The U.S. could add COVID-19 vaccines from AstraZeneca and Novavax to its storehouse by midspring, giving Americans more options while heaping pressure on President Biden to overcome hesitancy about the shots and share the largesse with the rest of the world.
AstraZeneca’s version fully staved off hospitalization and severe disease, was 79% effective against disease overall and did not produce blood clots or other safety problems in a large U.S. trial, the drugmaker reported Monday, giving the company a much-needed boost after hiccups in Europe.
The company plans to seek U.S. emergency-use authorization in the “coming weeks” for its two-dose vaccine, which was developed with Oxford University and is in widespread use in the United Kingdom.
The news follows similarly positive data from Novavax, a Maryland company that is targeting emergency approval from the Food and Drug Administration by May.
But President Biden says the U.S. will have enough doses of three approved vaccines from Pfizer-BioNTech, Moderna and Johnson & Johnson for every American adult who wants to be immunized, raising questions about how much vaccine the U.S. needs as other countries fall behind.
“It absolutely ratchets up pressure to start to share when you have a more than sufficient supply,” said Arthur Caplan, director of the division of medical ethics at the New York University Grossman School of Medicine. “I’ve argued we have a duty to take care of people in our own country first, to the get the nation stable — meaning schools reopened and the economy reopened. But we’re going to be there pretty soon. With a lot of vaccine and a stable situation, they will be under pressure to share.”
Biden administration officials hailed the AstraZeneca news Monday but said they won’t get ahead of the FDA on approval or proclaim a surfeit of vaccines in the U.S.
“I think it’s too early for us to declare that we’re in a surplus position,” COVID-19 adviser Andy Slavitt said. “Obviously, the more we get confidence in our increased supply, the more flexibility that gives us for different events down the road, whether it’s vaccinating adolescents, whether it is sharing that supply with other countries, as we announced at the end of last week.”
Mr. Slavitt was referring to the U.S. government’s decision to loan 4 million doses of the AstraZeneca vaccine to Canada and Mexico, since the shots were sitting in factories awaiting approval.
The U.S. is administering roughly 2.5 million doses of COVID-19 vaccine per day. It has given a world-leading 127 million doses overall, even as campaigns in the European Union lag and developing countries get their first shipments from global nonprofits and alliances.
“With the [AstraZeneca] and Novavax vaccines also potentially becoming available in the coming weeks, we will have hundreds of millions of extra doses at a time when most countries around the world, especially low- and middle-income countries, will still be trying to access doses,” said Krishna Udayakumar, founding director of the Duke Global Health Innovation Center.
He said beyond helping Canada and Mexico, the U.S. is working with India, Australia and Japan — the other “Quad” countries — to help the Indo-Pacific, although there isn’t “a comprehensive or strategic approach” to sharing additional U.S. supplies.
He said Latin American neighbors should be a priority, along with a credible plan for Africa, perhaps through the global vaccine partnership known as “COVAX,” bilateral means or partners in the African Union.
“As with domestic vaccination planning, we need to move with a sense of urgency to develop and implement a robust global strategy for vaccine access,” he said.
Asked if the U.S. would have enough vaccines in the coming months to ship all of its AstraZeneca supply overseas, White House press secretary Jen Psaki said she “wouldn’t jump to that conclusion at this point.”
“There are obviously a number of factors, including the fact that these variants are unpredictable, we’re still at war with the virus, we don’t know which one is going to work best with children, and so that’s one of the reasons the president and this administration wanted to be prepared as possible and ensure we had a range of options at our disposal,” Ms. Psaki said. “As we get increasing confidence that we have enough vaccine, we will explore options for sharing more broadly.”
Demand for COVID-19 shots is exceeding supply at the moment, forcing governors to carefully allocate weekly shipments. However, states are getting enough doses to open up eligibility to more of their residents.
Once supply catches up with demand, vaccine hesitancy could be a key challenge in reaching the type of herd immunity needed to wrangle the virus. Polls suggest large shares of Republican men, rural residents and essential workers beyond health care don’t plan to get vaccinated.
Drew Altman, the president and CEO of the Kaiser Family Foundation, says the best strategy might be to focus on a slightly less resistant, “wait-and-see” group that includes “equal shares of Democrats, independents and Republicans who are more persuadable than the harder core vaccine resisters are.”
The share of these fence-sitters declined from 39% in December to 22% in February, according to KFF polling, as they see others get vaccinated and overcome fears of side effects.
“Building vaccine confidence is a multidimensional challenge and no group can be ignored, including of course Republicans. Rural Americans in particular deserve their fair share of attention and so far they are not getting it,” Mr. Altman wrote in a column for the Kaiser Family Foundation, a nonprofit that focuses on health policy. “But the best strategy for building vaccine confidence would focus heavily on the wait-and-see groups to produce early results to build on. And, the wait-and-see groups include larger shares of people of color who are disproportionately affected by the pandemic.”