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  • With the coronavirus vaccine rollout dragging, the federal government is recommending several changes to help get more Americans vaccinated quickly.
  • The federal government is urging states to offer the vaccine to anyone 65 years and older.
  • While states are not obligated to follow these recommendations, the change will still affect how many vaccine doses each state receives.

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With COVID-19 cases and deaths in the United States rising at an alarming rate, the Trump administration announced on Tuesday several big changes intended to boost the rollout of the coronavirus vaccine and get more Americans vaccinated quickly.

First, the federal government is urging states to offer the vaccine to anyone 65 years and older and to people under 65 who have comorbidities that increase their risk of severe COVID-19.

“We’re telling states today that they should open vaccinations to all of their most vulnerable people. That is the most effective way to save lives now,” Alex Azar, Health and Human Services secretary, said at a press briefing Tuesday.

While states are not obligated to follow these recommendations, the change will still affect how many vaccine doses each state receives.

Starting in two weeks, the federal government will allocate doses based on a state’s over-65 population rather than the overall population, as is currently being done.

States that fail to administer doses in a timely fashion may see future shipments cut.

“[This new approach to allocating the vaccine] gives states a strong incentive to ensure doses are going to work, protecting people rather than sitting on shelves or in freezers,” Azar said. “We need doses going to where they’ll be administered quickly, and where they’ll protect the most vulnerable.”

This deviates from earlier guidance from the Centers for Disease Control and Prevention (CDC), which recommended a more nuanced rollout of the vaccine.

The CDC’s guidelines focused on vaccinating the highest risk groups first — healthcare workers, residents and staff of long-term care facilities, people 75 years and older, and frontline essential workers.

The Trump administration is also urging states to expand the sites where people can be vaccinated to include community centers, pharmacies, and “mega-sites” such as convention centers and arenas.

Disneyland Resort in Anaheim, California, will become one such vaccination “super” site, Orange County officials announced Monday.

In addition, the administration has authorized the release of all available doses of the vaccine to states. It had been holding back about half of the doses to ensure that there were enough available when people needed their second dose.

The two coronavirus vaccines authorized in the United States for emergency use — Moderna-NIAID and Pfizer-BioNTech — both require two doses given several weeks apart for optimal protection.

“Because we now have a consistent pace of production, we can now ship all of the doses that had been held in physical reserve,” Azar said. “We’re now making the full reserve of doses we have available for order. We are 100 percent committed to ensuring a second dose is available for every American who receives the first dose.”

President-elect Joe Biden announced last week a similar plan to release nearly all available doses soon after his inauguration.

At the time, Azar and other officials at Operation Warp Speed, the federal government’s vaccine program, were critical of Biden’s plan, reports The New York Times.

More than 29 million doses have been distributed by the federal government, and about only 10.2 million people have received their first dose, according to the CDC’s COVID Data Tracker.

The delay in the rollout comes as the country continues to set new COVID-19 records — averaging more than 248,000 new infections a day over the past week, along with more than 3,200 COVID-19 deaths a day, according to CNN.

Dr. Robert Amler, dean of the School of Health Sciences and Practice at New York Medical College and a former chief medical officer at the CDC’s Agency for Toxic Substances and Disease Registry, says the Trump administration’s new guidelines are a step in the right direction.

“Fewer people will have to hold back until their priority group is called,” he said. “There will be less frustration, so more people will plan to get vaccinated.”

William A. Haseltine, PhD, a former professor at Harvard Medical School and Harvard School of Public Health, and founder of nonprofit ACCESS Health International, thinks having less-complicated guidelines can also help speed up vaccinations.

“The simplest rule is if you’re of a certain age, you’re eligible to get the vaccine,” he said, “and you continually lower the age groups.”

However, he says that by taking into account comorbidities in people under 65 years old, the new guidelines complicate matters.

Several conditions are linked to a higher risk of severe COVID-19, including diabetes, chronic lung or heart disease, high blood pressure, and cancer.

But so is obesity, which would make over 42 percent of adults eligible to be vaccinated.

“The moment you open it up to include any kind of complexity, it’s going to be confusing and misinterpreted,” Haseltine said.

Amler agreed that simpler is better.

“The more restrictive approach — with many different categories, unclear distinctions, and guidelines that keep changing — hasn’t worked well so far,” he said.

He added that “open vaccination with fewer priority distinctions” will be even more important as people begin to come back for their second dose.

While Azar said the rollout will be aided by the “consistent pace of [vaccine] production,” Haseltine warned that manufacturing has not been the main cause of the lag in vaccinations.

Instead, it’s disorganization and lack of resources at the local level.

“Each locality is doing what they can with their limited resource to address those issues,” he said. “But they’re serious issues that haven’t been resolved yet.”