Tuesday, May 4, 2021

Where vaccines aren't working

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POLITICO Nightly logo

By Renuka Rayasam

Presented by Facebook

With help from Joanne Kenen

HOW TO VAX A BILLION — Battling the world's worst Covid surge, India is trying to vaccinate its way out of crisis: On May 1, the country made Covid vaccines available to all adults aged 18 and older.

It's too late for the strategy to work.

It might have worked in January when cases were low and India was just starting its vaccine rollout. But now 3.5 million people are being treated for Covid in the country. Thousands are dying daily as hospitals struggle to secure critical supplies. India's main opposition party is calling for a national lockdown to bring case levels down, a move that Prime Minister Narendra Modi has resisted. Instead he's hoping to ramp up vaccination levels, but it's an effort that will take months to implement, not soon enough to keep more Indians from becoming second-wave Covid victims in the coming weeks.

Modi is already at a disadvantage: India's vaccination effort is off to a sluggish start. There aren't enough doses in the country right now to boost vaccinations to a level that could blunt the Covid case rise.

"The current surge — the crisis that has resulted from it — is not something that can be managed by vaccination," Prashant Yadav at the Center for Global Development in Washington said in an interview with Nightly.

People receive their Covid-19 vaccines from medical workers at a vaccination center set up in the library of a government school in New Delhi, India.

People receive their Covid-19 vaccines from medical workers at a vaccination center set up in the library of a government school in New Delhi, India. | Getty Images

India started the year convinced that the pandemic was behind it. When India first made vaccine doses available on Jan. 16, residents didn't line up for them. Many were more worried about the vaccine than the virus.

Between January and March, the country, which has the world's biggest vaccine manufacturers, exported 60 million doses to other countries and to COVAX, which is trying to make sure the poorest countries have access to vaccines. Now, as the country hits 20 million cases, Indian states are struggling to get a hold of enough vaccine supply.

India's two big vaccine makers are now producing fewer than 3 million doses a day of two approved vaccines, Yadav said. The current crisis has boosted demand. The country has halted exports, disrupting vaccination efforts around the globe. But in a country of more than 1.3 billion people, the new doses have barely made a dent: Only about 2 percent of the population has been fully vaccinated and less than 10 percent has had at least one shot.

While vaccines alone won't get India out of its current crisis, Modi's plan can help prevent a third wave this fall, if everything goes well.

"Vaccines are something that, at best, will be useful in September," Yadav said.

India has approved Russia's Sputnik V vaccine and is working on a plan that could boost domestic manufacturing to an average of 5 million doses a day in three to four months, Yadav said. Plus there are efforts underway to import additional doses, which could add up to another 100 million doses in the next few months.

But even vaccinating another 50 million people would mean only another 4 percent of the country would be protected against Covid.

The Biden administration, under pressure from Indian Americans like Rep. Raja Krishnamoorthi, is making some moves to help. It lifted a raw material export ban, which will help India's vaccine makers maintain supply. And after some back and forth, the administration said it would export AstraZeneca to needy countries. India is, presumably, on that list.

One big caveat to Modi's vaccination efforts: Even though the central government opened up vaccinations to all adults, it is procuring vaccine doses only for people 50 and older and those at high risk, Yadav said. State governments are left to their own devices to get doses for people between 18 and 50, setting up internal competition that could drive prices up. Adar Poonawalla, chair of the Serum Institute of India, the world's largest vaccine maker, fled to London to escape threats from state government leaders and others who are desperate for more supply.

But public health officials say that in order to get those new doses in arms, India has to do more than just secure more supply. Right now the country is largely delivering vaccines through hospitals and clinics, which aren't equipped to ramp up distribution. In 1977 India eradicated smallpox through an aggressive vaccination campaign that started after the country became the global epicenter of the illness. (Lots of older Indians still bear a dime-size shot scar on their upper arms.) The country eradicated polio using health workers who went directly to people to get them vaccinated and through mass campaigns encouraging people to get immunized.

