Vaccine distribution, like tests, is a state-led effort in the U.S.

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• Hari Sreenivasan:

  For more on the U.S. rollout of COVID-19 vaccinations, I spoke with Caroline Chen who reports on public health for ProPublica.

  Caroline, we have gone from tracking the number of cases and deaths which are still, by the way, increasing, people are also as anxious about tracking where and when they can get a vaccine. And it seems pretty disparate, depending on the state, depending on the city, depending on your age. There's not sort of a uniform roll out here.

• Caroline Chen:

  Yeah, and I think that this is once again a similar picture to what we saw previously with testing. This is the way that it works in the US, that the states have their own ability to run vaccine distribution. So we are going to see 50 different pictures, 50 different stories, because the CDC can only give guidance over what order you give out the vaccine and then it's up to the states to actually manage distribution. And in fact, it's going to go down to the facility level, which is what's happening right now, because even though by and large, every state agrees that frontline health care workers get it first.

  Once the vaccines are delivered to the hospitals, it's up to the hospitals to decide who within their facility gets it first.

• Hari Sreenivasan:

  What is the guidance from the CDC say? Is it the elderly and then the elderly with immune-compromised status or preexisting conditions? I mean, how do you prioritize?

• Caroline Chen:

  So what's called phase 1-A right now, which is in the CDC guidelines, is frontline health care workers and nursing home long-term care facilities, which is a pretty small population, but as we all understand, is an absolutely critical population to get the vaccine.

  And then after that, phase 1-B is where there is some wiggle room and state to states are interpreting it differently.

  But by and large, the sort of the next tier is going to be elderly, especially elderly with preexisting conditions. Some states are adding sort of that clause on to that and then essential workers.

• Hari Sreenivasan:

  Also, there's been kind of a debate on whether or not we should just double the amount of vaccine that's available to everyone by not necessarily making two doses available. Is there a legit scientific argument there because you're still getting some protection, which is better than no protection, even though it might not be as good as the double dose?

• Caroline Chen:

  This is where the UK has been trending. And there are scientific reasons why a lot of immunologists say this may be something that you can do. They point to some people in the trials where you can see even after one shot, there was pretty good efficacy and pretty good protection. However, for now, the FDA and the CDC as well, Dr. Nancy Messonnier has really been on the side of the US saying we should stick to two shots because that is what was tested in the trials. That's what the FDA has authorized.

  And whatever we do in the US, my biggest concern actually is that we communicate it clearly to the public. So if we've been sending these messages: you have to get your two shots, you have to get your two shots, you have to get your two shots. Wait a second, we only, only need to get one shot. It's going to be confusing. So my hope would be for consistent, clear communication wherever, again, the science leads us.

• Hari Sreenivasan:

  The other thing that people are very concerned about regarding the vaccine right now is the news of these other strains that seem to be more contagious, whether or not these vaccines will protect them from the mutations of a virus, which naturally occur.

• Caroline Chen:

  So right now, we do have two variants, one that is commonly known as the UK variant and one that's coming out of South Africa that the data is pointing towards them being more highly transmissible right now. And that is a concern.

  As far as we have been able to see, we have no reason to think that the vaccine is not going to be effective against them. So that's good news. However, one thing that I'd point out is that the more cases there are out there, the more widely spread the coronavirus is, the more chances it has to continue mutating and to produce more variants.

  So this is not the time for us to say, oh, great, there's the vaccine and we can lower our guard. And it doesn't matter if we have more cases because the vaccine is on its way. Like we have to continue to be vigilant right now and not give the coronavirus more chances to mutate and produce variants that might be able to escape our vaccine.

• Hari Sreenivasan:

  So really, one of those things, if somebody in our audience is lucky enough to be getting a vaccine soon, is that does not give you license to just sort of take off your mask and start hugging strangers.

• Caroline Chen:

  What the trials have shown for Moderna and Pzifer's vaccine is that it is highly, highly effective in protecting you from getting sick. Does it protect you from being able to carry the coronavirus, like pick up the virus and then spread it to someone else? That is something that has not been 100 percent answered by the trials, and it's highly likely, but for now, even after you've got the vaccine, because we don't have 100 percent data, continue to wear your mask. And also because it's an important social signal, you've got to continue to encourage other people to wear masks. So we have to have the social signal to encourage other people who have not yet gotten vaccinated to continue to wear their masks as well.

• Hari Sreenivasan:

  All right, Caroline Chen of ProPublica, thanks again.

• Caroline Chen:

  Thanks for having me.