200 Million Served

The United States is vaccinating at a record pace. But were about to hit a wall.

Axios (“200 million COVID-19 vaccine doses“):

The U.S. has administered more than 202 million coronavirus vaccine doses since the start of its inoculation campaign, with nearly 4 million vaccinations reported on Friday alone, according to the latest data from the Centers for Disease Control and Prevention.

Why it matters: The numbers indicate Biden is on track to fulfill his promise of 200 vaccinations within his first 100 days in office. The president set a new goal late last month after it became clear the U.S. was outpacing his initial goal of 100 million doses.

By the numbers: 49.1% of U.S. adults have now received at least one dose. 64.6% of people in the country ages 65 and older are fully vaccinated. 38.5% of the total U.S. population has been vaccinated with at least one dose.

The big picture: Health officials continue to warn Americans to remain vigilant as dangerous coronavirus variants spread.

As good as the headline news is, the future doesn’t look so great:

There are also growing signs that parts of the country may be close to meeting demand for the coronavirus vaccine — well before the U.S. has reached herd immunity.

The politicization of the virus—dismissing it as “just the flu,” refusing to wear a mask and comply with other rules, and now vaccine hesitancy—is making fighting it extremely difficult. Hell, some one-third of United States Marines are refusing to get the shot.

I’ve been “fully vaccinated” (both Moderna shots plus 2 weeks) since Wednesday. My wife got her first Moderna dose two weeks ago yesterday and my oldest stepdaughter (20) got hers just yesterday. I suspect the other two over-16s in the family will get a dose in the next week or two. We’re doing our part!

Kevin Drum is among those advocating for making vaccination mandatory. He cites a NYT op-ed by Ezekiel J. Emanuel, Aaron Glickman and Amaya Diana urging:

Vaccines should be required for health care workers and for all students who plan to attend in-person classes this fall — including younger children once the vaccine is authorized for them by the Food and Drug Administration.

Employers should also be prepared to make vaccines mandatory for prison guards, E.M.T.s, police officers, firefighters and teachers if overall vaccinations do not reach the level required for herd immunity. Short of a mandate, these workers should be reminded that these vaccines have proved safe and are important not only for their health, but for the health of those they deal with in their jobs.

[…]

None of us likes being told what to do. But getting vaccinated is not just about our personal health, but the health of our communities and country.

Health care workers are professionals whose primary obligation is to their patients’ health and well-being. Except in extreme cases, their personal preferences are secondary.

When they decline to be vaccinated, they put their own preferences above the health and safety of their patients. No patient should worry whether her doctor, nurse or blood draw technician is vaccinated. Health care facilities should require all their workers to be vaccinated for the coronavirus, just as many do for the flu.

While I agree with that, some legal commentators have advanced the argument that the FDA emergency approval for the vaccines makes punishment for refusal unlawful. Whether that’s true hasn’t been tested but the fact that these drugs haven’t gone through the full vetting process is certainly part of the hesitancy problem. Indeed, it’s why US military personnel are not being required to get vaccinated.

Given that we’ve been administering the vaccine under emergency authorization for four months—and 200 million doses—you’d think the FDA could give full approval. That’s particularly true of the two mNRA variants (Moderna and Pfizer) which leave the system quickly. That would certainly allow mandating vaccination for front-line workers, teachers and students, and the like. Not to mention Marines.

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James Joyner
About James Joyner
James Joyner is Professor and Department Head of Security Studies at Marine Corps University's Command and Staff College. He's a former Army officer and Desert Storm veteran. Views expressed here are his own. Follow James on Twitter @DrJJoyner.

Comments

  1. Michael Cain says:

    The FDA can’t start their process until the drug companies file actual license applications, which none have. Moderna and Pfizer have both indicated they think they’ll be ready to file before the end of June. My understanding is that the license application has to include much more than just the efficacy/safety stuff, but complete production process, quality control, and supply chain information. (I believe that the episode early this month where a subcontractor error ruined 15M J&J doses was in a production situation that would get a license app rejected.) It’s also, I think, a complicated business decision. How many more doses can Pfizer sell of their -70 °C limited lifetime once thawed vaccine with an FDA license than they can under the EUA? Moderna is already starting trials for a vaccine variant to deal with the virus variants. Same business question — is the current vaccine the one they want to go to the effort and cost to license? Assuming a vaccine like J&J’s — single dose, cheaper to produce, easier logistics — proves effective and safe, do Pfizer/Moderna want to stay in the Covid vaccine business past the EUA, or move on to something like flu and HIV vaccines where they are simply better than the competing technologies?

