HHS Secretary Alex Azar early last week announced that the federal government would begin distributing its reserve of Covid-19 vaccine doses to help accelerate vaccinations in the United States, leading many states to expand eligibility for the vaccine with the understanding they would soon receive additional doses. However, Azar on Friday indicated that the federal government already had been distributing those reserve doses, meaning there are no extra doses available for states to ramp up vaccinations, state officials say.

The U.S. Covid-19 vaccination scenario planning guide

Background

Last Tuesday, the Trump administration released updated guidelines intended to speed states' distribution of authorized Covid-19 vaccines by recommending that states immediately expand who's eligible for vaccinations and broadening where Americans can receive the vaccines. Specifically, the new guidelines recommend that, in addition to health care personnel and long-term care residents, states should immediately open vaccine eligibility to all Americans ages 65 and older, as well as Americans with health conditions that put them at higher risk of developing a severe case of Covid-19 or dying from the disease.

As part of that initiative, Azar also announced that the federal government would move to distribute all of the available Covid-19 vaccine doses it currently had—which marked a reversal from the Trump administration's previous distribution plan. Under the initial plan, the Trump administration only had released doses of the vaccines that were intended to serve as patients' first shot in the two-dose vaccine regimens.

The administration had issued the new guidelines in response to criticism over America's lagging vaccine rollout. CDC data shows that, as of Friday morning, the federal government had distributed about 31.2 million doses of the Covid-19 vaccines currently authorized for use in the United States, and about 12.3 million Americans had received their first dose of the two-dose Covid-19 vaccines.

Azar says Covid-19 vaccine stockpile already has been depleted, without states receiving additional doses

However, at the time Azar announced that the federal government would begin distributing its reserved Covid-19 vaccine doses and urged states to expand eligibility for the vaccines, the Trump administration had already depleted its stockpile of additional Covid-19 vaccine doses, federal and state officials have told the Washington Post.

According to the Post, the Trump administration had begun shipping out the reserved doses at the end of December and had started distributing its final reserve of those doses nearly a week ago. In an email sent to the Post, HHS spokesperson Michael Pratt confirmed that the federal government had recently distributed the remaining doses in the reserve to states, the Post reports.

Separately, during an interview with NBC News on Friday, Azar also said the Trump administration does not have a reserve stockpile of Covid-19 vaccine doses any longer. However, Azar said the administration is confident that manufacturers will produce enough doses to ensure that people who receive their initial doses of the authorized Covid-19 vaccines can also receive their second shots.

"We now have enough confidence that our ongoing production will be quality and available to provide the second dose for people. So, we're not sitting on a reserve anymore. We've made that available to the states to order," Azar said.

But some state officials said they were shocked to learn that the Trump administration already had depleted its vaccine reserve, and that they had expanded eligibility for Covid-19 vaccines under the premise that the federal government had additional doses that would be available to states. Without those additional doses, states will be not be able to significantly accelerate vaccine administration, officials said.

For instance, Patrick Allen, director of Oregon Health Authority, in a letter sent to Azar wrote that Gustave Perna—who is the COO of Operation Warp Speed, the Trump administration's Covid-19 vaccine initiative—"informed us there is no reserve of doses, and we are already receiving the full allocation of vaccines." Allen continued, "If true, this is extremely disturbing, and puts our plans to expand eligibility at grave risk." He explained, "Those plans were made on the basis of reliance on your statement about 'releasing the entire supply' you have in reserve. If this information is accurate, we will be unable to begin vaccinating our vulnerable seniors on Jan. 23, as planned."

Separately, Oregon Gov. Kate Brown (D) in a series of tweets posted Friday wrote, "Last night, I received disturbing news, confirmed to me directly by General Perna of Operation Warp Speed: States will not be receiving increased shipments of vaccines from the national stockpile next week, because there is no federal reserve of doses." She added, "I am demanding answers from the Trump administration. I am shocked and appalled that they have set an expectation on which they could not deliver, with such grave consequences. This is a deception on a national scale. Oregon's seniors, teachers, all of us, were depending on the promise of Oregon's share of the federal reserve of vaccines being released to us."

New York Gov. Andrew Cuomo said his state's allocation of vaccine doses decreased this week, declining from 300,000 doses the previous week to 250,000 doses. Cuomo said, "The Trump administration said they would expedite the second dose. It turns out that was not true, they had already sent out everything they had, so there was no increase in supply." However, "[i]n the meantime there was a dramatic increase in eligibility," Cuomo added. "What they did was like opening the floodgates of eligibility, and that entire flood has to go through a syringe. That's the situation the federal government created."

Biden releases plan to ramp up Covid-19 vaccinations

Separately, President-elect Joe Biden on Friday released a plan aimed at  boosting Covid-19 vaccinations throughout the United States.

Under Biden's plan, the federal government would send vaccine doses to federally qualified health centers in disadvantaged communities and federal disaster-relief workers would set up mass-vaccination sites in sports stadiums, community centers, and churches. In addition, Biden said he would invoke the Defense Production Act to increase production of glass vials, needles, syringes, and other supplies needed to administer the vaccines. Biden said his team has identified companies that are prepared to take part in the effort under the law.

"This is a time to set big goals and pursue them with courage and conviction because the health of the nation is literally at stake," said Biden.

America grapples with persistently high rates of new coronavirus cases, hospitalizations, and deaths

The vaccine news comes as America continues to report persistently high rates of new coronavirus cases, hospitalizations, and deaths.

According to data compiled by the New York Times, U.S. officials as of Tuesday morning had reported a total of about 24.1 million cases of the novel coronavirus since America's epidemic began—up from about 23.3 million cases reported as of Friday morning.

According to the Times, the United States' average daily number of newly reported coronavirus cases over the past week was 207,495—which is down by 7% when compared with the average from two weeks ago.

As of Tuesday morning, data from the Times showed that the rates of newly reported coronavirus cases were "staying high" in Puerto Rico; the U.S. Virgin Islands; Washington, D.C.; and 31 states that have had a daily average of at least 15 newly reported cases per 100,000 people over the past week. Those states are Arizona, Arkansas, California, Connecticut, Delaware, Florida, Georgia, Illinois, Iowa, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Mississippi, Montana, New Hampshire, New Jersey, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, Texas, Utah, Vermont, Virginia, Wisconsin, and Wyoming.

The Times' data also showed that, as of Tuesday morning, the daily average of newly reported cases over the past seven days was "going down" in 18 states that had been seeing comparatively higher rates of coronavirus transmission. Those states are Alabama, Alaska, Colorado, Idaho, Indiana, Kansas, Michigan, Minnesota, Missouri, Nebraska, Nevada, New Mexico, North Dakota, Rhode Island, South Dakota, Tennessee, Washington, and West Virginia.

In Hawaii and Guam, meanwhile, rates of newly reported coronavirus cases were "staying low" as of Tuesday morning, according to the Times' analysis.

U.S. hospitalizations for Covid-19, the disease caused by the novel coronavirus, also have remained high, straining hospitals. According to data from The Atlantic's COVID Tracking Project, there were 123,848 Americans with Covid-19 hospitalized for treatment on Monday, including 23,226 who were receiving care in an ICU and 7,772 who were on a ventilator.

As of Tuesday morning, U.S. officials also had reported a total of about 399,053 U.S. deaths linked to the novel coronavirus since the country's epidemic began, up from about 388,785 deaths reported as of Friday morning.