India will need to do the same with Covid vaccines, said Brian Wahl, an epidemiologist with Johns Hopkins University who has been based in India for the last 12 years.

"Some state governments are starting to allow communities to have Covid-19 vaccine drives," said Wahl. "To me that's an encouraging development."

Welcome to POLITICO Nightly. Our Mid-Atlantic Nightly team member Tyler Weyant hasn't seen a cicada yet, but his dog is definitely digging a lot more than usual to find them. Send us you hopes and fears for the forthcoming Brood X (or pics of your first loud little friends) at nightly@politico.com. And reach out with news, tips and ideas for us at rrayasam@politico.com, or on Twitter at @renurayasam.

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What'd I Miss?

nightly video player of President Joe Biden

— Biden shakes up vaccine strategy as he sets new goal: The Biden administration will soon allow states to order coronavirus shots that other states aren't using , marking a major shift in strategy as the White House readies a new push to lift falling vaccination rates. President Joe Biden also unveiled a new goal of providing at least one vaccine dose to 70 percent of adults by July 4.

— Trump launches new webpage to connect with followers on eve of Facebook decision: Former President Donald Trump launched a new webpage to communicate with his followers. The posts that appear thus far largely appear to be a collection of the press release statements he has issued in recent days through his other channels, including his Save America PAC. The page is titled, "From the Desk of Donald J. Trump."

— Woman accusing NYC mayoral candidate of sexual assault files complaint with state AG: The woman accusing New York City mayoral candidate Scott Stringer of sexual assault and harassment filed a formal complaint today with the office of state Attorney General Tish James. Jean Kim has said Stringer repeatedly groped and kissed her without her consent when she was a volunteer on one of his campaigns 20 years ago.

— Pentagon watchdog opens new probe into military's handling of UFOs: The Pentagon's inspector general is looking into the actions the military has taken to address the spate of UFO sightings in recent years involving high performance aircraft that have violated military airspace. The probe comes as Congress awaits a public report, due next month, from a host of national security agencies on the issue, and as advocates complain that some departments and agencies are not fully cooperating by sharing data.

— Florida's Crist becomes first prominent Democrat to challenge DeSantis: Rep. Charlie Crist, the former Florida governor who left the Republican Party over the tea party backlash aimed at Barack Obama, became the first prominent Democrat in the state to announce a bid to knock off incumbent Gov. Ron DeSantis.

— Judge orders release of DOJ memo justifying not prosecuting Trump: A federal judge has ordered the release of a key Justice Department memo supporting former Attorney Bill Barr's conclusion that Trump should not be prosecuted for obstruction of justice over episodes investigated by special counsel Robert Mueller.

 

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First In Nightly

"Facebook always was hugely important to Trump in his political rise and reign. Twitter, which has booted him forever, tended to be more front and center — it was for Trump a rough, running focus group, and a real-time, utterly un-private diary. But if Twitter was the loudspeaker, Facebook was the less flashy but nonetheless critical organizing, advertising and fundraising infrastructure. Compared to Twitter's noisy café, Facebook was the underground pipes. It's hard to see how Trump would have become president without it."

— From Michael Kruse, "The Facebook Ban Hurt Trump in Surprising Ways," coming Wednesday morning in POLITICO Magazine.

VAX SCENE

THE BUCKEYE BUSLOAD — Health care editor at large Joanne Kenen emails Nightly the latest entry in our occasional series about what the Covid immunization drive looks like around the world:

In early spring, a group of elderly Ohioans got on a bus at their retirement home outside Cincinnati and took a ride to get the coronavirus vaccine that would enable them to reclaim a bit of normalcy in their lives. Most were low-income, and Black, and odds are they disagree politically with the U.S. Army Reserve doctor who boarded their bus as they rolled up their sleeves.

"We'd go onto the bus, get their history, clear them, and give them the vaccine right on the bus," said that doctor, Rep. Brad Wenstrup, a Cincinnati podiatrist, Iraq combat veteran and a co-chair of the GOP Doctors Caucus.

