As scientists and pharmaceutical companies work at breakneck speed to develop a vaccine for the novel coronavirus, public health officials and senior US lawmakers are sounding alarms about the Trump administration's lack of planning for its nationwide distribution.
The federal government traditionally plays a principal role in funding and overseeing the manufacturing and distribution of new vaccines, which often draw on scarce ingredients and need to be made, stored and transported carefully.
There won't be enough vaccine for all 330 million Americans right away, so the government also has a role in deciding who gets it first, and in educating a vaccine-wary public about its potential life saving merits.
Right now, it is unclear who in Washington is in charge of oversight, much less any critical details, some state health officials and members of Congress told Reuters.
Last week, a senior Trump administration official told Reuters that Operation Warp Speed, a White House task force first announced in May, was "committed to implementing the (vaccine) plan and distributing medical countermeasures as fast as possible."
However, Dr. Robert Redfield, director of the Centers for Disease Control and Prevention (CDC), told a Senate hearing on July 2 that his agency would spearhead the campaign to develop and distribute a vaccine for the new coronavirus. "This is really the prime responsibility of CDC," he said.
Republican Senator Roy Blunt, who chairs a panel overseeing health program funding, is one of several lawmakers pushing for the CDC, which was founded in 1946 to counter malaria, to lead the effort.
"They are the only federal agency with a proven track record of vaccine distribution and long-standing agreements with health departments across the country," Blunt said in a statement in mid-July.
HISTORY REPEATING?
The United States leads the world in COVID-related fatalities with more than 150,000 in five months. After underestimating the virus' threat, President Donald Trump and his advisers are embroiled in internal battles over how to handle the crisis just three months before his re-election bid against Democratic candidate Joe Biden.
A July 15-21 Reuters/Ipsos poll showed that only 38% of the public supports Trump's handling of the pandemic.
Health officials and lawmakers say they worry that without thorough planning and coordination with states, the vaccine distribution could be saddled with the same sort of disruptions that led to chronic shortages of coronavirus diagnostic tests and other medical supplies.
Washington should be educating people now about vaccination plans in order to build public confidence and avoid confusion, said Senator Patty Murray, the senior Democrat on the health program funding committee.
"What is the priority, who gets it first? First-responders, healthcare workers, those kinds of things," Murray said in a telephone interview. On July 13, Murray published a road map for vaccine distribution.
A poorly executed rollout would mean "we will be sitting here two years from now, three years from now, in the same economic and health position we are today," she said.
STATES IN THE DARK
Some state public health officials, meanwhile, say their entreaties to the Trump administration have been unanswered.
"We have not heard anything from the federal government since April 23," Danielle Koenig, health promotion supervisor for the Washington State Department of Health, said in an email.
That is when her agency received preliminary guidance on vaccine planning from the CDC.
Immunization experts along with state and local public health officials sent a letter to Operation Warp Speed on June 23 pleading for fresh guidance.
States need to know promptly if the federal government will pay for the vaccines, as it did during the H1N1 outbreak in 2009, the letter says. Will alcohol swabs, syringes and personal protective equipment be included? What about record-keeping and refrigeration to store the vaccine and who will deliver it?
So far, there's been no official response, said Claire Hannan, executive director of the Association of Immunization Managers, one of four organizations that signed the letter.
"We urgently await federal, state and local collaborative discussions to identify challenges and plan solutions. A vaccination campaign of this magnitude is unprecedented and it’s going to take more than an army," Hannan said on Tuesday, referring to Trump's repeated statements that the US military stands ready to deliver vaccines.
Trump insists everything is in place.
"We're all set to march when it comes to the vaccine," Trump said at a White House briefing on Thursday. .".. And the delivery system is all set. Logistically we have a general that's all he does is deliver things whether it is soldiers or other items.
"We are way ahead on vaccines, way ahead on therapeutics and when we have it we are all set with our platforms to deliver them very, very quickly," Trump said.