Vaccine Eligibility Floodgates Open Before Supply

Many states are moving to a first come, first served basis for COVID shots.

Earlier this month, President Biden directed states to make all residents over the age of 16 eligible for COVID vaccination by May 1. Today, he’s gone further.

Bloomberg (“Biden to Say 90% of U.S. Adults Eligible for Shot in 3 Weeks“):

President Joe Biden plans to announce that 90% of U.S. adults will be eligible to get a Covid-19 vaccine in three weeks, and that his administration will more than double the number of pharmacies where shots are available, officials familiar with the matter said.

Biden will make the announcement Monday afternoon at the White House, marking April 19 as a new milestone in the vaccination effort. He’ll also say that nearly all U.S. adults will be able to get a shot within 5 miles of their homes, said the officials, who spoke on condition of anonymity.

The announcement comes as the U.S. continues to ramp up its inoculation effort. Biden doubled his goal for vaccines last week after the U.S. reached his initial target six weeks early. The U.S. hit a record three-day stretch of at least 3 million daily shots from Friday to Sunday, and the White House has said its three authorized vaccine producers are all on track to meet their delivery targets this week.

Several states are moving even faster.

Ten states are set to open eligibility for COVID-19 vaccines to all adults this week, with 46 states and Washington, D.C., pledging to meet President Joe Biden’s goal of having all Americans eligible by May 1, reports USA Today. 

Kansas, Louisiana, North Dakota, Ohio, Oklahoma and Texas will remove vaccine restrictions today for those 16 and older. Minnesota will follow March 30, Indiana and South Carolina on March 31, and Connecticut April 1.  

That report, a mere three hours old, doesn’t include New York, which is joining suit:

Governor Andrew Cuomo on Monday announced that the state will make all New York adults eligible for vaccines no later than April 6, with residents 30 and older eligible beginning at 8 a.m. on Tuesday, March 30.

That’s all exciting news for those, like my wife, who wants the vaccine but is nowhere near the top of the current priority list. (And we live in Virginia, which has not yet joined this wave.)

Given his tendency to surround himself with competent people and listen to them, I’ll operate on the presumption that President Biden is making the right call based on the information available. We may simply be far enough along in vaccination the most critical populations that it’s more efficient to open the floodgates.

But, given that we’re still far short of having enough vaccine supply to meet demand, this means that the new prioritization will, effectively, be those most able to locate an available shot. Which, of course, will skew towards the affluent and educated. People like my wife, who have the luxury of being able to work from home on a guaranteed salary, stay on top of the research, and drop everything to make the appointment, which she can schedule at any time she pleases.

Naturally, the administration is aware of this:

Roughly three-quarters of vaccines still go directly to states, but Biden has steered a growing share to federal channels, including pharmacies, as supply has increased. That shift has allowed Biden to target disadvantaged zip codes as he tries to address disparities in access, often along racial lines.

Whether that will balance the scales remains to be seen. Especially since we’ve already seen plenty of evidence of affluent people figuring out how to get vaccinated in zip codes other than their own.

FILED UNDER: COVID-19, Economics and Business
James Joyner
About James Joyner
James Joyner is Professor and Department Head of Security Studies at Marine Corps University's Command and Staff College and a nonresident senior fellow at the Scowcroft Center for Strategy and Security at the Atlantic Council. He's a former Army officer and Desert Storm vet. Views expressed here are his own. Follow James on Twitter @DrJJoyner.

Comments

  1. Gustopher says:

    We have some red parts of Washington where supply outstrips demand right now. We should either be opening it up to more people, or allocating based on usage, rather than population.

    I favor an approach of getting shots in arms, and making special efforts to reach communities that are underserved.

    If that means the schoolbus full of nurses pulls up outside the chicken-processing plant, and everyone gets to get their shot (and then again in N weeks if it’s not J&J), do it.

    Same with urban areas and black neighborhoods, assisted living centers, big apartment complexes, and Bob’s Feed & Seed or whatever they have in rural america.

    Put a portion of the vaccine aside from the free-for-all to directly target at risk or disadvantaged. But give it to everyone. (Or everyone over 50, and then 40, 30, etc, but keep it simple and understandable, no “Phase 1B Tiers 3 & 4 are accepted as of March 31st”)

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  2. James Joyner says:

    @Gustopher:

    keep it simple and understandable, no “Phase 1B Tiers 3 & 4 are accepted as of March 31st

    Yes! Someone at the CDC must have decided that labeling the tiers 1, 2, 3, etc. with most everyone falling into something like 15 was bad optics so they put just about everyone in tiers 1 and 2 and then created so many damn subtiers as to make it absurd.

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  3. Argon says:

    After covering most of the people in the obvious risk groups we really need to get general coverage ASAP. The infection rates are going up among the sub-55 age groups now. The at risk groups should still be allowed to start at the head of the line but don’t let any locally excess availability go unused.

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  4. MarkedMan says:

    I fear this is going to backfire. All of a sudden 100M people are going to be trying to get shots. It may be fine in places that have a queue that can be checked (“You are 123,543 in the queue and it is advancing by 5093 per day. At the current rate you should get your shot in 25 days”), but those places are the tiny minority. People are going to be pissed.

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  5. CSK says:

    @Gustopher:
    The Reggie Lewis Center at Roxbury Community College (Boston) is in a Black neighborhood and staffed with Black and Brown medical personnel. (The center makes a point of emphasizing this.) Sadly, although they’ve been open since the end of February as an injection site and done a great deal of community outreach, it’s one of the few places in Massachusetts with wide-open slots for vaccinations.

