From the U.S. Government Accountability Office, www.gao.gov

Transcript for: COVID-19 Vaccine Availability and Initial Implementation
Challenges 

Description: Are you still waiting to get your vaccine? The federal
government has taken actions to increase the availability of COVID-19
vaccines, and says vaccines will be available to all adults in the U.S.
by the end of May. However, federal officials say that it can be
difficult to project the availability of doses in the future. We get an
update on federal efforts to make the COVID-19 vaccine available, from
GAO’s Alyssa Hundrup. 

Related GAO Work: GAO-21-443, COVID-19: Efforts to Increase Vaccine
Availability and Perspectives on Initial Implementation

Released: April 2021 

[Intro music:]

[Alyssa Hundrup:] The government has really taken critical steps to
ensure there really will be enough vaccine for all Americans. But there
is still a ways to go.

[Holly Hobbs:] Welcome to the Watchdog Report, your source for news and
information from the U.S. Government Accountability Office—celebrating
100 years of fact-based, non-partisan oversight. I’m Holly Hobbs.
Are you still waiting to get your vaccine? The federal government has
taken actions to increase the availability of COVID-19 vaccines, and
says vaccines will be available to all adults in the U.S. by the end of
May. However, federal officials say that it can be difficult to project
the availability of doses in the future. Today, we’ll get an update on
federal efforts to make the COVID-19 vaccine available, from Alyssa
Hundrup—an expert on public health issues, and an Acting Director in our
Health Care Team. Thank you for joining us Alyssa! 

[Alyssa Hundrup:] Hi Holly. Thanks for having me. 

[Holly Hobbs:] So, Alyssa if the federal government is saying it’s hard
to project the availability of vaccine doses, how can it also say there
will be enough doses for adults by the end of May? 

[Alyssa Hundrup:] Well, the manufacturing of vaccines is really a
complex process. So projecting the number of doses, really comes with
uncertainty. Going back to December and January, we were delivering
about more or less 10 million doses per week. When you fast-forward to
February, that number has more than doubled, rising to more than 24
million doses per week. And those numbers are expected to rise. So, in
our report, we stress the need for the government to provide timely,
clear and consistent communication about vaccine availability, really to
help manage public expectations and ensure public confidence and trust.
And this is especially important given that the initial vaccine rollout
did not match expectation set by the government. 

[Holly Hobbs:] So, what exactly has the government done to increase the
availability of vaccines? 

[Alyssa Hundrup:] The government has done several things. First, it has
purchased quite a number of doses. We have 700 million doses under
contract to be delivered by the end of July. That 700 million is enough
for approximately 400 million people when you factor in the two-dose
regiment for two vaccines that are authorized. But that’s just what the
government has purchased. The vaccine companies still have to
manufacture the vaccines that they’re on the hook to produce. So the
second thing the federal government has done is help with manufacturing.
For example, the government has helped identify ways to facilitate the
fill-and-finish process. And what I mean there is, putting the vaccine
directly into those glass vials, packaging, ceiling it and preparing it
for shipment. And the government has also used the Defense Production
Act to prioritize certain contracts and this has allowed vaccine
companies to obtain needed materials more quickly. 

[Holly Hobbs:] What about efforts to get vaccines into the arms of
vulnerable populations or communities of color? 

[Alyssa Hundrup:] So right now for example, the federal government is
sending additional vaccine doses directly to retail pharmacies to
vaccinate teacher and child care providers. It’s also sending vaccine
doses directly to federally-qualified health centers that provide care
to underserved populations. And the idea is to really ensure that these
communities and those disproportionately affected populations, such as
racial and ethnic minorities, receive the vaccines. 

[Holly Hobbs:] So, Alyssa in previous podcasts, we’ve talked about the
challenges with developing and manufacturing vaccines. What is the
status of those challenges and what new challenges have we seen under
the vaccine rollout?

[Alyssa Hundrup:] There continue to be manufacturing challenges related
to capacity, to supply chains, and available workforce. In our current
report, we highlight some of the steps the government and the vaccine
companies together are taking to address those challenges, such as
expanding manufacturing capacity and bringing on new partners. The real
challenge now, is where we have a huge demand for vaccines greatly
exceeding available supply—and to be able to have enough vaccine for all
adults by the end of May, as the administration is targeting—they’re
really going to need to be a significant increase in weekly deliveries
of vaccines. 

[Music:]

[Holly Hobbs:] So it sounds like the federal government has taking a
number of steps to increase the availability of COVID-19 vaccines, and
is saying there will be enough vaccines for all adults in the U.S. by
the end of May. But that these efforts face a number of challenges
including those involving manufacturing and distribution. So Alyssa, for
this report, we interviewed state and local health officials, and health
care providers about challenges in vaccine distribution and access. What
did they tell us?

[Alyssa Hundrup:] Well, in several instances we heard states and local
health department were given very little notice as to how many vaccine
doses they would receive and when. And this made it quite difficult for
them to understand the size of what they should be planning for in terms
of administering the vaccine. We also heard that health care providers
did not have an authoritative source to combat misinformation and
vaccine hesitancy. And I think what we’re seeing, as a result, is a
lower proportion of health care staff in long-term health care
facilities being vaccinated initially. We also learned that states and
local health departments really needed to hire and train new staff. They
had a lot of things to set up—new data systems, running vaccine clinics,
while at the same time, of course, treating COVID patients. And so it
really put a strain on their limited resources. Since that time, the
federal government has taken several steps. They’re providing additional
information to states. They have new resources and sources of funding
that come through. So we are of course encouraged by these steps, and
will continue to monitor them with our ongoing work. 

[Holly Hobbs:] And last question—what’s the bottom line of this report?

[Alyssa Hundrup:] The government really has taken critical steps to
ensure that there really will be enough vaccine for all Americans. But
there is still a ways to go. We still have to get vaccine through the
manufacturing process. We need doses delivered to the states and then to
the local areas, and then that critical getting shots into arms for
those that want them. We really can’t stress enough the importance of
effective coordination and communication across all levels of
government, and with the public of course, to accomplish this crucial
task at hand.

[Holly Hobbs:] That was as Alyssa Hundrup talking about GAO’s recent
review of federal efforts to promote vaccine access. Thank you for your
time, Alyssa! 

[Alyssa Hundrup:] My pleasure. Thank you Holly!

[Holly Hobbs:] And thank you for listening to the Watchdog Report. To
hear more podcasts, subscribe to us on Apple Podcasts! And make sure you
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For more from the congressional watchdog, the U.S. Government
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