Behind-The-Scenes Of PM Modi's Call With Joe Biden

The U.S. announced Monday it would share its entire supply of AstraZeneca Plc's Covid-19 vaccine with other countries and readied an aid package for India, as President Joe Biden pivots to ramp up U.S. pandemic assistance to the rest of the world.

The decision would make as many as 60 million vaccine doses available for export in coming months, if they clear a federal safety review. The plan represents a shift for Biden, who has hesitated to give vaccine doses and materials to other countries while focusing on ensuring Americans are vaccinated first.

"Given the strong portfolio of vaccines that the United States has already authorized and that is available in large quantities -- including two two-dose vaccines and one one-dose vaccine -- and given AstraZeneca is not authorized for use in the United States, we do not need to use AstraZeneca in our fight against Covid over the next few months," White House Press Secretary Jen Psaki told reporters on Monday.

The announcement reflects growing pressure the U.S. has faced to share its vaccine supply with other countries, such as India, that have seen surges of Covid-19 infections or struggled to jump-start their vaccination drives. It also shows that the Biden administration is confident in its vaccine stockpile, especially after sites over the weekend were cleared to resume administering the Johnson & Johnson one-dose shot.

Biden in a phone call Monday pledged his full support to Prime Minister Narendra Modi, who is combating the world's largest surge of infections. The assistance package offered to India, which includes raw materials for vaccines and therapeutics, reflects Biden's belief that the pandemic won't end unless the U.S. offers assistance to other countries, according to a senior administration official.

Sharing Doses

No final decisions have been made on which countries will receive the AstraZeneca doses, a senior administration official said. The U.S. previously loaned 4.2 million AstraZeneca shots to Mexico and Canada, the only Covid-19 vaccine doses it has shared so far. AstraZeneca has not sought Food and Drug Administration authorization for its vaccine, but has already manufactured millions of doses in the U.S. under a federal contract.

About 10 million AstraZeneca doses that have already been produced could become available for export in the next several weeks if they pass FDA checks for product quality, a senior administration official said. Another 50 million doses are still in production and could be ready to ship by May or June if they pass the inspections, according to the official.

Any decision to send doses to India could increase pressure from other countries that have been trying to get the U.S. to share shots but so far have been rebuffed. Mexico and Canada have asked for a larger allotment of AstraZeneca vaccines.

"We're in the planning process at this point," Psaki said.

More than 1.02 billion vaccine doses have been administered worldwide as of Monday, enough to fully vaccinate 6.7% of the global population, according to Bloomberg's Vaccine Tracker.

Still, the vaccination campaign has been uneven, with wealthier countries generally ahead of less wealthy ones in giving shots. Just 5.3% of India's population has been fully vaccinated as of Monday compared with 36% in the U.S.

The need for vaccines in India has become even more acute as it has become the global epicenter of the pandemic. The country recorded 352,991 new virus cases on Sunday, the fifth consecutive day it set a world record for a single-day increase in Covid-19 infections.

The spike brought the total number of cases in India to 17.3 million, second in the world only to the U.S. More than 195,000 people have died there as of Sunday, though public-health experts believe the death count is likely higher.

The U.S. announced Sunday it would send raw materials for vaccines to India and step up funding for the country to manufacture more doses. Ventilators, therapeutics, rapid testing kits and personal protective equipment will be sent as well, the White House said. While vaccine doses were not included, the U.S. is sending a supply of remdesivir, an anti-viral drug used to treat hospitalized Covid-19 patients, a senior administration official said.

India's Surge

In their Monday phone call, according to senior administration officials, Biden and PM Modi pledged to work closely together to combat the virus and Biden promised steadfast support for the people of India amid the surge in Covid cases.

The aid package includes oxygen and related supplies, with the U.S. looking at sending oxygen generation systems. A team of experts from the Centers for Disease Control and Prevention is being sent to India to assist public-health officials there as well, the White House said.

Anthony Fauci, Biden's chief medical adviser, said Monday that "everything is on the table right now for discussion" when he was asked why the U.S. had not given away doses of the AstraZeneca vaccine, including to India.

"I think we can safely say that the issue of doses of vaccine, particularly the AZ vaccine, are certainly under active discussion. And I would say, safely, that everything is on the table right now for discussion," Fauci said at an event hosted by the Harvard School of Public Health.

The U.S. has used wartime powers and contractual clauses to give its orders priority -- meaning that there are, as of now, no known U.S.-made doses that have gone to any buyer other than the U.S. government.

A spokesman for AstraZeneca said the company can't comment on specifics but said the doses were part of AstraZeneca's supply commitments to the U.S. government, and decisions to send supply to other countries would be made by U.S. officials.

Earlier this month, Bloomberg reported that the U.S. stockpile of the AstraZeneca vaccine had grown to more than 20 million doses, part of a total of between 80 million and 90 million doses in some stage of production for the U.S. order.

Biden signaled last week that the U.S. was considering loaning more, but said that won't happen until there is enough supply.

"We don't have enough to be confident to give it -- send it abroad now," he said. "But I expect we're going to be able to do that."

--With assistance from Jennifer Jacobs, Jeannie Baumann, Riley Griffin and Suzi Ring.