Trump vaccine plan left logistics to states, but it did exist

President Joe Biden’s chief of staff Ron Klain criticized the Trump administration’s vaccination campaign as "chaotic," adding Biden will work more closely with states to get vaccines into arms.

On Meet the Press, Chuck Todd asked Klain about conflicting comments by Biden officials about whether the new administration had to create a vaccination distribution plan from scratch. 

Klain said Biden was building on progress from the initial wave of vaccinations, "no question about it."

"But the process to distribute the vaccine, particularly outside of nursing homes and hospitals out into the community as a whole did not really exist when we came into the White House," Klain said.

Really? We found that’s taking things too far.

Many experts said that the Trump administration’s plan had some key holes, including a failure to communicate with the states and cities about the rollout and inadequate funding for vaccine distribution. But it did have a plan: rely on the states.

"The federal plan, much like the rest of the federal response to the coronavirus pandemic, was very hands off when it comes to details of implementing public health interventions," said Josh Michaud, associate director of global health policy at the Kaiser Family Foundation. "The last mile of vaccine delivery was not a big part of the federal plan by design."

We asked Michael R. Fraser, CEO of the Association of State and Territorial Health Officials, if the Trump administration had a plan for vaccine distribution.

"It is all in what you mean by ‘plan," Fraser said. "If you mean a tactical guidebook on how to do vaccination from A to Z, no, there is no federal plan." 

Prakash Nagarkatti, vice president for research at the University of South Carolina, told USA Today that "there was total lack of planning at the state level for mass vaccination, and the federal government did not help the states overcome the hurdles."

In September, the Trump administration announced a general strategy to distribute the vaccine which included deliveries to states and, later, pharmacy chains. A partnership with CVS and Walgreens administered vaccines in some long-term care facilities. 

The closest thing to a federal plan was the playbook the U.S. Centers for Disease Control and Prevention gave states to help them create their own distribution plans.

States wrote broad plans and submitted them in October. They lacked important details , such as how many doses they would get and when. (At the time, no vaccines were approved.)

Without dollars to make them happen, state plans were essentially wish lists, Claire Hannan, executive director of the Association of Immunization Managers, said on a podcast. It wasn’t until December that Congress approved a COVID-19 package with $8 billion for vaccine distribution. 

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At the same time, it’s clear there was some level of coordination. The U.S. would not have been able to give shots to millions of people, enroll tens of thousands of private providers, and set up a data collection system tying in all 50 states if the federal and state governments had done no planning.

"To say there wasn’t planning is not accurate," Hannan told PolitiFact. "However, I don’t think there was communication from the federal government about the plan, about the vision, about how things would work."

A couple of days after Klain’s interview, Biden offered a softened take on the work of the Trump administration.

"We want to give credit to everyone involved in this vaccine effort and the prior administration and the science community and the medical sphere … for getting the program off the ground," Biden said Jan. 26. "And that credit is absolutely due."

But Biden said that once he took office, he found that the vaccine program was in worse shape than he expected. 

The Biden administration has envisioned a more prominent federal role, including setting up  100 vaccine centers across the nation by the end of February. Officials say the biggest roadblock is lack of vaccine supply. Biden announced that his administration aims to purchase enough doses to fully vaccinate 300 million Americans by the end of the summer or beginning of the fall.

While the philosophical approach to federal involvement is different, "you can’t say absence of plan when the plan isn't the one you would have created," said KFF’s Michaud.

The Washington Post reported that Biden’s advisers inherited something "more like a black box than a bare cupboard — the result of fractured communication among federal, state and local officials and a juggling act between manufacturers making a new product and thousands of providers, from big hospital systems to tiny clinics, struggling to plan around an unknown amount of vaccine."

As of Jan. 26, about 20 million people had received their first dose and about 3.5 million had received a second dose, according to the CDC. About 44 million doses had been distributed.

The main challenge that states now face is they only know how many doses they are getting a few days in advance. Most state officials have said they could deliver double or triple the number of shots if they had a larger supply.

"The story here is the supply, not needing a plan," Fraser said.

Klain said, "The process to distribute the vaccine, particularly outside of nursing homes and hospitals out into the community as a whole, did not really exist when we came into the White House."

Klain was focusing his criticism on the phase of getting vaccinations into the arms of the general public, not the initial phase of vaccinating health care workers and workers and residents of long-term care facilities.

The Trump administration’s approach to distributing the vaccine was to give it to locations chosen by the states and to let them take it from there. There are many criticisms of this process, including that it took too long to give states money to implement their plans and a lack of communication from the top about how the rollout would work. But that was the plan they drew up.

Saying there a plan "does not really exist" is beyond saying a plan is lacking. We rate Klain’s claim Mostly False.

CORRECTION, Jan. 28: We corrected the number of Americans the Biden administration hopes to fully vaccinate by the end of summer or early fall.