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  2. Moosebreath says:

    At least 4 more today — my whole family is getting our first Pfizer shots today.

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  3. JohnMcC says:

    I see reports that 1/3d of the overall military are refusing the vaccines and that 40% of Marines are also not accepting it. If it is likely to be made mandatory that seems like the logical place to start. Since it has not been discussed, I’m thinking requiring vaccination is a dead letter.

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  4. Michael Reynolds says:

    I have a question for the more medically inclined: as I understand it, the goal is to achieve herd immunity by inoculating whatever the number is, 80% or so. And that the purpose of striving for herd immunity is, in addition to simply making it less likely that any given person will get sick, also to limit the ability of the virus to mutate as it spreads. If all that is correct, given the fact that we already have variants named for various countries here in the US, wouldn’t we have to achieve global herd immunity before we could hope to curtail new mutations?

    Thanks, I’ll take my answer off the air.

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  5. Teve says:

    @Michael Reynolds: that’s correct. And many parts of the globe are getting virtually no vaccines yet. It may not be possible to reach global herd immunity anytime soon; the earliest, most optimistic estimates I’ve seen are for mid to late 2022. But even without herd immunity, the more people are vaccinated, the slower the spread and the fewer people get sick. And so far it looks like getting a vaccine for one strain gives you some amount of immunity to many or most other strains.

    73 hrs til I get Moderna #2 and I can hardly wait.

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  6. Jen says:

    Scheduled to get Pfizer #2 at the end of the month, and I am thrilled about it!

    But Michael is correct that global herd immunity is what we need, and we are likely not going to get there anytime soon.

    I just hope that doesn’t end up negating everything we’ve done so far. The potential for destructive variations is immense.

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  7. Question.

    Can the military order all active duty soldiers, sailors,:and Marines to take the vaccine?

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  8. James Joyner says:

    @Doug Mataconis: One imagines they would have if they could have. The emergency approval is the stated rationale for making it voluntary.

  9. Gustopher says:

    @Michael Reynolds: Adding onto what Teve said — until we get global herd immunity, there will always be a risk of a breakout variant that is able to get past the vaccines.

    The variants we know about are able to do that somewhat, but not so much that the R0 — the number of people an infected person is likely to infect — rises above 1. So outbreaks might be bad (nursing home, poorly ventilated office, etc) but will fizzle out in the general population.

  10. Stormy Dragon says:

    @JohnMcC:

    My understanding is that the military can’t require the COVID19 vaccines since they technically only have an Emergency Use Authorization and not a full approval.

  11. @James Joyner:

    Could the Preaudent acting as Commander In Chief issue an order that all active duty troops to be vaccinated.

    Also, I’ve been told when I raised this issue on social media that refusal to vaccinate would result in someone bring ruled non-deployable. This seems especially important when it comes to deployment in the Navy.

  12. It’s worth noting that this is 200 million doses not 200 million individuals fully vaccinated

  13. James Joyner says:

    @Doug Mataconis: I would think he could, although it might be challenged as an illegal order. It would be a lot simpler if FDA would just give it official status.

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  14. Michael Cain says:

    @James Joyner:

    It would be a lot simpler if FDA would just give it official status.

    It would. Having spent part of the afternoon skimming, though, there are a bunch of hoops that each drug company and the FDA have to jump through before they can issue an actual license. The filings for the Pfizer and Moderna vaccines are probably harder than usual because it’s a new class of product with new processes: no one’s done an mRNA vaccine before. The Pfizer and Moderna filings will have to include enough material to teach the FDA staff to understand the details of the process and evaluate the quality control procedures, etc.

    Bitch at Congress, they wrote the rules. I’m at least modestly impressed that they remembered to include an EUA for situations like this one. And they could certainly require the military to be vaccinated.

  15. Stormy Dragon says:

    @Michael Cain:

    Bitch at Congress, they wrote the rules.

    Counterpoint, those rules are probably the only thing that saved us from mandatory bleach and oleander injections last year.

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