Left out of Covid-19 vaccine planning, Biden advisers developing their own distribution strategy

Shannon Pettypiece and Geoff Bennett and Laura Strickler

WASHINGTON — Doctors close to President-elect Joe Biden’s transition team are working to develop their own plans to mass distribute a coronavirus vaccine, concerned that Trump administration planning will leave them underprepared when he leaves office.

President Donald Trump's ongoing refusal to concede and his administration's unwillingness to acknowledge Biden means that those working to develop the vaccine distribution plan cannot start to share the plans with those who will take over in January.

"We're in a Covid crisis," said Ron Klain, Biden's incoming chief of staff in an interview with MSNBC Thursday. "Right now, there are officials inside the department of Health and Human Services who are busy planning a vaccination campaign for the months of February and March when Joe Biden will be president so the sooner we can get our transition experts into meetings with the folks who are planning the vaccination campaign, the more seamless the transition."

Trump, speaking on Friday for the first time in over a week, stopped short of acknowledging that another administration will be making Covid-19 policy decisions in the future.

"I will not — this administration will not be going to a lockdown," Trump said from the Rose Garden. "Hopefully the — whatever happens in the future — who knows which administration it will be. I guess time will tell, but I can tell you this administration will not go to a lockdown."

The physicians working with Biden's team have been in contact with CVS and Walgreens, which they see as key distribution points for the general public, and have been tracking whether the retail pharmacies will have the staffing and supplies needed to vaccinate millions of Americans, said one person close to the transition.

The Biden team has also been in contact for months with Pfizer as it tries to sort out the sub-zero storage requirements for the company’s vaccine, a transition official said.

Trump aides have continued to insist that the Republican president will prevail in litigation which alleges mass fraud but have so far failed to provide details. But even Republicans who continue to echo Trump have begun to push for the administration to allow some transition steps to begin.

Republican senators have started to call for Biden to receive intelligence briefings, access to critical information about the nation's security and actions abroad. But they have not yet made calls for Trump to let Biden access coronavirus response information.

“They are not yet allowed to talk to people in the government, which is a particular problem for this issue,” said Eric Toner, a senior scholar with the Johns Hopkins Center for Health Security, who isn’t directly involved in the transition. “For this issue, really getting an understanding of the details of Operation Warp Speed and what has been communicated to the states and what their plans are, that is something they are really going to need to know. The sooner they can get access to that, the better.”

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Pharmaceutical companies are racing to develop a vaccine that could help return the world to normal after the Covid-19 pandemic hobbled economies and killed more than a million globally, but getting an estimated 300 million doses to Americans after approval is expected to produce new challenges. Mass inoculation could begin in the weeks before Biden takes office on January 20th.

The Trump administration has developed a plan, parts of which have been made public and rely heavily upon the military.

Trump’s coronavirus task force met Monday, for only the second time since Oct 20 and the president hasn’t regularly attended those meetings. On Friday, Moncef Slaoui, the chief scientist for Operation Warp Speed, said the administration plans to have enough vaccine doses available to immunize about 20 million people in December, and another 25 to 30 million per month from thereon.

The Trump administration has laid out the broad outlines of its strategy publicly, including its plan to use an existing contract with drug distributor McKesson to transport the vaccine to locations where it will either be administered to the public, like hospitals or retail clinics, or delivered to points where the vaccine will be further distributed, according to an HHS report from September. The Centers for Disease Control and Prevention also released a 75-page plan last month and states have released summaries of their plans.

"President Trump’s Coronavirus Task Force and Operation Warp Speed have been working non-stop for months with states, territories, tribes, local public health programs and their partners on distribution plans," said White House spokesman Brian Morganstern. He added, that General Gustave Perna, chief operating officer of Operation Warp Speed and his deputy "have confirmed preparedness to ship vaccine doses to every zip code in America within 24 hours of the issuance" of an Emergency Use Authorization by the FDA.

But doctors assisting the Biden transition have been in the dark about the details of that plan because the head of the General Services Administration has declined to sign the paperwork allowing the incoming administration access to current government officials.

The president-elect announced on Monday an advisory board of researchers and physicians to provide guidance to his transition. The 13-person group, which will likely grow and is still in the early stages, had its first meeting this week and is expected to meet again in the coming days, said a person involved in the planning.

There is a small universe of experts who specialize in vaccine and infectious disease work and those health experts working with the Biden team know many of the Trump administration health officials well, like Dr. Anthony Fauci and Dr. Deborah Birx. But those working with the Biden team have been waiting for the transition to be officially sanctioned by the White House and GSA before reaching out so as not to put anyone in a tough position professionally, said a transition official.

Biden's team has outstanding questions about the plan, like how the vaccine would be distributed in rural areas or how to get it to marginalized groups, like minority communities that have been disproportionately affected by the pandemic, said one person advising the transition team.

Should Pfizer’s vaccine be approved, the incoming administration will have to deal with unique logistical challenges unlike those seen with other common vaccines, like the flu vaccine. Pfizer’s vaccine must be stored at around 100 degrees below zero, which requires a special refrigerator that not all health care providers have. Pfizer has devised a packaging system using dry ice to keep it at the ultra cool temperature for shipping, but once the container is opened the vaccine in that batch will have a limited shelf life.

There is also concern by those close to the transition that there won’t be enough supplies to carry out a massive vaccination program, an issue that has dogged the Trump administration throughout the pandemic.

A GAO report from September showed the administration was behind on its goal of having a 90-day supply of personal protective equipment, or PPE. While the administration has made progress on its stockpile of masks, gowns and ventilators, they are behind on gloves, which are used for administering injections.

HHS set a goal to have a 90-day supply, or 4.5 billion gloves. But at of the end of October,the agency had 2 million gloves, according to department officials.