The United States remains still millions of shots away from meeting President Biden's original goal of 70% of American adults receiving at least one dose ofvaccine by July 4, a milestone that White House officials conceded that they were likely to miss by at least a few weeks.
Now as some of the White House's most widely-cited incentives for vaccinations are set to lapse, from discounted Uber rides to free child care, the Biden administration faces an uphill battle to boost vaccination rates that have slowed to a pace not seen since late last year.
The Centers for Disease Control said Friday that over 172 million Americans, or about 67% of the adult population, have received at least one dose of the COVID-19 vaccine. About 156 million have received both doses, or about 47%.
"I've run several major crises now. And you set these goals because they force you and everybody to get very, very focused on what is the most important thing," says Andy Slavitt, once a key adviser to the White House's COVID-19 team who has now published a new book "Preventable" on the country's pandemic response.
Slavitt credited Mr. Biden's public goals and an accompanying deluge of initiatives in helping raise awareness around the shots, even if the president missed his Independence Day goal.
"In a kind of crisis response, you have a very limited ability to test without wasting valuable time. So the playbook in a crisis is actually to try everything, even if you can't necessarily attribute actions, then do the best you can to pick things apart," said Slavitt.
The U.S. is currently averaging less than 300,000 first doses daily, according to figures published by the CDC. When Mr. Biden announced his goal on May 4, the country was averaging more than 820,000 first doses a day — close to what it would have needed then to reach 70%.
Following the president's announcement in May, the Biden administration rolled out an array of new efforts to expand access to the once-scarce shots. A growing share of the nation's vaccine supply was redirected from mass vaccination sites to smaller-scale clinics and roaming teams of vaccinators. Stores in the federal retail pharmacy program ramped up shots in communities hard-hit by COVID-19 deaths, and now make up around a third of vaccines delivered to many states.
Soon, White House officials were also aggressively promoting a website, hotline and text message service to help Americans easily locate available shots near them. That tool has been used over 25 million times, one of the top developers of the Vaccine Finder site said recently.
Expanding access to the shots coincided with a flood of new incentives touted by federal health officials for Americans to get a shot of COVID-19 vaccine, following polls suggesting many unvaccinated Americans were too busy to get the shots or felt they did not need them.
Some came in the form of eye-popping lotteries and giveaways by states, which the Biden administration said they would allow governors to use federal COVID-19 relief dollars to pay for. Another incentive came with the broad lifting of mask requirements for fully vaccinated Americans in most settings and expanded authorization of Pfizer's vaccine in adolescents.
But while the pace of first doses surged in the days that followed those announcements, by June — as the Biden administration was kicking off its "month of action" to deploy door-to-door canvassing and other campaign-style tactics to promote vaccinations — the nationwide moving average was once again in freefall.
Efforts to shore up confidence in the vaccines, like the "COVID-19 Community Corps" that sought to recruit local leaders and health providers to field concerns about the shots authorized by the Food and Drug Administration for emergency use, ran up against what one top federal health official described as a "dedicated opposition."
A large share of those on the fence over vaccinations told pollsters they would be more likely to get the shots if they were required to return to their normal lives, like to fly on an airplane or attend large gatherings. But few businesses are able to levy more than cursory checks to verify if customers are fully vaccinated, foiled by a patchwork system of immunization records so-called "vaccine passports" for reopening in many states.
Now, the largest gap in vaccinations remains among younger Americans: less than half of those between 18 and 24 years old have gotten at least one dose of the vaccine, according to the CDC's tally.
Though faster-spreading mutant variants of SARS-CoV-2, the virus that causes COVID-19, have sparked stern warnings from health officials in recent months, only around 26% of adults under 40 surveyed by the CDC who did not plan to get vaccinated said they were concerned about catching COVID-19.
"If you were in that category of younger people or on the fence, if you weren't feeling urgency before, you're feeling even less urgency now," said Slavitt, remarking that the administration had "become, to some extent, a victim of our own success."
Meanwhile, one large opportunity to assuage a common concern among the unvaccinated — and pave the way for many employers and schools looking to require the shots — could come within the next month: full approval from the FDA for a COVID-19 vaccine.
Though the process for full approval typically takes around 8 months to be completed, top FDA vaccine officials have said that the regulator had processed these kinds of applications amid prior outbreaks in only a few months and hoped to "try to do as good or better here."
"In this case, since they're already under emergency use authorization and the large bulk of additional information coming in will be safety data and information on manufacturing, we're intending to speed that review," the FDA's Dr. Peter Marks told Endpoints News in April.
"In previous public health emergencies, for instance, with the meningococcal B outbreak in 2014, we were able to get through those BLAs in roughly 3-4 months," added Marks.