One immediate priority of the Biden administration will be to accelerate distribution of the COVID-19 vaccine to meet the new administration's goal of staunching the impact of the pandemic in the U.S. While the Biden team has made clear in recent days that it will be taking a dramatically different policy course than its predecessor, we anticipate President-elect Biden's efforts to meet his goal of “100 million doses in 100 days” will include the following:
GREATER FEDERAL INVOLVEMENT IN THE SUPPLY CHAIN
Much of the reason for the halting vaccine rollout so far can be attributed to the supply chain challenges integral to such a large undertaking—particularly in the “last mile” of transporting the vaccine from inventory storage hubs to the hundreds or thousands of locations where the vaccine is to be administered. While the Trump administration has been reluctant to have the federal government adopt an “end-to-end” role in the vaccine delivery process, the Biden administration has signaled it advocates a dramatic increase in federal financial support. We expect this support to be given to the supply chain stakeholders that are closest to the “ground zero” point where the public's arm meets the syringe needle. These stakeholders include state and local health departments; local healthcare providers such as pharmacies, hospitals, and urgent care clinics; and key local-based employers with substantial workforces. Hefty financial support to these constituencies is likely to be accompanied by top-down policy and operational guidance to state and local governments that will cover key supply chain decision points such as the priority of different categories of vaccine recipients and logistics for front-line administration of the vaccine.
MORE EFFECTIVE VACCINE EDUCATION
In order to maximize the impact of what we anticipate will be a surge in federal support, the federal government effort around public education and information will also likely increase. In November 2020, the Department of Health and Human Services (HHS) announced the launch of its COVID-19 and Flu Public Education Campaign, which aimed to pave the way for large-scale vaccination by increasing public confidence in COVID-19 vaccines while reinforcing basic prevention measures that slow the spread of the virus. Since the campaign was announced, two vaccines have been authorized by the Food and Drug Administration (FDA) for emergency use, yet skepticism and misinformation about COVID-19 vaccines among the public remain high.
Overcoming this skepticism and misinformation is essential for a successful clinical outcome for the vaccine rollout. The Biden administration will need both out-of-the box thinking and end-to-end coordination at local, state, and federal levels. These efforts must include public-private and grassroots community partnerships, transparency, and the involvement of credible messengers who can reach people across political and cultural divides.
A WIDENING OF THE VACCINE PIPELINE
In the face of COVID-19 mutations and the surging levels of hospitalizations in hot spots around the country, the Biden administration will likely conduct a broad reassessment of the vaccine development and evaluation process that has been run by HHS, the FDA, and the Centers for Disease Control. While the strategy of the Trump administration's Operation Warp Speed has been to focus on a limited number of vaccine candidates, the Biden administration may consider broadening the scope of its active developmental support to include a wider pool of vaccine manufacturers with clinical trials underway. However, the emergence of more vaccine candidates could present a double-edged sword, if adding options to the defensive arsenal against the pandemic inadvertently increases uncertainty and confusion among the public.
While the Biden administration, in its first 100 days, will need to hit the ground running on multiple fronts against the pandemic, we expect these three areas to form the core of the administration's COVID-19 strategy.
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