Kamala Harris, the US vice-president, oversees the rollout in Washington DC last month
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The United States is set to overtake the UK in its vaccination rollout as it surges back toward normality.
America’s distribution programme forged ahead after Donald Trump bought up vast supplies, then Joe Biden put the country on a wartime footing, poured in money, and appointed a vaccine tsar from Facebook known as “Mr Fix-It”.
The UK currently has the fourth most successful national vaccination programme in the world, having delivered 45 doses per 100 people.
But the US is in fifth place and closing, with 38 doses injected per 100 people. The US’s is the largest vaccine rollout in the world, having delivered 130 million doses, about a quarter of the global total.
It is already soaring ahead of the UK on full vaccinations, with 14 per cent of the US population inoculated compared to 3.6 per cent in the UK.
That is partly due to 45 million Americans having received Johnson & Johnson’s single-dose vaccine.
Last week, the British government warned of a “significant reduction” in weekly vaccine supply from manufacturers, and it faces a battle with Europe over supplies of the AstraZeneca vaccine.
By contrast, the US has no supply issues and just hit three million vaccinations a day. Mr Biden wants to ramp that up to five million.
US vaccination rate projection
He hit his target — of 100 million “shots in arms” in his first 100 days — six weeks early. There are expected to be enough doses to vaccinate all Americans by the end of May.
On Thursday, in his first press conference as president, Mr Biden announced a new target of administering 200 million doses by his 100th day in office.
“I know it’s ambitious, twice our original goal,” he said. “No other country in the world has even come close.”
Solving ‘the world’s biggest Rubik’s Cube’
The US rollout began shakily, due partly to differing approaches taken by individual states, and the size of the country. Health officials compared it to solving “the world’s biggest Rubik’s Cube puzzle.”
But an early decision that paid off was made under Mr Trump’s “Operation Warp Speed” vaccine production initiative.
At the outset Mr Trump’s administration spread its bets, signing contracts with an array of pharmaceutical companies trying to produce a vaccine, knowing only a few would succeed.
In all, it signed contracts for 800 million doses, way more than necessary for its 328 million population.
A student nurse administers a jab at a speedway course in Martinsville, Virginia
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Of the ultimately successful vaccines it already had contracts for 100 million doses from Pfizer-BioNTech, 100 million from Moderna, and 100 million from Johnson & Johnson. It had also signed early for 300 million doses from AstraZeneca, which is not yet approved in the US.
The US had made sure to sign “priority” contracts, putting itself at the front of the queue, meaning other nations were forced to wait until America’s deliveries were fulfilled.
It amounted effectively to a vaccine export ban as the US hoarded supplies. White House officials deny there is a ban, arguing that it is simply prioritising its own citizens.
The first Johnson & Johnson vaccine arrived in the US in Kentucky on March 1
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When he became president Mr Biden declared that Mr Trump had still not bought enough vaccines. Five days after being sworn he bought 200 million more doses from Moderna and Pfizer.
Like Mr Trump, Mr Biden also invoked the Defense Production Act, which originated during the Korean War, and gives the president sweeping powers to order private companies to assist with national security.
It led to an improbable partnership between two of America’s biggest drug companies as Merck agreed to help make the one-shot Johnson & Johnson vaccine. The Pentagon was ordered to back them up with equipment and machinery. With Merck’s help Johnson & Johnson began running its manufacturing plants around the clock.
Biden turned to ‘Mr Fix-It’
Meanwhile, Mr Biden recruited an old friend from the Obama years, Jeff Zients, as his “Covid tsar”. The president told Mr Zients he was “on a war footing”.
Mr Zients earned his Washington nickname “Mr Fix-It” in 2013 when he rescued the bungled "healthcare.gov" online marketplace that was a key plank of Obamacare. As one former White House official put it: “Jeff basically gets stuff done.”
Until last year he was on Facebook’s board of directors, then Mr Biden called him back to the White House.
Jeff Zients is the White House Covid co-ordinator
Credit: AP
On a call this week Mr Zients said: “Our approach to this wartime effort is to have as many tools in our toolkit as possible.”
He said 27 million vaccine doses were being allocated to states this week. That weekly level has tripled since January.
Most go to state governments to distribute but Washington also sends millions directly to 14,000 pharmacies through its Federal Pharmacy Program. Mr Biden wants that doubled. There are also 500 mobile clinics.
Eighteen mass vaccination sites are being set up by the federal government, along with 400 smaller ones. Thousands of members of the military are among those being used as vaccinators.
Two weeks ago Mr Biden’s $1.9 trillion coronavirus relief package included another $20 billion for vaccination centres and community health workers.
Joe Biden received his vaccine in January
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The US expects 50 per cent of the population to have had at least one dose by May 11, 70 per cent by June 11, and 90 per cent by July 29.
Already, five low-population states — New Mexico, Alaska, Connecticut, South Dakota, Maine and Rhode Island — are at over 30 per cent. Georgia is the lowest at 19 per cent.
A total of 7,683,903 doses have been administered in nursing homes, and cases in them have plummeted by 89 per cent between December and mid-February.
Zip code lottery as states set own rules
The turnaround has been remarkable. As the new year dawned the US vaccination programme was being widely derided. At the time the White House called it “messy”.
New York couldn’t vaccinate its hospital workers. Bill de Blasio, the mayor, tweeted: “We’re burning through our supply. We need more doses IMMEDIATELY.”
There has since been a wide variation in how different states rolled out the vaccines.
Most states put health care workers and nursing homes first but governors were faced with public pressure to expand eligibility.
Some vaccinated by profession, including teachers and police officers. At least two thirds of the states are vaccinating some shop workers.
Vehicles fill up the car park at Dodger Stadium in Los Angeles, repurposed as a vaccination centre
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Five states — including Texas — have already extended eligibility for a vaccine to anyone over 16.
On Thursday, California, the most populous state with 40 million people, said it would take the same step from April 15. Currently, only over-65s and people with severe health conditions are eligible.
Gavin Newsom, California’s Democrat governor, said: “With vaccine supply increasing the light at the end of the tunnel continues to get brighter.”
US vaccination map
The varying approaches by different states mean only 69 per cent of people in the US aged over 65 have received their first dose, which is much lower than in the UK.
Figures from the Centers for Disease Control and Prevention have also, surprisingly, showed that states faring best are those who went "slow and steady" by targeting particular age groups, such as Hawaii.
Rapid expansion of eligibility led to chaos with crashed websites and cancelled appointments.
Dr Rebecca Wurtz, of Minnesota University’s School of Public Health, said: “The infrastructure just wasn’t ready. It kind of backfired. In the rush to satisfy everyone, governors satisfied few and frustrated many.”
Hawaiians queue up to get their jab on the rural island of Kauai earlier this month
Credit: AP
Jennifer Kates, director of global health at the Kaiser Family Foundation, said the main factors in the turnaround included federal intervention and increased vaccine supply.
She said: "In the US it was a very challenged process for the first month and a half. The Trump administration took a hands-off approach and left it up to the states. The Biden administration has been much more hands-on federal intervention. Knowing the supply will be enough has made a huge difference.
“The US is catching up to the UK, and the UK trajectory is a little slower. If their supply changes, it’s pretty clear the US could surpass.”
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