May 12, 2022 - Health

Biden administration and GOP clash over vaccine strategy

Illustration of pattern of blue Covid-19 vaccine bottles on top of red and white stripes of American flag.

Illustration: Rae Cook/Axios

Congressional Republicans' concerns about wasting COVID vaccines are colliding with the Biden administration's commitment to making the shots as widely accessible as possible, adding another wrinkle to the stalled COVID funding negotiations.

The intrigue: Some Republicans are growing skeptical of the currently available vaccines' ability to contain the Omicron variant, and don't want to allocate money for more doses without a firmer plan in place for the fall.

The big picture: Democrats stripped more than $15 billion of funding for more COVID countermeasures from a spending bill in March due to internal divisions over how the package would be paid for.

  • Democrats and Republicans have been at loggerheads since then, and the administration has warned that the country won't have critical tools for managing the virus this fall without new funding.
  • But two senior GOP Senate aides say that Republicans are also raising broader questions about the administration's vaccine strategy.

State of play: COVID vaccines are packaged and distributed in multi-dose vials. Once a vial of Pfizer or Moderna's mRNA vaccine is opened, it must be used the same day, because the vaccines don't contain preservatives.

  • In practice, that forces a choice between throwing out unused doses and limiting the number of places offering vaccines at any given time to concentrate demand.

Yes, but: Republicans say the current strategy is wasteful, and it would be better to rein in accessibility so that more doses are likely to be used.

  • Although the administration is working with vaccine makers on updated vial sizes, including single-use vials, these aren't expected to be ready until late this year or early next year, according to a senior Biden administration official.
  • "If someone arrives at a rural or urban site and they're the only one who shows up that day, they can get a vaccine," the official said. "From a public health policy, we want to ensure that everyone has easy access, no matter where they live."

By the numbers: As of now, 79% of available vaccine doses distributed in the U.S. have been administered to patients, according to Department of Health and Human Services officials.

  • That figure is an average over the last year and a half, but there have been fluctuations. The administration didn't specify how many doses are currently going unused or how the rate has changed over time.
  • "Vaccine utilization was very high in the early months of the vaccination campaign and has decreased in recent months; however, our commitment to providing vaccine, and now boosters, to anyone who wants one remains unchanged," the HHS officials wrote in an email.

The other thing: It's no secret that Pfizer and Moderna's vaccines don't work as well against the Omicron variant, although they remain highly effective preventing hospitalizations and deaths. Pfizer and Moderna are testing updated vaccines that are target Omicron as well as the original COVID-19 strain.

  • Some Republicans want to prioritize buying therapeutics, given the vaccines' reduced effectiveness and the evolution of the virus.
  • "Republicans are skeptical of using federal money to buy more vaccines that are proving not to last very long and questions remain if they will work against future variants," one senior GOP Senate aide told Axios.
  • "We're not saying don't get vaccinated. We're saying that the current shot and boosters are reducing in effectiveness. New vax isn't ready and it's unclear where they are in the plan," the aide added. "Since there is no plan, we don't want to give them blank check."

The other side: The administration says it has a plan, and the problem is lawmakers haven't authorized the money to implement it.

  • Even though Pfizer and Moderna are still collecting data on updated versions of their vaccines, the data that the administration has seen so far "strongly point in the direction of a bivalent, variant-specific vaccine for the fall." For that to be available, a contract needs to be in place within the next several weeks, a senior Biden administration official said. "You can't wait until the fall to do the contract."
  • That means it's increasingly unlikely that the fall vaccine campaign will be with the same vaccines everyone's already had.
  • The FDA will review updated data at the end of June and make recommendations.
  • "If members of both parties in Congress want to continue saving American lives, they will need to provide us the additional resources we urgently need for tests, treatments and vaccines," said a White House official.
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