This Dec. 2, 2020 photo provided by Johnson & Johnson shows vials of the Janssen COVID-19 vaccine in the United States. On Thursday, Feb. 4, 2021, Johnson & Johnson has asked U.S. regulators to clear the world’s first single-dose COVID-19 vaccine, an easier-to-use option that could boost scarce supplies. (Johnson & Johnson via AP)
With shortages hitting vaccination sites from San Francisco to San Diego, news that Johnson and Johnson’s COVID-19 vaccine could win emergency authorization this week comes as a relief to health officials worried about the spread of dangerous new variants, and raises hopes there could be enough doses this spring to vaccinate anyone who wants a shot.
But is that a realistic timeline?
Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, and other health experts earlier this month said vaccines would be widely available to anyone as soon as April, though Fauci has since moved back his projection and said it could be late summer before most are inoculated. President Joe Biden last week said deals to secure 600 million doses of the Pfizer and Moderna vaccines by the end of July will provide enough for every American to get inoculated.
But some experts warn that it could be months before enough people get shots to have widespread herd immunity. And a closer look at the numbers suggests that, without speedier vaccine approvals or significant changes in how we’re vaccinating, that pessimism may be justified. Manufactured supply doesn’t necessarily track with getting it into people’s arms — there are logistical constraints — including shipping delays due to severe weather this week — and the unwillingness of many to get the shots.
The good news: The U.S. has picked up the vaccination pace, from averaging less than 1 million a day a month ago to about twice that now, according to the U.S. Centers for Disease Control and Prevention. That pace is likely to quicken as vaccines by Johnson and Johnson and other companies become available.
The bad news: Vaccination sites around the state are curtailing hours because they are running low on supply. Even Kaiser Permanente, one of the state’s largest HMOs, cannot provide shots to everyone who is qualified to have one. And emerging virus variants raise concerns that vaccines could be rendered less effective before enough people have had the shots to prevent outbreaks.
So far more than 41 million people in the U.S. have received at least one dose of the Pfizer and Moderna vaccines, and more than 16 million have received both doses, the CDC said. In California, nearly 6.5 million people have received at least one dose, and more than 1.5 million have received both doses, according to the CDC.
Last week Gov. Gavin Newsom pointed out that the state had vastly ramped up its vaccination program, to an average of 201,000 shots a day. But he lamented that it could be better, if the state could only get more supply. And there is more competition for the life-saving serum since several California counties, including San Francisco, Los Angeles, Alameda and Santa Clara, have announced eligibility criteria beyond health care workers and the vulnerable elderly to include those whose essential jobs put them at risk of exposure, such as teachers and agricultural workers.
Despite the shortages, there is optimism.
Dr. Ashish K. Jha, dean of the Brown University School of Public Health, said earlier this month that “sometime around April and May we will be in a situation where any American who wants a vaccine can get one.”
Doctors Scott Gottlieb of the American Enterprise Institute and Mark McClellan of Duke University’s health policy center, both former Food and Drug Administration commissioners, wrote earlier this month that health officials should prepare for a spring vaccine glut — and prepare a campaign to promote the vaccines’ safety.
“At some point, perhaps in April, supply will start exceeding demand,” they wrote in the Wall Street Journal earlier this month.
McClellan said Friday that nothing has altered his calculus on that.
“It is not that far off,” McClellan said. “It could be pretty soon when we get to the real challenge of making sure all those Americans who are unsure get the information they need to make a good decision.”
In the WSJ article McClellan and Gottlieb note that a Kaiser Family Foundation survey shows just under half of U.S. residents — 47% — say they want the COVID-19 vaccine, with the highest numbers among retirement-aged adults who are most at risk. Two-thirds of those 65 and older say they want to be vaccinated as soon as possible, while just 38% of adults under 30 say that.
Fauci last week said he tempered his expectations after learning that Johnson and Johnson’s vaccine production won’t ramp up as fast as he’d initially hoped, pushing his projection for when vaccines would be widely available “into late May and early June.”
“We were expecting a greater number of doses from Johnson and Johnson, and it looks like even though it’s a good vaccine, that we’re not going to have a substantial amount of doses until we get into April and May,” Fauci told the Los Angeles Times.
Health experts are urging government officials to streamline approvals and get more shots into arms faster in a race against the evolving virus. Pfizer and Moderna last week noted a new study in the New England Journal of Medicine that questioned their vaccines’ effectiveness against the South African variant that has now been discovered in California.
“I am quite distressed about the ‘moving target’ that is happening from our political leaders right now about when enough supply will be available,” said Dr. Monica Gandhi, a medical professor at UC San Francisco.
Gandhi fears the country’s current vaccination pace won’t get shots to all who want them until September. She says government officials should speed emergency authorization of other vaccines in the pipeline and delay second doses of two-shot vaccines to allow more first-dose shots. That would offer at least some protection to more people, she said.
“At the current rate, we will not reach herd immunity until December,” Gandhi said, adding that her recommendations could speed that up by about four months.
Dr. Peter Jay Hotez, dean for the National School of Tropical Medicine at Baylor College of Medicine, agrees with speeding up vaccine approvals.
“The only big concern I have about the whole thing is whether we’ll have adequate supply over the spring,” Hotez said. He noted that the AstraZeneca vaccine already has been approved for emergency use by the World Health Organization and European Medicines Agency.
“Getting the American people fully vaccinated by the fall, that was a good plan,” Hotez said. “The problem now is the U.K. variant. We need to accelerate that timetable.”