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  6. Michael Reynolds says:

    I like to imagine it’s 1665 in London, and Charlie 2 has announced that the alchemists have come up with an actual preventative so that entire towns won’t be wiped out by the Black Death, and millions won’t lie dead and rotting in the streets. . . however, there may be a wait of hours and a tiny pinprick in one arm.

    Wait in line for a few hours or die a hideous death? What to do, what to do?

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  7. CSK says:

    thetriad.thebulwark.com/p/shame-on-deborah-birx

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  8. Neil Hudelson says:

    In Indiana the state has announced a bevy of mass vaccination sites opening on April 1st, all of which will offer the J&J, whereas virtually all of the current small-scale vaccination sights are offering moderna or pfizer. I just signed up this morning and was able to secure both a time and a place for my jab.

    Based on this limited information, I’m assuming the J&J shot has been the game chamber for boosting supply, and the governors and white house are privy to informational regarding supply lines that are making them confident.

    The Indianapolis mass vaccine sight–the motor speedway–will handle 100,000 people in 10 days. I think (hope) the governor wouldn’t commit to the boggling logistics of setting up multiple such sights if there were still questions about vaccine supply.

  9. Andy says:

    It’s about time IMO. We’ve never had enough supply – that isn’t new. The problem is/was the rigidity of the tiered system and the stupidity of rules that would rather see doses thrown in the trash instead of into the wrong people’s arms.

    In an ideal world, technocrats could consistently and accurately balance supply against a priority system in a diverse nation where priority groups are not evenly distributed in society. We don’t live in that ideal world. Regardless, at this point, the most vulnerable to Covid have had access to the vaccine for two months. There isn’t a substantial enough difference in the other tiers to justify trying to separate them out and prioritize them. Just let everyone who wants one get in line. If someone from a vulnerable population shows up somewhere, they should still get head-of-the-line privileges, but we are far enough along that we can let most everyone else join the line.

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  10. Michael Cain says:

    There are reports the states are going to get a flood of J&J vaccine in the next several days, and a general increase in supply starting next week (something more than 3M doses per day across the three types). I have read/heard things that suggest at least in my state the “not getting the vaccine, nope, nope, nope” crowd is bigger than expected. Plus rumors that the FEMA mass sites aren’t paying attention to the state eligibility rules anyway.

    Given those things, yeah, just jab arms.

  11. Kathy says:

    @Michael Reynolds:

    I wonder if vaccine hesitancy among Republicans could be solved by announcing, loudly and often, that since there’s a huge vaccine surplus, as people are not taking it, the Biden administration will donate them, shipping included, to third-world countries.

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  12. Teve says:

    @Andy:

    It’s about time IMO. We’ve never had enough supply – that isn’t new. The problem is/was the rigidity of the tiered system and the stupidity of rules that would rather see doses thrown in the trash instead of into the wrong people’s arms.

    The fundamental reason we haven’t had enough supply is that it takes 110 days to make a batch of the Pfizer vaccine. And Moderna had literally never manufactured or sold a drug commercially before and had to outsource production to subcontractors in multiple countries.

    Normally scientists and engineers spend a few years designing the manufacturing process for a vaccine. This time they did it in months, but that still delayed mass production until late last year.

    The previous world record for designing, testing, and producing a vaccine is four years.

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  13. Teve says:

    I wonder if vaccine hesitancy among Republicans could be solved by announcing, loudly and often, that since there’s a huge vaccine surplus, as people are not taking it, the Biden administration will donate them, shipping included, to third-world countries.

    LOL

    Announce that any unused doses will be donated to Obama’s relatives in Kenya.

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  14. Andy says:

    @Teve:

    The previous world record for designing, testing, and producing a vaccine is four years.

    Oh, I agree! I didn’t intend to poo-poo on the manufacturing effort.

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  15. Gustopher says:

    @Teve:

    I wonder if vaccine hesitancy among Republicans could be solved by announcing, loudly and often, that since there’s a huge vaccine surplus, as people are not taking it, the Biden administration will donate them, shipping included, to third-world countries.

    No, just reduce doses to red counties, using a usage-based allocation. Simple, fair, and infuriating. And try to get a few conservatives to nibble on “They’re taking your vaccine and giving to a socialist” stories.

    If you think the right hates Mexicans, you should see how much they hate Demoncrats.

    And, if it doesn’t work, more doses for the blue areas. Win-win, as they say.

    Then we will get the Vaccine Passports going, and shove the holdouts into FEMA Covid Ghettos.

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  16. Gustopher says:

    @James Joyner: By the way, I am not exaggerating in any way with the Washington State categories. I am Phase 1B Tier 3.

    When I exaggerate, I claim to be “Phase 1B, Tier 3, Tranche 2, Team Alpaca”, which is only slightly more ridiculous, and far more adorable.

  17. Paine says:

    I was encouraged to contact the local hospital here in eastern Washington about getting on a waitlist. They asked me an eligibility question that I wasn’t sure how to answer to the person on the other end whispered to me: “Say yes.” I said yes and a week later got my first Pfizer shot (last Thursday). So they don’t seem to picky about who gets the shot out this way.

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  18. Teve says:

    @Gustopher:

    Then we will get the Vaccine Passports going, and shove the holdouts into FEMA Covid Ghettos.

    FINALLY! Jade Helm was such a disappointment.

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