It seems likely that when historians look back at President Joe Biden's record, what he'll be judged on is whether his administration was successful in delivering COVID-19 vaccines to all 330 million Americans quickly.
Biden launched his presidency with big goals for vaccine delivery, promising in December 2020 that he would get "at least 100 million COVID vaccine shots into the arms of the American people in the first 100 days" of his term.
When first asked about that pledge in December, the Biden team said the president meant 50 million people would get their two-dose regimen. The Biden administration has since updated this plan, saying it will release vaccine doses as soon as they're available instead of holding back some of that supply for second doses.
Regardless of how many people get vaccinated, getting the 100 million shots in 100 days is "attainable," but going to be "extremely challenging," said Claire Hannan, executive director of the Association of Immunization Managers, in a Jan. 13 interview.
To achieve Biden's objective, about 1 million vaccines would need to be administered every day of his first 100 days. Current numbers show vaccine administration is below that. An average of 939,000 have been administered daily in the last week, according to current data on Bloomberg News' COVID-19 Vaccine Tracker. The Centers for Disease Control and Prevention's Vaccine Tracker estimates that 17 million total doses have been administered since mid-December when vaccination efforts began. Experts also warn vaccine supply may not be at the levels needed to reach this 100 million.
Plus, Biden has inherited a vaccine rollout from the Trump administration that has been plagued by sluggishness, due to a lack of communication between the federal government and state and local health departments, insufficient funding for large-scale vaccination efforts, and confusing federal guidance on vaccine distribution.
Some of the steps that Biden took on his first couple of days in office attempted to address these issues.
The White House released a 198-page COVID-19 response plan on Jan. 21 which included a section outlining the administration's strategy to "mount a safe, effective, comprehensive vaccination campaign."
The vaccine strategy section says the government will try to speed up vaccine administration by continuing to recommend vaccinations be made available to anyone over the age of 65, and also by providing states with consistent projections for vaccine supply so they can plan better. Among the many other vaccination initiatives outlined in the document were pledges to: ensure equitable vaccine distribution, compensate providers fairly for administering vaccines, launch a national vaccination public education campaign, build strong data systems to monitor vaccine distribution and secure a large health care workforce to administer the vaccines.
Biden also issued several executive orders related to fulfilling his vaccination promise. One signed on Inauguration Day, Jan. 20, created a new position within the White House of the COVID-19 response coordinator. Jeff Zients, an Obama-era official is filling this role. He will report directly to Biden and direct the federal government's efforts to oversee vaccine distribution, increase testing efforts and improve the supply of personal protective equipment.
On Day 2 in office, Biden signed another executive order directing the federal government to assess what supply shortfalls existed and, if necessary, use any legal action, including the Defense Production Act, to produce any vaccine materials needed such as glass vials or needles.
During a Jan. 21 press briefing about the orders, Biden said he will set up 100 federally run-vaccination sites across the country by the end of the first month of his presidency. The sites will be administered by the Federal Emergency Management Agency.
But, the wide-scale vaccination efforts Biden outlined will require funding from Congress, which could be a sticking point. Biden released a $1.9 trillion dollar plan the week before his inauguration that provided a means of funding his vaccine plan. But Republicans have indicated they may not be on board due to the high cost of the legislation.
These executive orders and national strategic vaccination plan reflect Biden positioning the federal government to take a stronger role in vaccine distribution.
It's a great starting point especially in aiming to solve some of the vaccine rollout challenges seen under the Trump administration, said Dr. Marcus Plescia, chief medical officer of the Association of State and Territorial Health Officials, such as disjointed communication with states. But, Biden will still need to make sure the federal government is clearly communicating with state and local leaders.
"They need to engage with their communication people in states before they roll a lot of these things out," said Plescia. "We also need steady leadership and realistic expectations. That's going to be very important in accomplishing this goal."
It remains to be seen whether these efforts will be enough to increase vaccination to reach 100 million doses by the first 100 days of Biden's presidency, which ends on April 30, 2021. There's much more that could happen over the next three months to either accelerate or hamper this goal.
We rate this promise In the Works.