The Ohio lawmaker has been a strong voice in favor of vaccination against Covid-19. Knowing that Republicans are among the most vaccine-resistant demographics in the country, he's among the GOP lawmakers who appeared in a recent pro-vaccine video aimed at conservatives, stressing that vaccines are a pathway to freedom from government-imposed restrictions.

He's spent a lot of time trying to understand how to build trust in vaccines. He's also been administering shots — by his own estimation, he's put roughly 100 of them in people's arms directly, and provided medical oversight of other aspects of immunization drives for many more people.

And not just in buses. With the Guard, and as a medical volunteer in other settings, he's done drive-through vaccinations through car windows in barns. He's given shots at fairgrounds and at federally-funded community health clinics.

Back home, he told Nightly, he knows people trust him when he's "in my scrubs." When he's wearing a business suit and his congressional lapel pin, "then all bets are off," he said, only half-jokingly.

"They want to hear from their doctors, not politicians," he said. And they "want to be educated, not indoctrinated." Scolding, lecturing, condescending doesn't help.

When he's in his medical uniform, he doesn't talk politics.

On that bus, "one lady said to me, 'Can I get a selfie with you?'" he said. "Yes, ma'am," he replied.

"I don't think I agree with you on one thing politically," she told him. "But I do thank you for your service."

"That's America," he told us. "Right?"

 

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Around the Nation

CANNABIS CORRUPTION CONUNDRUM — By making local officials the gatekeepers for million-dollar businesses, states have unintentionally created a breeding ground for bribery and favoritism. Mona Zhang explores the corruption in the second episode of a two-part POLITICO Dispatch series on the unintended consequences of marijuana legalization laws.

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AROUND THE WORLD

WE HAVE A (DELAYED) DEAL The European Commission has temporarily put on hold efforts to ratify its investment agreement with China , EU Trade Commissioner Valdis Dombrovskis told Agence France-Presse today.

"We have ... for the moment suspended some efforts to raise political awareness on the part of the Commission, because it is clear that in the current situation, with the EU sanctions against China and the Chinese counter-sanctions, including against members of the European Parliament, the environment is not conducive to the ratification of the agreement," Dombrovskis told the French news agency.

The deal was already on ice. Because of Beijing's sanctions on European officials and academics, members of the European Parliament were vowing never to ratify it. The European Commission has traditionally been highly defensive of the accord, agreed in principle at the end of last year, but Dombrovskis' remarks are the clearest sign to date that the executive is now also alive to the rapidly deteriorating political climate over the past four months, and is backing off despite heavy German pressure to get the deal done.

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Nightly Number

12

The number of states that have reached 60 percent or more of adults having received at least one dose of the Covid-19 vaccine as of the end of April, according to a new Kaiser Family Foundation brief . Eight of these 12 states are in the Northeast. Thirteen states have reached less than 50 percent of adults, with nine of these states in the South.

Parting Words

Illustration of former President Donald Trump

POLITICO illustration/Photos by AP and Bill Kuchman

TO LIKE, OR TO SAD FACEA group of 19 lawyers, scholars, activists and journalists from around the world will announce on Wednesday whether Trump's Facebook account is to be reinstated or kept off the platform for good, a ruling with massive implications for U.S. politics, Cristiano Lima writes.

The so-called Facebook oversight board has been deliberating Trump's case since January, when he was booted off after the Jan. 6 siege of the Capitol over fears he might incite more violence. Their decision could give the former president back one of his most powerful megaphones or muzzle him permanently on yet another major social media platform.

While the board members have spoken sparingly about how they are weighing Trump's suspension, many have a long track record of weighing in on contentious issues around free speech on social media, and their backgrounds could offer a glimpse into how they each approached Trump's blockbuster case.

The board has no shortage of vocal Trump critics — some who have even suggested he should be imprisoned over his role in the storming of the Capitol or that he's a bigot and a racist. But their views on free speech online are far more complex.

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