MI vs. The White House: Should Shots Be Allocated by Population or Infections?

Michigan Gov. Gretchen Whitmer is asking the White House for more vaccines as her state faces a deadly surge of COVID-19 infections, but it’s not clear if her request will be granted anytime soon. The Great Lakes state saw a 38% rise in the number of cases over the last 14 days, thanks in large part to a new variant known as B.1.1.7.

Whitmer’s been a vocal supporter of President Biden in the past, but the dispute highlights the global demand for COVID-19 vaccines. Should Michigan get more vaccines if other states aren’t using them?

Allocating by Population

Since the first set of COVID-19 vaccines were approved last December, they have been largely allocated to the states based on population, regardless of how many people are getting infected.

However, Michigan is facing one of the worst outbreaks in the nation, with over 7,000 new cases a day, just under the all-time high it reached last December. Hospitalizations and deaths are rising as well.

That’s not for a lack of safety restrictions. Gov. Whitmer has been adamant about keeping Michiganders safe, despite armed protests across the state denouncing her policies. Bars and restaurants are still restricted to 50% indoor capacity.

“We are seeing a surge in Michigan despite the fact that we have some of the strongest policies in place, mask mandates, capacity limits, working from home. We’ve asked our state for a two-week pause,” the governor recently told CBS.

Gov. Whitmer and public health experts say more vaccines are needed to stem the rising number of infections.

“I would be surging a lot of vaccines to Michigan right now,” said Ashish Jha, the dean of the Brown University School of Public Health. “To me, this is a no-brainer policy, and I would be curious to hear why the Biden team hasn’t done this.”

But earlier this week, the Biden Administration announced it wouldn’t be sending more vaccines to Michigan based on recent infection numbers.

Andy Slavitt, a senior advisor to the President on coronavirus, said, “We have to remember the fact that in the next two to six weeks, the variants that we’ve seen in Michigan, those variants are also present in other states. So, our ability to vaccinate people quickly in each of those states, rather than taking vaccines and shifting it to playing whack-a-mole, isn’t the strategy that public health leaders and scientists have laid out.”

Slavitt said the Biden Administration isn’t ready to concede its current allocation plan, at least for now. “By and large, we are still allocating vaccines based upon population. Clearly, we will get to a place where more targeted strategies will work, but right now I would commit to you that we’re doing both,” he added.

Despite denying the governor’s request, the Biden Administration has supplied the state with additional testing and treatment supplies, as well as FEMA vaccinators to help give out the shot.

Allocating by Infection

Some argue the U.S. should alter its approach to vaccine allocation so that states with the most infections get the most shots, especially if other states aren’t using them.

Mississippi, Georgia, Tennessee, Arkansas, and Alabama all have some of the lowest vaccination rates in the country. In Mississippi, for example, just 25% of the population has received at least one dose, compared to a national average of 33%. Last week, the state’s scheduling website had more than 73,000 open slots available with few takers.

Increased rates of vaccine hesitancy have made it difficult to allocate the shot in the south, and access remains limited in rural areas.

However, others have argued that taking vaccines away from these states could backfire down the line if they see an outbreak or people change their minds.

The Biden Administration tweaked the nation’s allocation strategy in late January to favor states that administer the vaccine quickly, but unused shots are still pilling up across the country.

Would More Vaccines Make a Difference?

CDC Director Dr. Rochelle Walensky says Michigan needs more aggressive policies, not more vaccines. She says it would take about two weeks after the shots get administered for immunity to take effect, which makes the move impractical.

“The answer is not necessarily to give vaccines. The answer to that is to really close things down, to go back to our basics, to go back to where we were last spring, last summer, and to shut things down — to flatten the curve, to decrease contact with one another,” Walensky said. “I think if we tried to vaccinate our way out of what is happening in Michigan, we would be disappointed that it took so long for the vaccine to work, to actually have the impact.

However, Gov. Whitmer argues she doesn’t have the authority to shut everything down and go back to where we were last summer, citing the fact that the state Supreme Court ruled last year that she can’t issue new executive orders related to COVID-19 after April 30th of this year.

“Policy change alone won’t change the tide,” she said. That’s why she asked her constituents to take a two-week break for indoor dining and social gatherings.

Michigan is playing catch-up with other states when it comes to administering the vaccine. The state says it has administered 5.4 million doses with 3.3 million people fully vaccinated. The state ranks 26th in a list of all 50 states based on the percentage of the population.

Gov. Whitmer says she will continue to ask the federal government for more shots.

“When there is a surge, we think that it’s important that we rush in to meet where that need is, because what’s happening in Michigan today could be what’s happening in other states tomorrow,” Whitmer said. “And so, it’s on all of us to recognize we can squash where we’re seeing hot spots. It’s in everyone’s best interest.”