Biden Has a New Vaccine Goal. It's Still Too Low.
Supply is increasing to the point that even inoculating 4 million people a day would leave tens of millions of doses unused at the beginning of June.
President Biden used his first televised press conference on Thursday to reset his administration’s vaccination goal. Instead of 100 million shots in 100 days (which was achieved on Day 58), he announced that the new target is 200 million vaccinations in that timespan. While this sounds ambitious, it is actually still below what is needed to make effective use of available supply.
As of March 25, the U.S. had administered a total of 133 million vaccinations, with 117 million of those coming since January 20. Day 100 of the Biden term is April 30, which means the administration has 36 days to put another 83 million shots into arms. That works out to an average of about 2.3 million shots per day, which is well below the 2.5 million pace that we have sustained since mid-March.
Merely meeting the president’s goal, and not exceeding it, would be a disappointing outcome: It would mean the U.S. had failed to escape the recent trend of newly available vaccine supply far exceeding the pace of vaccinations.
That trend is discernible in recent data. The three approved manufacturers have delivered a total of about 174 million doses to the U.S. market as of this week, up 22 million from one week earlier. The pace of seven-day total deliveries has improved steadily over the past month, from about 19 million earlier in March. Although the Biden administration announced recently that its weekly distribution is now at 27 million doses, the latest bump in delivered supply is not yet visible in official data.
While deliveries have increased and vaccine administration is much improved over the pace in January and February, the rate at which the U.S. has gotten shots in arms leveled off in the second half of March. The seven-day average of daily vaccinations is the same now as it was on March 13.
As deliveries increase while daily vaccinations hold steady, the gap between available inventory and administered vaccines grows. According to the Centers for Disease Control and Prevention (CDC), as of March 1, manufacturers had delivered a total of 96.4 million doses since the vaccination program began in December, and the U.S. had administered 76.9 million shots. That left an unused supply of 19.5 million vaccines sitting in freezers and on shelves at various points in the distribution network. As of March 25, just three weeks later, the stock of unused inventory has more than doubled to 40.2 million doses.
From the beginning, states have noted that reporting delays inflate the estimates of unused supply. Perhaps that is still a factor, but it would not explain why the gap between reported inventory and administered shots has widened over the past month.
The Biden administration’s public updates tell the story of a growing divergence between available supply and shots injected. With Johnson & Johnson’s one-shot vaccine now in the mix, the administration says it has ramped up total weekly deliveries through all of the available distribution channels (states plus the federal pharmacy and community health center programs) to 27 million doses. If daily vaccine administration stalls at an average of 2.5 million shots per day, that’s 17.5 million shots per week, or 9.5 million less than the weekly increase in available inventory.
A system dynamics model of inventory and vaccine administration, updated to reflect the pace of recent weeks and the supply commitments from manufacturers, shows that the stock of unused supply will continue to build substantially in the coming weeks if 2.5 million shots per day remains the norm. As the chart below shows, by April 19, there will be 105 million unused vaccines available for inoculations. By the start of May, that number will reach almost 135 million, and by June 1, nearly 200 million. If the pace matches the Biden target of 2.3 million per day, the unused supply would balloon to over 140 million doses by May 1 and almost 210 million by June 1.
US stock of vaccines based on different administration capacities
Source: Authors’ calculations
To make maximum use of the coming supply, the average daily vaccination rate needs to accelerate, and soon. A daily vaccination rate of 3 million shots would add 15 million Americans to the fully vaccinated category between now and June 1 compared to a scenario of no improvement. Administering 4 million shots per day would provide full vaccine protection to 75 percent of the total population by the early days of June, including 44 million people who will remain wholly or partially unprotected if the daily rate stays at 2.5 million. The supply commitments from the manufacturers are such that even inoculating 4 million people per day would leave around 84 million doses unused at the beginning of June.
Can the U.S. reach such a goal? Many states have said they can ramp up their vaccination totals if given sufficient supply. That may be true, but the gap between available and used vaccines has widened over the past month.
According to CDC data, the 50 states and District of Columbia have, on average, administered 78 percent of the doses delivered to them, with five of them utilizing less than 70 percent of their available inventory (Alabama, Arkansas, Georgia, District of Columbia, and Mississippi). This data suggest there is substantial room for improvement.
In addition to increasingly large stocks of unused vaccines, the slow growth of daily inoculations may complicate President Biden’s goal of reaching a level of normalcy in the country by July 4. At the current rate of daily vaccinations, there still will be more than 105 million Americans (including all of the country’s children under age 16)—approximately 32 percent of the population—not fully vaccinated when that holiday comes around, which is likely too many to allow the country to achieve herd immunity. The experience of Israel shows that new infections among the unvaccinated will likely remain high until herd immunity is reached.
The Biden administration has taken steps to improve the pace of daily vaccinations, and reach more populations, with solid results. Even so, working with the states, the federal government needs to set the bar much higher than 200 million vaccinations in Biden’s first 100 days. Opening up more appointments through pharmacies, providing funding for 24/7 operations at mass vaccination sites, and financial incentives that reward states and practitioners for accelerating the pace all should be on the table at this point. With the latest COVID response legislation, there is no shortage of available funds to devote to the effort.
This is the kind of full-court press the president should be calling for at this stage in the vaccination program. The goal should not be an easily achievable target but rather one that pushes all involved to get shots in arms as fast as the manufacturers can deliver the available doses—and thus end the pandemic without any unnecessary delay.
Kieran Allsop is a research assistant at the American Enterprise Institute. James C. Capretta is a resident fellow and holds the Milton Friedman Chair at AEI. Scott Ganz is a research fellow in economic policy studies at AEI and an assistant professor at Georgia Tech’s School of Public Policy.