World that fear by anti ballast. This is democracy now democracy now dot org the quarantine report. I'm amy goodman with nursing shea. More than eight thousand. Americans have died from cove in one thousand nine hundred in the last two days alone. Experts believe the outbreak will get even worse before the effects of vaccines are felt the centers for disease control and prevention warns. another ninety. Two thousand people could die in the next. Three weeks is complaints grow over the slow distribution of vaccines and effort to speed up the vaccine. Roll out the cdc's expanded its guidelines to include eligibility for anyone sixty five or older as well as those with some underlying health conditions for more we go to omaha nebraska on the rollout around the world and in the us. We're joined by. Dr ali khan epidemiologist and dean of the college of public health at the university of nebraska medical center where he joins us now. He's the former director of the cdc's office of public health preparedness and response where he the strategic national stockpile. Dr khan welcome back to democracy now so you have these new. Cdc guidelines anyone sixty five or older can get this vaccine or people with co morbidity with underlying problems below that As well as of course teachers and healthcare professionals and the biden decision as well as the trump administration decision now to just release everything not to save half for people to go back and get their second dose for the moderna and the pfizer vaccines which requires two doses for the full protection. What are your thoughts about this. Thank you so. This really helps to balance the supply demand. Mismatch were seeing across america. So they've been approximately thirty million doses distributed but only about ten million doses actually administered. So i think the overall national numbers thirty percent of doses that have been distributed have been administered. We're seeing again. Great variability across states actually a fourfold ability in their ability to get this vaccine out by releasing all the vaccine you take care of addressing issues where sites have more people than vaccine and by increasing the number of people who are eligible. You'd take care of sites that are throwing away vaccine because they can't give it to anybody so it addresses some of the mismatch. But there's a real concern here so the first concern. Is this a no way addresses. The continued operational insufficiency We are seeing at local and state level. Do they have the processes and procedures in place to enroll these people vaccinate them and track them. I also have slight concern about trust so by increasing the people who are eligible. That's approximately one hundred and fifty million people who have just now been made eligible. What's not going to happen is there isn't going to be three hundred million doses of vaccine that are about to be released tomorrow so these individuals still going to get vaccinated over the next couple of months And so we need to remind people that this doesn't mean you can get vaccinated tomorrow. The other concern is from the manufacturing standpoint. So we've had a mismatch between distribution and administration but there's also the concern of a mismatch between matinee between manufacturing and administration because we know one vaccine is not sufficient you need to get to vaccines and so manufacturing be able to keep up with all of this increased demand for vaccine so it's not a panacea. It's not a solution. It'll help some of the problem. But the fundamental issues around improving operations remain untouched. Upon could you comment also on the reports that some health workers who were of course the first among those to be offered the vaccine that some health workers have been refusing the vaccine. That's one point. And then the second issue is what we know about those who received both doses of either vaccine the likelihood of them still being able to spread the virus if they become infected a so. Those are excellent questions. We should not be surprised that there's vaccine hesitancy in the united states including amongst healthcare workers as we heard from your last guest has been a significant polarization in politicization of this response. And often that hasn't been see sorta cleaves along ideological lines In our facilities here in nebraska. We've almost had over ninety five percent compliance so people are lining up to get back. Sonate it so. We need to be careful about anecdotes about who does not wanna get vaccinated. The good news is that for people who are getting two doses of vaccine. Recent report suggests that the likely protected for a year which is excellent news about the vaccine. We do not yet have the data if getting vaccinated present prevents disease transmission. So you could get back. Aided you may have mile day symptomatic disease but you still could be infecting other people We just didn't have enough time to collect that data and often that data is collected after the fact is back. Scene is administered within the community. So your question is a great reminder that even would vaccination. We still need to make sure that people are wearing masks that their social distancing that they're washing hands and a great reminder that there's one point seven billion people right now who wake up with near zero cases and zero beds they go to live sporting events. Their economies are growing. And we can do that. Same thing here in the united states we use good science if we're data driven and we won't need a whole lot of vaccine to drop this tragic number of cases we continue to see in the us. And i believe for the fourth time third time in a row. We've had over four thousand debts in a single day from completely preventable disease. Terrible fear that now flattening the curve means going straight up. What about dr kahn. If you're getting to vaccines. Johnson and johnson apparently now has a one shot vaccine and they are just about to make an announcement about that. But if you get the pfizer for example what if you go back and they only have the moderna. Are the studies done that. Show that this is okay to mix and match. No there are actually. No studies are available. That suggest it's okay to mix and match and this is a lot of effort at the local health departments to make sure you go back and get the exact same vaccine Good point also by johnson and johnson. That vaccine would be a game changer. If the phase three studies suggest that it's efficacious and safe to give to americans. It's a single dose. There's not these issues about refrigeration freezing maintaining these vaccines under frozen conditions and it does allow the more typical mindset of mass vaccination campaign. Because you don't need to have a relationship with the people who you vaccinate and you don't need to follow up with. You just need to give them that one dose. So hopefully we'll hear good news. In the next couple of weeks on the johnson and johnson vaccine and their commitment to supply approximately twelve million doses by the end of february. And let's not forget is the world. Health organization has pointed out of the forty-six six countries. That started vaccinating. The population's only one is low income. A future discussion tomorrow. We'll be joined by dr peter. Salt the son of jonas salk inventor of the polio vaccine. Dr ali khan thanks so much for being with us from omaha epidemiology epidemiologist and dean of the college of public health at the university nebraska medical center former director at cdc.