwards, government vaccine allocations are based on a country’s population aged 65 and over, not the general adult population. However, it was unclear whether this would apply after January 20, when Mr Biden took office.
“This next phase reflects the urgency of the situation we are facing,” said Azar. “Any dose of vaccine sitting in a warehouse instead of walking into an arm could mean another life is lost or another hospital bed is occupied.”
Mr Biden’s transition team had said a few days ago that the incoming administration would release almost all cans from government reserves. Mr Azar responded at the time that doing so would compromise the system to ensure second doses are available.
Tuesday’s reversal reflected the slow start of vaccine adoption, although the pace has picked up significantly over the past week. Some states, including Florida, Alaska, Michigan and Texas, have already started vaccinating people aged 65 and over, who number more than 50 million nationwide. This leads to long lines and confusion about how to get a shot.
The new policy could add to this confusion. Many states have met their own carefully set deadlines to get the vaccine into priority groups – including teachers, rescue workers, grocery store workers, and other types of key workers that Mr Azar didn’t mention at all in his announcement.
Only Texas has offered shots to all residents with at least one chronic condition. The C.D.C. It is estimated that more than 100 million adults have conditions such as obesity, which affects at least 40 percent of adults, and diabetes, which increase the risk of developing serious illness from Covid-19.
Other states had planned to gradually expand access to older residents over the next month. Ohio, for example, should start vaccinating people 80 years and older next week, people 70 years and older on February 1, and people 65 and over on February 8.
The Centers for Disease Control and Prevention last month recommended that states vaccinate, after vaccination of health workers and residents of long-term care facilities, people over 75 and certain “frontline workers” who cannot do their jobs from home should. Only then was the C.D.C. Recommended, states should apply to people ages 65 to 74 and adults of all ages with high-risk diseases. The C.D.C. Recommendations were not binding, but many states have largely followed them while demand far outstrips supply.
“Many of our members feel that this is just getting too fast,” said Dr. Marcus Plescia, the Chief Medical Officer of the Association of State and Territorial Health Officials. “What we’re going to achieve is a first-come, first-served approach to vaccine distribution, and it just doesn’t do it justice.”
How Mr Azar’s enforcement threat will work is unclear. In two weeks, Mr. Biden will have been sworn in as President.
Mr Biden is expected to release details this week on his own vaccination schedule, which will include nationwide supported mass vaccination clinics. The Biden transition team declined to comment on the new Trump policy on Tuesday. However, one person familiar with the president-elect’s plans said that Mr Biden also had plans to expand the universe of those eligible for vaccination.
Mr Azar said the Trump administration always expected to stop holding back the cans once it was convinced of the supply chain.
Dr. Paul Offit, a professor at the University of Pennsylvania and a member of the Food and Drug Administration’s Vaccine Advisory Board, praised the government’s decision and compared the current situation to the Titanic, where there weren’t enough lifeboats to save everyone. “And you have to decide who you want to pass on. “
While the exact order of vaccine recipients may vary from state to state, most doctors and residents of long-term care facilities will come first. If you want to understand how this decision is made, this article will help.
Life will only get back to normal when society as a whole receives enough protection against the coronavirus. Once countries approve a vaccine, they can only vaccinate a few percent of their citizens in the first few months. The unvaccinated majority remain susceptible to infection. A growing number of coronavirus vaccines show robust protection against disease. However, it is also possible for people to spread the virus without knowing they are infected because they have mild or no symptoms. Scientists don’t yet know whether the vaccines will also block the transmission of the coronavirus. Even vaccinated people have to wear masks for the time being, avoid the crowds indoors and so on. Once enough people are vaccinated, it becomes very difficult for the coronavirus to find people at risk to become infected. Depending on how quickly we as a society achieve this goal, life could approach a normal state in autumn 2021.
Yeah, but not forever. The two vaccines that may be approved this month clearly protect people from contracting Covid-19. However, the clinical trials that produced these results were not designed to determine whether vaccinated people could still spread the coronavirus without developing symptoms. That remains a possibility. We know that people who are naturally infected with the coronavirus can spread it while they don’t have a cough or other symptoms. Researchers will study this question intensively when the vaccines are introduced. In the meantime, self-vaccinated people need to think of themselves as potential spreaders.
The vaccine against Pfizer and BioNTech, like other typical vaccines, is delivered as a shot in the arm. The injection is no different from the ones you received before. Tens of thousands of people have already received the vaccines, and none of them have reported serious health problems. However, some of them have experienced short-lived symptoms, including pain and flu-like symptoms that usually last a day. It is possible that after the second shot, people will need to have a day off to work freely or go to school. While these experiences are not pleasant, they are a good sign: they are the result of your own immune system’s encounter with the vaccine and a strong reaction that ensures lasting immunity.
