AILSA CHANG, HOST:
President-elect Biden is planning to take a dramatic step aimed at increasing the amount of COVID-19 vaccine available. His team said today that he will release almost all available doses of vaccine when he takes office on January 20 in order to get the first shot to as many people as possible. Now, that is a reversal of the Trump administration's policy of holding back shots in order to ensure there's enough to give people their second dose. We have one of the president's-elect COVID-19 advisors here to talk about that. Surgeon and Harvard professor, Dr. Atul Gawande, welcome back to ALL THINGS CONSIDERED.
ATUL GAWANDE: Thank you.
CHANG: All right, so what is the thinking behind this decision?
GAWANDE: Two things - No. 1 is that there is every reason, especially with the new strain out there, to be moving more vaccinations into people's arms. Second, we believe that there will be a steady increase in production from the vaccine manufacturers so that - holding back out of concern there won't be rising volume of vaccines is hurting us now with a high likelihood that there is going to be increased production later.
CHANG: But it's not just a question of availability right now. It's about actually getting these shots into people's arms. I mean, the CDC says as of today, 22 million doses have already been distributed, but less than 7 million have actually been given. So specifically, what is Biden's plan to make sure available shots are actually getting injected into people? What will that take?
GAWANDE: First of all, you're right. There are multiple failure points along the way. The problem of distribution - vaccines sitting on shelves that aren't getting into people's arms - is a mix of so many different failure points along the way - lack of planning that should have started months ago that now has to be accelerated. Second, you know, you hear from a lot of states, lack of transparency. They don't know how many doses are going to be coming two or three days away. And that makes it impossible for providers trying to make - schedule visits. They find themselves with too many doses, not enough doses. So there are - there's everything from being much more transparent, providing a clear planning and clear understanding of what's coming and what's not coming down...
CHANG: OK.
GAWANDE: ...The pike. There are - and then there's distribution of resources. There's so many different failure points.
CHANG: But how do you get the shots into people's arms?
GAWANDE: It will take time to ramp up, but it will get there.
CHANG: How do you get the shots into people's arms?
GAWANDE: Yeah, so No. 1, you have the pharmacies that are ramping up right now and, of course, their support that the administration will provide to enable them to keep doing it. But they're not going to be the only solution. So you have hospitals. You have clinics. There are mass vaccination sites being set up by states here in Massachusetts, even in stadiums where - which is where I live. And those places need predictability. They need resources to hire staff. And they need a lot of regulatory blockers moved out of the way and push as many doses down those channels as possible.
CHANG: The thing is, the FDA has said it does not support extending the length of time between the first and second shots. So if the Biden administration releases all of the second doses that have been held in reserve, are you absolutely confident that there will be enough vaccine production to get everyone their second doses on time?
GAWANDE: Well, first of all, I want to be clear. We're committed to the idea that people should get their second doses on time. We are not wanting to extend those - the amount of time until they get their second doses. That is the way the clinical trials showed these vaccines can work. There is - there's a lot of confidence and faith in the manufacturers who are indicating that they can ramp up production to keep up. And so there is a certain degree of uncertainty that, you know - inevitable gamble that there can be hitches along the way. But the harm of not getting vaccines in arms now against the possible risk of a delay of a week or two - there's so much more harm now with the highest death rate that we've ever experienced under this pandemic currently occurring now.
CHANG: We should point out that a few members of Congress have tested positive for the virus even after getting their first dose of vaccine. So just to be clear, a first dose does not completely protect you, right?
GAWANDE: That's right. First of all, it takes time, after even the first dose - it looks like at least a couple of weeks afterwards - to start to see any mild effect. Furthermore, it's the combination of that first dose, followed by the booster dose...
CHANG: Right.
GAWANDE: ...That really gets you to the 95% effectiveness.
CHANG: Dr. Atul Gawande is a member of the Biden-Harris Transition COVID-19 Advisory Board. Thank you so much for joining us today.
GAWANDE: Glad to be here. Transcript provided by NPR, Copyright NPR.