Don’t Hold Back COVID Vaccine Doses, White House Officials Say

WASHINGTON — Healthcare providers who have been holding back vaccine doses in order to make sure that patients receiving their first dose will have a second dose available when the time comes should stop doing that, Andy Slavitt said Monday.

“We believe that some healthcare providers are regularly holding back doses that are intended as first doses and instead keeping them in reserve for second doses for patients,” said Slavitt, who is senior advisor to the new White House COVID-19 Response Team, during a press briefing. “We understand why healthcare providers have done that, but it does not need to happen and should not happen.”

Because providers are rightfully concerned about whether a second dose will be available for a particular patient when needed, “that’s one reason why last week we announced that the federal government will provide a continual 3-week window into how much vaccine they can expect to receive,” Slavitt continued. “With this action, states and vaccine providers will more rapidly use their allotment of first doses to vaccinate as many people as quickly and equitably as possible, because they now have the predictability that the second dose will be there when the time comes.”

Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases and President Biden’s chief medical advisor, agreed. “Given that we now have more and more confidence in the even flow of doses to go to locations … we don’t want to hold back things,” he said. “If you give 50 million doses to individuals, and then the next time around you get more doses, when you’re at that third or fourth week, the first priority will always be to get the people who’ve gotten their first doses to get their second doses. Additional doses will be given to the next group of people who will get their first doses. In this way, there are no doses that are hanging around. A dose that’s available is going to go into someone’s arm.”

Fauci also addressed concerns that some coronavirus vaccines — such as the Johnson & Johnson vaccine that has yet to receive emergency use authorization — appear to be less effective at combatting the newer COVID-19 variants. For the Johnson & Johnson vaccine, which has an overall 72% effectiveness rate in the U.S. compared with 94% to 95% for the Moderna and Pfizer vaccines, “when you look at serious disease, hospitalizations, and deaths, it has had a profound impact on them … There may be some advantages you might see with one versus the other. For example, the idea of a single dose, the lack of a very strict cold chain, as well as the availability of a large number of doses” are all advantages for the Johnson & Johnson vaccine.

As to the various vaccines’ effectiveness against the South African variant, although the numbers are a little lower compared with the response to other variants, “it was still within the cushion level of providing some protection,” he added.

Slavitt also announced an agreement between the Department of Health and Human Services (HHS), the Department of Defense, and a company called Ellume to offer an at-home COVID test that can detect the virus with 95% accuracy in 15 minutes. The test, which is done using a mid-turbinate nasal swab, will be useful both for people who are symptomatic and for those who have no symptoms and want to verify that they can go safely to work and school, he said.

“Making easier-to-use tests available to every American is a high priority with obvious benefits,” Slavitt continued. The company will ship 100,000 tests per month to the U.S. from February to July.

“That’s good, but it’s obviously not where we will need to be, so the Department of Defense and HHS have awarded $230 million to Ellume in order to scale the manufacturing base and capacity of this easy-to-use test,” he said. “They will be able to manufacture more than 19 million test kits per month by the end of this year, 8.5 million of which are guaranteed to the U.S. government.”

During a question-and-answer session, a reporter asked Slavitt how the tests will help meet the Biden’s administration’s health equity goals given that each test costs $30. “The purpose of today’s announcement is to move to mass production and scale,” Slavitt said. “Obviously, the unit costs will come down only when we can get to mass production and scale. So there’s a ‘chicken-and-egg’ problem that I think we’ve taken a step to solve today, by creating mass production so we’ll have tens of millions of these tests out there. Secondly, we know there are efforts to create even lower-cost and even more innovative approaches, and we welcome those.”

CDC Director Rochelle Walensky, MD, noted that although the continued decrease in COVID-19 cases and hospital admissions is hopeful, “deaths continue to rise.” In addition, the variants do remain a “great concern,” with at least 33 jurisdictions reporting 471 variant cases as of Jan. 31st, she said. Of those, 467 are the U.K. variant, another 3 cases are the South African variant, and one case is the Brazilian variant, which was found in Minnesota.