A person holds a vial of Pfizer-BioNTech Covid-19 vaccine at the University of Louisville Hospital in Louisville, Kentucky, United States on Monday, December 14, 2020.
Scotty Perry | Bloomberg | Getty Images
The US states are eagerly awaiting billions of federal funds to fund their vaccine distribution plans, which are currently being implemented in Washington and threatened with veto threats by President Donald Trump.
After weeks of legislative silence, the outgoing President shocked Washington Tuesday night by calling the bill a “disgrace” and urging lawmakers to increase direct payments from $ 600 to $ 2,000. The package also includes more than $ 8 billion to fund government vaccine distribution programs, which are currently suspended as House Democrats scramble to meet Trump’s demand.
“We are concerned because this is the money we needed in the spring. It is now late December,” said Adriane Casalotti, the top lobbyist for the National Association of County and City Health Officials.
Now that the first doses of Pfizer and Moderna’s Covid-19 vaccine hit the arms of the first million Americans, public health experts are concerned about how they will pay for the historic vaccination campaign. Time is of the essence – the US wants cans to be available to all 331 million Americans by summer.
Trump’s attack raises $ 8.75 billion in much-needed funding that states believed could help pay for vaccine distribution, said Dr. Marcus Plescia, Chief Medical Officer of the Association of State and Territorial Health Officials, in a telephone interview.
“It’s one of those things we started celebrating too early,” he said, adding that his organization has been pushing for funding for vaccine distribution for months.
Congressional approval for funding “came a little late in the game but I think it will be okay. It will get where it needs to be on time,” he said. “If this is further delayed, it will be a problem.”
Walk slowly
Vaccine distribution will require additional staff for vaccination clinics, adequate resources for the safe storage of cans at extremely low temperatures, needles and other critical consumables, and increased communication efforts to convince people of the safety of the drugs, among other things, experts say. To fund their pandemic responses, the country’s states and counties have already had to cut spending and suspend capital infrastructure projects to balance their budgets, experts said.
“We have two vaccines that are approved for use in the field and yet we have no money to distribute,” said Casalotti. “Every minute of delay affects how many people can get the vaccine and when. So we urge the President to sign the bill as soon as possible.”
So far, vaccination efforts have been slow. Around 9.5 million doses have been distributed and just over 1 million people in the United States received their first dose of a coronavirus vaccine on Wednesday morning, according to the Centers for Disease Control and Prevention. That’s about 19 million doses, falling short of previous December forecasts, and officials have a little over a week – about 8 days – to try to fill that void.
“Just how fast the ramp-up of vaccinations and gun shots is slower than we expected,” said Dr. Moncef Slaoui, tsar of President Donald Trump’s coronavirus vaccine, told reporters during a press conference Wednesday afternoon. “And as I told you, we are here to help states accelerate appropriately,” he said, adding that the target of 20 million vaccinations “is unlikely to be met.”
The vaccines have reached a crucial point in the nation’s response to the pandemic. New coronavirus cases in the US have risen to a weekly average of 212,142 cases per day, and the virus is currently killing an average of more than 2,669 people per day, according to a CNBC analysis of data compiled by Johns Hopkins University.
The U.S. Department of Health announced last week that the Centers for Disease Control and Prevention would allocate an additional $ 227 million to 64 states and jurisdictions for vaccine preparation and response, bringing the total federal government contribution to nearly 430 Million US dollars. But states say they need billions of dollars, not millions, to distribute the shots.
While every dollar helps, HHS money is “a drop in the bucket” compared to what it will take to fund the states’ comprehensive immunization plans, Casalotti said. For months, state and local health departments have been asking Congress to allocate an additional $ 8.4 billion in funding to carry out its vaccine distribution plans, which were finalized in October and presented to the CDC.
The Trump administration proposed $ 6 billion for state funding, but Congress approved the states, allocating $ 8.75 billion for state vaccination plans in the latest coronavirus relief package. Even then, additional funding may be needed for widespread vaccinations over the next year, Casalotti said.
“We really see this as a sign of hope, but as a down payment,” said Casalotti. A spokesman for HHS did not respond to CNBC’s request for comment.
US officials said Operation Warp Speed, the federal government’s vaccination program, will pay some of the cost. The US will pay for the dispensing of the cans and will provide kits of adjuncts to administer the vaccinations, including needles, syringes, diluents and other supplies.
However, some supplies, including hand sanitizer and gloves, are not from the federal government. Other expenses, like tents or staff to set up vaccination clinics, will have to be borne by states, said Claire Hannan, executive director of the Association of Immunization Managers (AIM), which represents state health officials who lead vaccination planning.
Personnel issues
“The staffing is very important because to get this in place for all Americans in a short time – about six months – and to vaccinate everyone who wants to be vaccinated, you really need all hands on deck,” said Hannan.
States are also needing money to get more vendors to offer the shots, but the process is taking longer than expected because some health departments don’t have the staff to answer their questions and verify their credentials, she said.
“I think it’s more of a problem for the broader scale, but we could also see delays in phase one when the public health needs to be vaccinated and they can’t stop vaccines,” Hannan said.
The bill for vaccination programs could get bigger over time and more people are reluctant to make the vaccine safe, requiring greater coverage for these communities, said Casalotti of the county and city’s health department. As the dependency on the Pfizer vaccine becomes greater than on others, there is an additional cost to store the cans in ultra-cold temperatures.
“All of this work would have been hard enough beforehand to scale up the largest mass vaccination campaign we’ve ever tried,” said Casalotti. “You are now doing all of this in a reduced timeframe with very few resources while battling a pandemic at the same time.”
Program cuts
The funds distributed by HHS so far went directly to 64 jurisdictions, including the 50 states, territories and some of the country’s largest cities. When it comes to most counties, the size of the funding will depend on whether the money goes to them, which it doesn’t always, said Blaire Bryant, a lobbyist who specializes in health issues with the National Association of Counties.
“This is a big problem for us because none of our health departments really see these funds,” said Bryant.
States, counties and local governments have already had to cut other programs to offset lost revenue from their Covid-19 response, said Teryn Zmuda, chief economist for the county group. According to an August report by the group, the country’s counties will see a $ 30 billion hole in un-budgeted Covid-19 response costs by the end of fiscal 2021.
“We are seeing a lot of cuts in investment projects, economic development and repair of investment infrastructure,” said Zmuda. “Those projects that are seen as less important or of secondary importance to public health are being cut to keep up with future developments.”