No. Moderna and Pfizer vaccines use a genetic molecule to boost the immune system. This molecule, known as mRNA, is eventually destroyed by the body. The mRNA is packaged in an oily bubble that can fuse with a cell, allowing the molecule to slide inside. The cell uses the mRNA to make proteins from the coronavirus that can stimulate the immune system. At any given moment, each of our cells can contain hundreds of thousands of mRNA molecules that they produce to make their own proteins. As soon as these proteins are made, our cells use special enzymes to break down the mRNA. The mRNA molecules that our cells make can only survive a few minutes. The mRNA in vaccines is engineered to withstand the cell’s enzymes a little longer, so the cells can make extra viral proteins and trigger a stronger immune response. However, the mRNA can hold for a few days at most before it is destroyed.
“Without a doubt there will be people who will die in the next three or four months because they didn’t get this vaccine,” said Dr. Offit. “It’s tragic.”
Dr. Grace Lee, a pediatrician at Stanford University and a member of the committee of experts who drafted the CDC’s recommendations for prioritizing the vaccine, said she was excited to see far more people vaccinated but feared some at-risk groups could be lost in the shuffle .
“We should make sure that we keep an eye on the results at the national level: efficiency and equity,” said Dr. Lee.
Almost 380,000 people have died of Covid-19 in the United States since the pandemic began. In the past few days, the number of daily deaths in the country has exceeded 4,000.
As of Monday, approximately nine million people had received at least one dose of a Covid-19 vaccine, the C.D.C. said far behind what the federal government originally promised. According to a survey by the New York Times of all 50 states, at least 151,000 people in the United States had been fully vaccinated by January 8. But Mr Azar said Wednesday the country was “on track” to hit the rate of a million vaccinations a day in a week or so. He said the perceived delay in using cans was at least partially due to slow data collection.
The idea of using existing vaccine supplies for the first doses has raised objections from some health workers and researchers, who fear that frontloading shots increase the risk of delaying the second injections. Clinical studies testing the vaccines showed that the shots were effective when given in two doses on a strict schedule. And while some protection seems to work after the first shot, experts aren’t sure how far that protection goes or how long it could last without the second dose to increase its effects.
Others, however, have vocal in favor of delays on the second dose, arguing that a wider spread of the partial protection a single shot provides will save more lives.
Even ahead of Tuesday’s order, health professionals and state officials faced difficult choices as they decided which groups should have priority when the vaccine was rolled out. While older Americans have died from the virus at the highest rate, key workers have been at greatest risk of infection, and the category includes many poor and colored people who have suffered disproportionately high rates of infection and death.
Despite the bumpy rollout in his state, Florida Governor Ron DeSantis, who has always focused on people 65 and over, believed that questioning all older people was always the right thing to do.
The initial guidelines “would have enabled a 20-year-old healthy worker to get vaccinated in front of a 74-year-old grandmother,” DeSantis said Tuesday at a press conference in the sprawling age community called The Villages. “That doesn’t see how this virus affected the elderly.”
In New York, where vaccination began this week for people aged 75 and over and more important workers, Governor Andrew M. Cuomo said the state will accept the new federal guidelines for prioritizing those over 65, but stressed that the state would this would not have done nearly enough short-term vaccine to reach the newly targeted populations.
The new guidelines will call more than seven million New Yorkers into question for the vaccine, Cuomo said, although the state is currently only receiving 300,000 doses a week.
“With 300,000 a week, how can you effectively care for seven million people, all now eligible, without priority?” he asked.
New Yorkers 65 and older can make appointments right away on the state’s website, according to Melissa DeRosa, one of Cuomo’s top counselors. who added that the state with the C.D.C. about who is considered a weakened immune system.
New guidelines released on Monday by C.D.C. Now note that while people should get their second shots “as close as possible to the recommended three-week or one-month interval,” there is “no maximum interval between first and second doses for either vaccine.” gives.
The update puzzled experts, who said that other previously approved vaccines could be given at multiple doses months or even years apart, but there is still no evidence to clearly support this strategy for Covid-19. “You need data to back this up,” said Marion Pepper, an immunologist at the University of Washington.
The UK health authorities now allow intervals between the first and second dose of Pfizer vaccines of up to 12 weeks. Last week the World Health Organization said the injections could be given up to six weeks apart.
In response to questions about dose delays, Pfizer and Moderna representatives repeatedly referred to the company’s clinical studies testing dosing regimens with two shots separated by 21 days for Pfizer and 28 days for Moderna.
“Two doses of the vaccine are required to provide maximum protection against the disease, a vaccine effectiveness of 95 percent,” said Steven Danehy, a Pfizer spokesman, this month. “There is no data to show that protection is maintained after the first dose after 21 days.”
On Tuesday afternoon, Kristen Nordlund, a spokeswoman for the C.D.C., said the agency’s guidelines would allow “flexibility” if the vaccine rollout continues.
But she added, “We’re not trying to encourage delays on the second dose in order to get more people vaccinated on the first dose.”
The coverage was contributed by Katie Thomas from Chicago, Roni Caryn Rabin, Katherine J. Wu and Amanda Rosa from New York and Patricia Mazzei from Miami.