WASHINGTON – It was the focus of his first White House prime-time speech last week, and he doubled down on the marker Thursday.
But President Joe Biden’s directive to states to make COVID-19 vaccines available to all adults no later than May 1 doesn’t create an especially high bar. Former health officials said that wasn’t the point.
The move was part of broader strategy to jolt states into action without rankling Republican governors – who may be concerned about federal overreach – as the country prepares for a surge in vaccine doses.
“It was conservative, but it was supposed to be conservative,” said Dr. Kavita Patel, former White House health policy director under the Obama administration. “I think the timeline will be moved up again, not by the president of the United States, but by states in conjunction with (the Federal Emergency Management Agency) and other vaccinators – and that’s deliberate.”
Governors of both parties have said their states will have no trouble meeting the May 1 deadline as long as the federal government supplies state health officials with enough vaccination doses. National Governors’ Association spokesman James Nash said no governors have expressed concern about the president laying down the May 1 marker or that it’s an unrealistic goal.
Some states had already planned to expedite eligibility before hearing from the president.
Hours before Biden’s address last week, Wisconsin Gov. Tony Evers, a Democrat, outlined a May timeline for the general public to become eligible for vaccines in his state. The next morning, Michigan Gov. Gretchen Whitmer, another Democratic ally of Biden, revealed all Michiganders 16 or older will be eligible by April 5 – nearly a month before the president’s benchmark. This week, Connecticut Gov. Ned Lamont, a Democrat, and Iowa Gov. Kim Reynolds, a Republican, moved up overall vaccination eligibility to the same April 5 date.
“Over the course of the next month, I think you’re going to find that everybody has vaccines and appointments available to them,” Lamont said of the situation in his state.
‘Independence from this virus’: President Biden shifts from ‘darkest days’ to hope on the horizon
‘We have to fight this together as one’: President Biden tells governors of pandemic response
A strategy of setting expectations
In all, 24 states are currently planning to open COVID-19 vaccine eligibility to all adults on or before May 1, according to the Kaiser Family Foundation, a health care nonprofit tracking the rules, while other governors said they are in position to do the same.
Biden adopted an early strategy of setting manageable expectations in the fight against COVID-19, notching political victories as he expands on the vaccine production effort set in motion by his predecessor.
The president initially pointed to the end of July as when vaccines would be available for all Americans, before moving that timeline up to May. Biden said Thursday the USA is on track to meet his goal of 100 million shots in his first 100 days on Friday, his 58th full day in office.
“I’m glad to see that several states are already taking that step to make more and more Americans eligible even before May 1,” Biden said in remarks from the White House celebrating the 100 million-shot milestone. “Next week, I’ll announce our next goal to put shots in arms.”
The May directive is aimed at empowering states as the Biden administration builds a national strategy absent from President Donald Trump’s approach to the pandemic while striking a balance between federal and state tensions, according to Patel.
“It’s accomplishing what we want, which is to open up eligibility way beforehand without the federal government coming in and overtaking state efforts already underway,” she said.
Trump largely relied on states to procure their own testing materials and other critical equipment as COVID-19 tore through the country last year, which resulted in shortages and some states pitted against each other in bidding wars. Both Democratic and Republican governors complained of the “backup role” Trump said the federal government was playing as the COVID-19 crisis unfolded.
Biden came to office on the promise of nationalizing the response but has faced pushback as some Republican governors defied his guidance on fighting the spread of the coronavirus. That resistance includes Texas’ Gov. Greg Abbott, who earlier this month ended a statewide mask mandate this month, allowing businesses to operate again at 100% capacity.
‘A strong signal to states’
This week, Texas opened vaccine eligibility to anyone at least 50 years old, putting the state on pace to meet Abbott’s stated goal of making shots available to anyone who wants a vaccine by spring.
Abbott’s press secretary, Renae Eze, said in a statement that Texas was on track to meet its goal but pointed to two factors that have hindered more progress: “a limited vaccine supply and outdated population data from the federal government.”
She said Texas’ weekly allocation of vaccines is smaller relative to other states because the federal government relies on data that doesn’t take into account Texas’ massive growth.
