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People wait in line to receive the first of two doses of the Pfizer vaccine for COVID-19, Sunday, Jan. 24, 2021, at a one-day vaccination clinic set up in an Amazon.com facility in Seattle and operated by Virginia Mason Franciscan Health. (AP) People wait in line to receive the first of two doses of the Pfizer vaccine for COVID-19, Sunday, Jan. 24, 2021, at a one-day vaccination clinic set up in an Amazon.com facility in Seattle and operated by Virginia Mason Franciscan Health. (AP)

People wait in line to receive the first of two doses of the Pfizer vaccine for COVID-19, Sunday, Jan. 24, 2021, at a one-day vaccination clinic set up in an Amazon.com facility in Seattle and operated by Virginia Mason Franciscan Health. (AP)

Amy Sherman
By Amy Sherman January 27, 2021

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

If Your Time is short

  • The Trump administration planned to get the vaccines developed and then send them to locations chosen by states. States wrote their own plans, and they were responsible for setting up places to get vaccines into Americans’ arms.

  • The Trump administration’s approach was flawed, experts said, because it failed to adequately communicate about the anticipated number of doses and the rollout.

  • The Biden administration plans more federal involvement in getting vaccines into arms, including setting up 100 FEMA sites nationwide.

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."

Trump administration’s plan relied on the states 

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."

Biden’s plan calls for more federal involvement

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.

Our ruling

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.

Our Sources

White House, National strategy for the COVID-19 response and pandemic preparedness, Jan. 21, 2021

President Joe Biden, Briefing, Jan. 26, 2021

White House, COVID-19 press conference, Jan. 27, 2021

Health and Human Services, Trump Administration Partners with CVS and Walgreens to Provide COVID-19 Vaccine to Protect Vulnerable Americans in Long-Term Care Facilities Nationwide, Oct. 16, 2020

U.S. Centers for Disease Control and Prevention, COVID-19 Vaccination Program Interim Playbook for Jurisdiction Operations, Oct. 29, 2020

Kaiser Family Foundation, States Are Getting Ready to Distribute COVID-19 Vaccines. What Do Their Plans Tell Us So Far? Nov. 18, 2020

NBC, Meet the Press interview with Ron Klain, Jan. 24, 2021

American Hospital Association, Letter to Health and Human Services Secretary Alex Azar, Jan. 7, 2021

White House, Press Briefing by Press Secretary Jen Psaki, Jan. 21, 2021

Fox News, Biden's chief of staff insists Trump admin had no vaccine plan, Jan. 24, 2021

Fox News Sunday, CDC director predicts COVID-19 vaccine distribution will increase dramatically by late March, Jan. 24, 2021

MSN, Birx: No "full-time team" working on COVID in Trump White House, Jan. 2021

AP, Vaccine rollout confirms public health officials’ warnings, Jan. 10, 2021

AP, Coronavirus vaccination sites across US canceling appointments amid shortages, Jan. 26, 2021

Operation Warp Speed, Vaccination distribution process, Sept. 16, 2020

Association of State and Territorial Health Officials podcast, Getting Shots Into Arms: The Race to Vaccinate Against COVID-19, Jan. 21, 2021

Snopes, Did Biden Inherit ‘Nonexistent’ COVID-19 Vaccine Distribution Plan? Jan. 22, 2021

CNN, Biden inheriting nonexistent coronavirus vaccine distribution plan and must start 'from scratch,' sources say, Jan. 21, 2021

Washington Post, ‘Pixie dust’: Why some vaccine sits on shelves while shortages intensify nationwide, Jan. 21, 2021

CBS Face the Nation, Full Transcript: Dr. Deborah Birx on "Face the Nation," Jan. 24, 2021

Associated Press, Biden unveils $1.9T plan to stem COVID-19 and steady economy, Jan. 14, 2021

USA Today, COVID-19 vaccine rollout hasn't worked, but change is coming, vaccine panel predicts, Jan. 18, 2021

Kaiser Health News, CVS and Walgreens Under Fire for Slow Pace of Vaccination in Nursing Homes, Jan. 15, 2021

PolitiFact, What are state and federal plans for distributing COVID-19 vaccine? Dec. 9, 2020

Email interview, Kevin Munoz, White House spokesperson, Jan. 26, 2021

Telephone interview, Josh Michaud, Associate Director for Global Health Policy at the Henry J. Kaiser Family Foundation, Jan. 25, 2021

Telephone interview and email interview, Michael Fraser, Chief Executive Officer of the Association of Health and Territorial Officials, Jan. 25, 2021

Email interview, Dr. Jeffrey S. Duchin, Health Officer and Chief, Communicable Disease Epidemiology & Immunization Section Public Health - Seattle and King County and University of Washington professor in medicine, Jan. 26, 2021

Telephone interview, Vivian Riefberg, Professor of Practice at the Darden School of Business at the University of Virginia and Director Emeritus and Senior Advisor with McKinsey, Jan. 26, 2021

 

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

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