Joe Biden coronavirus team tempers vaccine expectations as governors start canceling appointments

President Biden’s blueprint for tackling COVID-19 signals a departure from President Trump’s vaccine-or-bust strategy, doubling down on masks, testing and other measures to stop the coronavirus while scrambling to get more shots into arms.

He might not have a choice.

Governors say they are running out of doses and have had to cancel vaccination appointments as efforts to expand eligibility result in a confusing patchwork of sign-ups and lotteries among older people.

Mr. Biden is banking on a boost in federal funding and guidance and on using the Defense Production Act to fill shortages. But with vaccine reserves already exhausted, ramping up the rollout could be difficult in the near term. The president’s team says it is on track to meet initial goals but is tempering expectations and warning of a tough road ahead.

“We said 100 million doses in the first in 100 days, and we’re going to stick to that plan. But I also want to be very cognizant of the fact that after 100 days, there’s still a lot of Americans who need vaccine,” Dr. Rochelle P. Walensky, the new director of the Centers for Disease Control and Prevention, told NBC’s “Today” show.

Dr. Walensky said the Biden administration is working with Army Gen. Gustave Perna, who is handling vaccine logistics, to locate the gaps. For instance, “do we need syringes or chemical products?” Dr. Walensky said.

Vaccines remain the focus of Mr. Biden’s plan, with calls for 100 vaccination centers under the Federal Emergency Management Agency and more direct communication between the federal government and states.

But the blueprint explicitly calls for “a comprehensive national public health effort to control the virus — even after the vaccination program ramps up.”

“We’re going to take steps necessary now to slow the spread of the disease as well,” Mr. Biden said.

It’s a break from the protocol of Mr. Trump, who tended to characterize the pandemic as a series of individual medical problems that could be solved with cures and vaccines developed at “warp speed,” while teasing mask-wearers and complaining that diagnostic efforts boosted case counts.

Mr. Trump said little about the worsening crisis in the waning days of his term as he fixated on blaming his Nov. 3 election loss on voter fraud.

“Trump put all his chips on vaccines to the extent which he paid attention to COVID, which varied,” said Arthur Caplan, director of the division of medical ethics at the New York University Grossman School of Medicine. “He was a guy who wanted a quick fix, a big win, rapid change.”

Mr. Biden, he said, is “putting more chips on more numbers.”

The new president signed a series of executive orders Thursday that set up a pandemic testing board, mandates masks on interstate travel, and ordered the Occupational Safety and Health Administration to release clearer guidance for businesses to prevent the spread of COVID-19.

He said he will appoint a COVID-19 coordinator for each state after the Trump administration left governors on their own to fight outbreaks, and will fully reimburse governors for use of the National Guard.

“Help is on the way,” Mr. Biden said in a White House ceremony during his first full day in office.

He said foreign travelers entering the country will have to quarantine upon arrival and test negative for infection from the virus. He also said he will give scientists a bigger platform.

The plan is “based on science, not politics. It’s based on truth, not denial,” said Mr. Biden, offering a thinly veiled dig at his predecessor.

Mr. Biden is recommitting the U.S. to international efforts after Mr. Trump moved to withdraw from the World Health Organization and refused to participate in an international vaccine initiative known as COVAX.

“The United States stands ready to work in partnership and solidarity to support the international COVID-19 response, mitigate its impact on the world, strengthen our institutions, advance epidemic preparedness for the future, and improve the health and well-being of all people throughout the world,” Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told the executive board.

At the White House, Dr. Fauci said the Biden team is on track to deliver on its vaccine schedule at home.

“I think starting now, you’re going to see it. The average of at least a million a day,” he told reporters.

Congressional Republicans said the Trump administration deserves credit for getting the nation to this point.

“By doing simple math, we are on track to deliver 100 million doses in 100 days, showing that President Biden’s plan is not a new plan at all and leans on the Trump administration’s success,” said House Minority Whip Steve Scalise, Louisiana Republican. “If President Biden wants to develop a new plan to administer 200 million vaccines in 100 days, congressional Republicans stand ready to work with President Biden to help further speed vaccine distribution.”

Michael Bars, who was a Trump White House communications aide, rejected Mr. Biden’s claim that the vaccine rollout was a “dismal failure” that put too much of the burden on states.

“Pfizer and Moderna have been contracted to provide Operation Warp Speed with 100 million doses of lifesaving vaccine each by the end of March, with 200 million doses each by the end of June. By the end of the term, the Trump administration exercised the Defense Production Act for each of the six vaccine candidates to help bring them to market faster than ever before, through comprehensive distribution plans coordinated with every U.S. state and territory to deliver coronavirus vaccines to high-risk groups of Americans, and eventually every American who needs one,” he said.

State leaders, meanwhile, say they are starting to get a handle on the process but will need more doses to meet increasing demand.

“If you’re able to get us more vaccine, which I’ve asked the federal government, we will be able to do even more than the 400,000 we did last week,” said Florida Gov. Ron DeSantis, a Republican.

Pennsylvania health officials said 12 million people visited a webpage showing a map of vaccine providers after it announced an expansion of eligibility to people 65 and older and those younger than 65 with certain medical conditions.

“It is clear that many Pennsylvanians are eager to get the COVID-19 vaccine. Unfortunately, we do not have enough vaccine for everyone who wants it right now, but we will have more in the future,” state Health Department spokesman Barry Ciccocioppo said. “We are asking Pennsylvanians to be patient. This is a global pandemic, and vaccine manufacturers are working to provide doses across the globe.”

One game-changer could be the approval of new vaccines.

Johnson & Johnson is expected to seek approval of its vaccine by the end of the month or early February. It requires one dose instead of two, so it could accelerate the rollout.

An AstraZeneca-Oxford University vaccine could be right behind them in seeking U.S. approval. That version requires two doses but is already in use in the United Kingdom and is relatively inexpensive.