Funding challenges force tough choices as Biden administration prepares to roll out new Covid-19 booster shots

By Jeremy Diamond, CNN

As soon as this weekend, Americans will for the first time be able to get a coronavirus vaccine booster shot that targets the two most prevalent Omicron subvariants as well as the original strain of the virus.

It almost didn’t happen.

Absent new funding from Congress, securing tens of millions of those new bivalent vaccines — which the US Food and Drug Administration authorized for emergency use on Wednesday — required making funding decisions the White House’s coronavirus response coordinator called “painful.”

“This is such an extraordinarily important thing for protecting the American people this fall and winter that we absolutely needed to make sure we were going to have the resources,” Dr. Ashish Jha told CNN in an interview Wednesday.

“It’s been painful,” he added. “We have gotten resources from other things that we also think are really high priorities. We will not have a testing stockpile that we need as we go into the fall and winter. We will not have personal protective equipment — PPE stockpiles will be depleted, will be inadequate as we head into the fall and winter.”

A second senior administration official described the trade-off as “robbing Peter to pay Paul.”

“There were no easy choices,” the official said.

White House officials are now confident that millions of doses of Pfizer and Moderna’s new booster shots will be widely available as soon as next week, but they openly acknowledge — and lament — that it came at the expense of funding for tests and personal protective equipment that will also likely be needed later this year. A public education campaign to encourage Americans to get the new and improved booster shots will also be scaled back, two administration officials told CNN.

The Biden administration purchased 171 million doses of Pfizer and Moderna’s updated vaccines this summer, but only after reallocating about $5 billion in funds intended for other pandemic resources. Amid resistance from Republicans, Congress failed to reach a deal on supplemental funding and so in June, the Biden administration’s top health officials decided they needed to find another way.

Shots won’t go into arms until the US Centers for Disease Control and Prevention issues its official recommendations for the newly authorized shots, which is expected to be done by the end of the week, but ​the government has already made over 20 million doses available for pre-order for states, primary care providers, pharmacies and clinics.

The administration is still planning to launch that public education campaign in the first weeks of September to educate Americans about the benefits of the new shots and encourage them to get boosted, based in part on results of the Department of Health and Human Services survey of at least 1,500 people per week that was done to test different messages.

But with that campaign too, the administration is facing more hard choices.

Paid advertising will be scaled back and “particularly targeted” to key communities, the senior administration official said, and the administration will increasingly rely on earned media and partnerships with local officials, experts and organizations to get the word out.

“Our funding challenges are real and we’re doing everything we can to mount as robust and comprehensive campaign as possible, but we’re doing that with substantial constraints,” said the senior official, who described educating the public on the new shots as a “big, big hill to climb.”

While more than two-thirds the US population is fully vaccinated, less than a third of the country has gotten a booster shot, according to data from the CDC. Getting those people a booster shot will be critical to mitigating the potential for tens of thousands of Covid deaths this winter as Americans head indoors and transmission increases.

The funding trade-off also means that it will might be harder for the US to detect and slow transmission in the fall and winter months as testing will likely become more scarce once again.

“We are absolutely concerned about our ability to detect and respond to any future wave,” the senior administration official said, adding that the White House is continuing to urge Congress to provide billions of dollars in supplemental funding.

Experts say the White House ultimately did the right calculus by prioritizing funding for vaccines over testing and PPE.

“I think it is a crying shame that they had to make that choice,” said Dr. Megan Ranney, an emergency physician and the academic dean at Brown University’s School of Public Health. “Given the fiscal constraints that the federal government is under, it was the right choice. The vaccines are going to have a greater bang for their buck than maintaining a stockpile of PPE or testing. It would be unconscionable for us to not fund a vaccine.”

Still, Ranney said she worries shortages of PPE and testing could come back to bite the US should a new, more dangerous variant emerge and send cases soaring.

“We’re choosing not to prepare for the eventual in order to be able to treat the current,” she said.

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