Trump administration to shake up state COVID vaccine allocation methods

Trump administration to shake up state COVID vaccine allocation methods
© Bonnie Cash

The Trump administration is changing how coronavirus vaccines are allocated to states, Health and Human Services Secretary Alex Azar said Tuesday.

Rather than distribute vaccines based on population, the administration instead will allocate doses based on how quickly they can administer the shots, as well as on the size of the population over age 65, Azar said. 

States will have two weeks to prepare for the change, Azar said, which should give them time to improve their reporting to a federal database. 


Azar indicated some of the current slowness is a result of data reporting issues, and the change in the allocation method will give them an incentive to fix those issues.

"This new system gives states a strong incentive to ensure that all vaccinations are being promptly reported, which they're currently not," Azar told reporters during a press briefing. 

"It gives states a strong incentive to ensure doses are going to work protecting people rather than sitting on shelves or in freezers," he added.

The policy change would reward states that inoculate people quickly and comes as top administration officials have been complaining about the slow pace of vaccinations. 

Azar said that states' rigid adherence to eligibility criteria has led to a bottleneck. The administration's Operation Warp Speed has made available nearly 25 million first doses over the past month, but just over 9 million people have been vaccinated.

"We need doses going to where they'll be administered quickly, and where they'll protect the most vulnerable," Azar said.


To that end, the administration is also pushing states to give shots to anyone age 65 and older, regardless of underlying health conditions, as well as anyone under age 65 with an underlying condition. The administration will also release second doses of the vaccines it had been holding in reserve, in an effort to double the number of doses available.

Centers for Disease Control and Prevention Director Robert RedfieldRobert RedfieldCDC gets a second opinion: Seven steps to heal our COVID-19 response Pence delivers coronavirus task force report to Biden Overnight Health Care: Testing capacity strained as localities struggle with vaccine staffing | Health workers refusing vaccine is growing problem | Incoming CDC director expects 500,000 COVID deaths by mid-February MORE said a post-holiday surge has created a sense of urgency. 

“It’s going to be a difficult January and probably February, but with a vaccine and the new therapeutics we have, there’s really strong light at the end of that tunnel as we enter March,” Redfield said. "We really need to commit right now to get as many Americans vaccinated as we can that are particularly the most vulnerable and at risk for hospitalization.”

But current Trump officials will no longer be in charge in two weeks, and it's not clear if the incoming Biden administration supports such a change. Azar said Operation Wap Speed had not yet spoken with the transition team about the change.

"While we will certainly brief the Biden team on those changes, we operate as you know, with one government at a time, and this is the approach that we believe best fulfills the mission and the current situation that we are facing today," Azar said.

A spokesperson for the Biden transition did not respond to a request for comment. 

If implemented, the policy change could add even more headaches for state and local officials that are already struggling with what they say are inadequate resources and communication from the federal government.

It will ultimately be up to governors, state and local officials to decide who is eligible to receive the vaccine in their state. Many states are already bucking the initial CDC recommendations on prioritization, but the updated recommendations could turn statewide distribution into a free-for-all.