WASHINGTON — The Pentagon is considering sending active-duty troops to large, federally run coronavirus vaccine centers, a major departure for the department and the first significant sign that the Biden administration is moving to take more control of a program that states are struggling to manage.
The Federal Emergency Management Agency is hoping to set up roughly 100 vaccine sites nationwide as early as next month, and on Wednesday night requested that the Pentagon send help to support the effort. The sites, and the use of the military within them, would require the approval of state governments.
While many state governors have turned to their National Guard units to assist with the mass effort to vaccinate Americans and outrace more contagious variants of the coronavirus, the Pentagon’s role has been largely behind the scenes, providing help with logistics.
During his confirmation hearings last week, Lloyd J. Austin III, the secretary of defense, said he would increase military support to manage the pandemic. On Thursday, Max Rose, Mr. Austin’s senior adviser for Covid-19, said his first topic of conversation in meetings with senior leaders had been making this the “No. 1 priority.”
Sending troops to help set up sites, assist with logistics and even put shots in arms is something the Defense Department is “actively considering,” Mr. Rose said. He declined to provide specifics, saying that Pentagon officials would be reviewing the request from FEMA carefully.
“We are obviously going to source this request,” said John F. Kirby, the Pentagon press secretary, noting that, after a review, it would most likely be filled with more National Guard, reserve and active-duty troops.
“I would say we are talking days, certainly not weeks, to get this sourced,” Mr. Kirby said. “We know there’s an urgency.”
The military is likely to provide thousands of troops in the next several months, not unlike the mobilization that the Trump administration put together a few years ago to supplement enforcement at the border with Mexico.
Many states and territories have set up large vaccination sites, and over half are using National Guard members to give shots, drawing on doctors, nurses, medics and others skilled in injections. FEMA, an agency within the Department of Homeland Security, has already told six states, two territories and Washington, D.C., that it would spend $1 billion on vaccine measures, including community vaccination sites.
It was not immediately clear where the vaccines would come from for new federal sites; they would most likely be drawn from the supply already given to individual states and territories. Most states have not come close to administering the vaccine they have been given.
Currently more than 150 million people — almost half the population — are eligible to be vaccinated. But each state makes the final decision about who goes first. The nation’s 21 million health care workers and three million residents of long-term care facilities were the first to qualify. In mid-January, federal officials urged all states to open up eligibility to everyone 65 and older and to adults of any age with medical conditions that put them at high risk of becoming seriously ill or dying from Covid-19. Adults in the general population are at the back of the line. If federal and state health officials can clear up bottlenecks in vaccine distribution, everyone 16 and older will become eligible as early as this spring or early summer. The vaccine hasn’t been approved in children, although studies are underway. It may be months before a vaccine is available for anyone under the age of 16. Go to your state health website for up-to-date information on vaccination policies in your area
You should not have to pay anything out of pocket to get the vaccine, although you will be asked for insurance information. If you don’t have insurance, you should still be given the vaccine at no charge. Congress passed legislation this spring that bars insurers from applying any cost sharing, such as a co-payment or deductible. It layered on additional protections barring pharmacies, doctors and hospitals from billing patients, including those who are uninsured. Even so, health experts do worry that patients might stumble into loopholes that leave them vulnerable to surprise bills. This could happen to those who are charged a doctor visit fee along with their vaccine, or Americans who have certain types of health coverage that do not fall under the new rules. If you get your vaccine from a doctor’s office or urgent care clinic, talk to them about potential hidden charges. To be sure you won’t get a surprise bill, the best bet is to get your vaccine at a health department vaccination site or a local pharmacy once the shots become more widely available.
That is to be determined. It’s possible that Covid-19 vaccinations will become an annual event, just like the flu shot. Or it may be that the benefits of the vaccine last longer than a year. We have to wait to see how durable the protection from the vaccines is. To determine this, researchers are going to be tracking vaccinated people to look for “breakthrough cases” — those people who get sick with Covid-19 despite vaccination. That is a sign of weakening protection and will give researchers clues about how long the vaccine lasts. They will also be monitoring levels of antibodies and T cells in the blood of vaccinated people to determine whether and when a booster shot might be needed. It’s conceivable that people may need boosters every few months, once a year or only every few years. It’s just a matter of waiting for the data.
Gov. Ron DeSantis of Florida, a Republican, has already said he does not want “FEMA camps” in his state. “That’s not necessary in Florida,” he told reporters last week after the Biden administration released its plan to address the pandemic, including the FEMA sites. “All we need is more vaccine.”
The Trump administration largely preferred the states to manage efforts to combat the pandemic, leaving governors to acquire protective gear for health care workers and manage testing, contact tracing and other aspects of response. While it cut deals with pharmaceutical companies to expedite the development of vaccines and offered guidance on whom to prioritize in receiving shots, it largely left states to manage their supplies.
State governments have run into a number of snags in getting their vaccines into arms, including resistance among some health care and nursing home workers and others in prioritized groups to the vaccine, and struggles in medical centers to manage their supplies.
The Biden administration has set goals to get more Americans vaccinated quickly, but it is not clear that there will be enough supply should it succeed in speeding up the logistical system, particularly with many Americans now awaiting second shots.
The federal government had been reimbursing states — many of them struggling from large drops in tax revenue — for only 75 percent of their National Guard costs associated with coronavirus relief. The administration will increase that to 100 percent, including for support needed to distribute and administer vaccines, until the end of September.
Zolan Kanno-Youngs contributed reporting.