January 14, 2021
The Honorable Joseph R. Biden
President-elect of the United States
1717 Pennsylvania Avenue, N.W.
Washington, DC 2006
RE: Expediting the Administration of COVID-19 Vaccines
Dear President-elect Biden:
As you take office next week, we know that one of your top priorities is to bring to an end the COVID-19 pandemic. On behalf of the American Hospital Association’s (AHA) nearly 5,000 member hospitals, health systems and other health care organizations, and our clinician partners – including more than 270,000 affiliated physicians, 2 million nurses and other caregivers – and the 43,000 health care leaders who belong to our professional membership groups, we share this priority and pledge to work with you to end the pandemic. As a first step, we want to work with you in expediting the administration of COVID-19 vaccines throughout the nation.
Despite valiant efforts, including countless acts of heroism by front-line health care providers and others, that have undoubtedly saved thousands of lives, the data suggest that the virus has been winning far too many of the battles. However, in December, our country was energized by the release of the first two COVID-19 vaccines that give us hope we can conquer this virus and eventually restore normalcy to everyday life. To turn that hope into reality, we urge your administration to provide strong federal leadership of the vaccine distribution and administration process.
This effort must be large and multifaceted, and it will require exceptional leadership and coordination to ensure none of the vaccine is wasted. The most challenging task will be the work to keep the manufacturers, distributors, state and local officials, hospitals, pharmacies, other providers, schedulers, planners, site coordinators, data collectors, and others working as a team. We strongly believe the most important role for your administration will be to act as the quarterback for this massive undertaking. There are many willing hands, but as the number of entities involved in the effort grow, the task of minimizing confusion and keeping everyone working toward the same goal becomes more critical – and more difficult.
Thus far, when health care workers and nursing home residents only have been eligible for vaccination in most parts of the country, we have seen how miscommunications and a lack of effective planning and coordination have resulted in hospitals and others having to work extra hard to get the job done without letting vaccines go to waste. They have had to scramble to line up staff to receive vaccines when shipments have arrived without prior notice; experienced confusion over where health care workers not associated with a hospital should go to receive their vaccine; seen scheduling websites crash; received too little vaccines in some locations and an abundance in others; and witnessed a host of other issues that have slowed the pace of vaccine administration.
During the past week, you have announced plans to release large quantities of vaccines, as well as your intention to urge the states to abandon the previous tiering system and move to vaccinating individuals age 65 or older and individuals who have co-morbidities that put them at increased risk from COVID-19. We share your sense of urgency and applaud your decision to simplify the task by eliminating some of the tiering and by making more vaccines readily available. However, as we wrote in a Jan. 6 letter to Health and Human Services (HHS) Secretary Alex Azar, we believe many additional actions will be needed to enable the full scale vaccination effort that will be necessary to achieve our shared goal of herd immunity in the next few months.
Without clear leadership and direction from your administration, these problems will inevitably worsen as the number of people seeking to be vaccinated grows exponentially. To get to the scale our country needs to in order to vaccinate millions of people per day, hospitals and others who are able to contribute to the effort will all need to become part of the team. Those new to the effort, as well as those who have been engaged thus far, need coordination, communication and the ability to work with others to resolve the issues that arise. We need to be realistic about what it will take to support a national level of engagement in vaccination and provide the support that it will require.
We also need to recognize that hospitals and some other providers have the special responsibility of caring for a large number of very sick patients. The daily data collected by HHS tell us that the numbers of hospitalizations in parts of the country are overwhelming some hospitals now, and in many other parts of the country, the number of hospitalizations are extraordinarily high. Hospitals’ responsibilities to these patients will limit their ability to engage fully in the vaccination effort until hospital occupancy drops to more normal levels.
As you take office, please know that you and your colleagues can count on hospitals and health systems to continue to be committed partners in addressing all aspects of this pandemic, including being a vital part of the vaccination efforts. We look forward to working with your team as it provides strong federal leadership throughout the entire vaccination process from manufacturing to putting shots in arms. The AHA looks forward to providing insights and perspectives from hospitals and health systems to inform and improve the work to ensure America is protected against COVID-19.
Please feel free to contact me or to have your staff contact Nancy Foster, AHA’s vice president for quality and patient safety policy, at firstname.lastname@example.org. I look forward to discussing this with you further.
Richard J. Pollack
President and Chief Executive Officer