The Biden administration is planning to ask Congress for approval of $415bn in emergency spending for Covid-19 vaccination, testing, contact tracing, genomic sequencing, and other efforts to fight Covid-19 as part of a $1.9 trillion stimulus programme. Of these funds, $20bn will be allocated for a national vaccination programme, $30bn for purchasing supplies and protective gear, and $50bn for a scaled-up diagnostic testing programme. On 26 January, the White House further announced plans to buy 200 million additional vaccine doses from Pfizer / BioNTech and Moderna and to increase the number of vaccine doses distributed weekly to states from 8.6 million to 10 million.

More funding for the mass rollout of Covid-19 vaccines is urgently needed, as the US reported on average nearly 170,000 new daily confirmed Covid-19 cases and more than 3,300 deaths per day over the past week, although the new case numbers are trending down. While hospitals and healthcare personnel on the ground are inundated with new Covid-19 cases, little capacity is left for vaccinations. The Biden administration’s plan to deliver 100 million vaccine doses in the first 100 days in office is an ambitious goal, and letting pharmacies in the US distribute the vaccine and organising mass vaccination drives could be measured to speed up the vaccination effort. Furthermore, a central register to keep track of vaccine doses, of people in prioritised groups, as well as of vaccine recipients would greatly facilitate the process and help in case of future vaccinations.

Whereas countries with universal, modern healthcare systems, such as Israel and Denmark, are off to a rapid start, the largely private and compartmentalised US healthcare system was not prepared enough due to a lack of high-level organisation, funding, and personnel, in combination with the complicated logistics of such a massive rollout. Although more than 44.4 million vaccine doses have been distributed to the states, only 23.5 million doses have been administered. Operation Warp Speed’s initial goal was to vaccinate 20 million people in 2020, a goal that seemed feasible after vaccine approvals in November, after less than one year in development.

The new administration will provide a three-week vaccine supply forecast to the states, so institutions can plan vaccination appointments more reliably. All vaccine doses are now released immediately in order to vaccinate as many people as possible; a speedy campaign will also help to decrease the risk of more transmissible SARS-CoV-2 variants taking a foothold in the US. However, this strategy is putting more pressure on vaccine manufacturers to keep up with production, so that second doses will be available on time.