Joshua Sharfstein, a former U.S. Food and Drug Administration commissioner and a professor at Johns Hopkins University, said Biden’s executive order is less about setting a target and more about sending a message to states to prepare for an influx of supply.
State officials have viewed the vaccine rollout with a “week-to-week mentality” as early distribution was hampered by logistical hurdles, inconsistency in data, supply shortages and weather delays, Sharfstein pointed out.
“Now there are really no excuses,” Sharfstein said. “This is a way to get the country moving, and this was a clear statement from the federal government that the vaccine supply is going to be there.”
Kristina Box, Indiana’s state health commissioner in Republican Gov. Eric Holcomb’s administration, called the latest directive a “reasonable goal” during a panel discussion Tuesday at the Forum at Harvard T.H. Chan School of Public Health.
“Hopefully by May, if we truly receive that much vaccine, yes, we can open that up and and allow Hoosiers (Indiana residents) to decide if they’re ready to be vaccinated,” she said.
States brace for a boost in supply in April
In a weekly call with governors Tuesday, White House COVID-19 response coordinator Jeff Zients told states to expect to receive more vaccine doses during the first week in April, when Johnson & Johnson anticipates a dramatic boost in its doses, according to Democratic Gov. John Carney of Delaware.
The Johnson & Johnson shot is the only one of three vaccines authorized for use in the USA that does not require a follow-up appointment for a second dose, meaning more Americans will be fully vaccinated sooner.
“That allotment will be considerably more than what we’ve been getting, and it will stay at that level for the weeks after that,” Carney said. “So we need to be prepared ourselves to move those vaccines in people’s’ arms.”
Delaware, Biden’s home state, made vaccines available Wednesday to Delawareans 50 years or older. Nearly 332,000 people in Delaware, 20% of its population, have received at least one vaccine. Carney said the state is on its way toward meeting the May 1 directive.
“We’re moving in that direction anyway because of the increased supply and our focus on fast and fair,” Carney said.
The USA averaged 2.4 million daily vaccinations over the past seven days, according to Andy Slavitt, a White House senior adviser on COVID-19 response, up from 2.2 million the week before. Nearly 30% of all adults and two-thirds of seniors 65 or older have received at least least one vaccination shot, according to the Centers for Disease Control and Prevention.
More than 16 million vaccine doses, a record allotment, are being distributed to states this week, the White House said, totaling 22 million doses when including vaccines sent to pharmacies and health centers.
Most of the doses are from Moderna and Pfizer. The Johnson & Johnson allotment is likely to add 4 million to 6 million next week.
Biden’s directive doesn’t mean states must ensure all adults are vaccinated by May, but people can at least sign up by then.
“We anticipate having enough vaccine to be able to open up before May 1. That would be my goal,” Florida Gov. Ron DeSantis, a Republican, said last Friday at a retirement community in Port Orange. He lauded his state’s progress vaccinating its large population, asking residents on hand to raise their hands if they’d gotten a shot.
“See, most of them have had it,” DeSantis said. He said he expects the state to make vaccines available to residents 55 and older in March before expanding to all adults in April.
States have generally made vaccinations available to citizens in tiers beginning with front-line workers, seniors 65 or older and teachers before moving to adults younger than 65 with health conditions before expanding to the general population.
Kentucky Gov. Andy Beshear, a Democrat, called Biden’s directive a “big challenge” but a doable one that depends on the federal government delivering enough doses and expanding beyond the 500 vaccination sites in his state.
Beshear expects every adult in Kentucky who wants a shot will be able to get one by the end of the May.
“And I think we’re going to beat his goal in opening up vaccinations up to everyone before May 1,” he said.
Govs. Asa Hutchinson of Arkansas and Bill Lee of Tennessee are among other Republican governors who, through spokespeople, said they’re on target to meet the May 1 deadline.
West Virginia Gov. Jim Justice, one of the few Republican governors who openly pushed for passage of Biden’s recently approved $1.9 trillion American Rescue Plan, expressed optimism as well.
“We’re confident we’re going to be ready to be able to pull that off here in West Virginia,” Justice said. “We’re on the glide slope to being able to get our lives back to normal. And that’s what we want more than anything.”
Contributing: The Associated Press
Reach Joey Garrison on Twitter @joeygarrison. Reach Courtney Subramanian on Twitter @cmsub.