Biden plans to release the entire coronavirus vaccine supply instead of reserving half to guarantee second doses

• President-elect Joe Biden plans to release all available coronavirus vaccine doses when he takes office on January 20, CNN reported.
• The Trump administration is currently holding back half the supply to guarantee there will be enough for two shots per person.
• But some public-health experts say the US could be more generous with the current supply, since vaccine production is unlikely to grind to a halt.

US officials faced a difficult choice when vaccine rollout began: They could either get as many doses as possible into arms right away, or hold back enough to make sure everyone who received a first shot would be guaranteed their second.

The Trump administration opted for the latter approach. Federal officials haven't shipped roughly half of the available vaccine inventory so far.

Neither the Moderna nor Pfizer vaccine is fully effective unless a person receives two doses. Moderna's shots should ideally be 28 days apart, while Pfizer's should be 21. The US is still manufacturing more doses of both, but so far, federal officials have been keeping a considerable reserve in case of an emergency, like a breakdown at a manufacturing plant that would cause production to halt.

However, some public-health experts think the chances of that disaster are low and say the US doesn't need to be as careful with its current supply.

So President-elect Joe Biden plans to release all available vaccine doses when he takes office on January 20, CNN reported Friday.

"The President-elect believes we must accelerate distribution of the vaccine while continuing to ensure the Americans who need it most get it as soon as possible," TJ Ducklo, a spokesman for Biden's transition, told CNN. "He supports releasing available doses immediately, and believes the government should stop holding back vaccine supply so we can get more shots in Americans' arms now."

The strategy could hit the same roadblocks the current distribution process has, however. State health departments are simultaneously struggling with a tsunami of coronavirus patients while overseeing a giant vaccine rollout. Many health departments lack the staff to administer shots in large batches, so the arrival of even more doses may pose an additional challenge.

As of Thursday, the US still hadn't administered 15.5 million of the 21.4 million doses that have been distributed so far, according to data from the Centers for Disease Control and Prevention.

"At this time, suggesting changes to the FDA-authorized dosing or schedules of these vaccines is premature and not rooted solidly in the available evidence," Stephen Hahn, the FDA commissioner, and Dr. Peter Marks, director of the FDA's Center for Biologics Evaluation and Research, told CNN in a statement. "Without appropriate data supporting such changes in vaccine administration, we run a significant risk of placing public health at risk, undermining the historic vaccination efforts to protect the population from COVID-19."

The benefits of a riskier strategy

In the UK, officials have decided to delay second doses for up to 12 weeks in order to administer as many first doses as possible. The UK aims to give out 2 million shots per week by the end of January, the BBC reported. So far, only 1.5 million people in the UK have been vaccinated.

Biden's strategy is different. He doesn't intend to extend the window between the two doses. Instead, he's assuming that manufacturing and pharmaceutical companies will continuously deliver more doses in accordance with their contracts.

By contrast, federal officials and members of an FDA advisory committee are currently "planning for a scenario where we can not produce a single dose of a vaccine for months because we have a disaster," Dr. Ashish Jha, dean of Brown University's School of Public Health, told Business Insider.

"That can't possibly be our scenario that we plan for," he said. "We've got to be able to think through and get more doses."

Read more: What's coming next for COVID-19 vaccines? Here's the latest on 11 leading programs.

Last month, Pfizer CEO Albert Bourla told CNN the company was on track to deliver 100 million doses to the US in the first quarter of 2021. By the end of July, the company expects to have delivered all 200 million doses purchased.

Moderna, meanwhile, expects to deliver 85 to 100 million doses to the US in the first quarter of 2021, with the goal of delivering all 200 million purchased by the federal government by the end of June.

"We can make some hedges that say we should hold some doses back, but assume that our production is not going to completely collapse for months and months," Jha said.

A recent study published in the Annals of Internal Medicine found that distributing as many first doses as possible would help the US prevent more natural infections. So far, the US is vaccinating around 1.5 million people per week. But the study found that if the US supplied 6 million doses per week over eight weeks, and withheld just 10% of the doses for the first three of those weeks, the nation could reduce coronavirus cases by 29%.

"We find that under most plausible scenarios, a more balanced approach that withholds fewer doses during early distribution in order to vaccinate more people as soon as possible could substantially increase the benefits of vaccines, while enabling most recipients to receive second doses on schedule," the researchers wrote.

Federal officials are also hoping that Johnson & Johnson's one-dose shot could get US authorization next month. The company is aiming to manufacture 1 billion doses in 2021.

Hilary Brueck contributed reporting.