There's A Vaccine Bottleneck. It's Hard To Say Why. : The NPR Politics Podcast President Biden has promised that 100 million doses of vaccines will be administered in his first 100 days — but some public health experts think the country can do much better.

Gang of Eight, Gang of Six, Grand Compromise... the storerooms of Congress are littered with tried-and-failed drafts of comprehensive immigration reform proposals from the past four presidents. Now, it is President Biden's turn to give it a go.

This episode: White House correspondent Tamara Keith, White House reporter Ayesha Rascoe, health reporter Selena Simmons-Duffin, and congressional correspondent Kelsey Snell.

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There's A Vaccine Bottleneck. It's Hard To Say Why.

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There's A Vaccine Bottleneck. It's Hard To Say Why.

There's A Vaccine Bottleneck. It's Hard To Say Why.

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TERI MILNES: Hi. This is Teri Milnes (ph) in Bellingham, Wash., and I'm a fully grown, capable, intelligent woman who just spent half the day making Bernie Sanders memes. This podcast was recorded at...

TAMARA KEITH, HOST:

1:11 p.m. on the 22 of January.

MILNES: Things may have changed by the time you hear it. Hopefully I'm not still making memes. OK, here's the show.

(SOUNDBITE OF THE BIGTOP ORCHESTRA'S "TEETER BOARD: FOLIES BERGERE (MARCH AND TWO-STEP)")

KEITH: Funny story - I was so busy looking at Bernie Sanders memes, I kind of forgot to say the time.

(LAUGHTER)

AYESHA RASCOE, BYLINE: They're really engrossing, you know?

KEITH: Yeah. Well, more on that to come later in the show. But hey there. It's the NPR POLITICS PODCAST. I'm Tamara Keith. I cover the White House.

RASCOE: I'm Ayesha Rascoe. I also cover the White House.

KEITH: And yesterday on the podcast, we talked about some of the steps that President Biden is taking to ramp up the federal response to the coronavirus pandemic. And today, we have a special guest with us to talk through where we are in the pandemic in more detail and also what the Biden administration is trying to do. Selena Simmons-Duffin is from NPR's health care team. Hello there.

SELENA SIMMONS-DUFFIN, BYLINE: Hi, Tam.

KEITH: So we have to start in a dark place, which is that there are now more than 400,000 deaths in the U.S. from the coronavirus. It is - I mean, these numbers are just stunning. And more Americans have died from it than died in World War II. And Joe Biden yesterday - President Biden said that we could hit 500,000 next month. But at the same time, I think there is a little bit of a silver lining - right? - that maybe we have finally maybe possibly reached the peak in the number of cases.

SIMMONS-DUFFIN: Yeah, it looks like cases are starting to slow. And that's a real relief to see that. It doesn't mean that deaths are going to start to slow quite yet because usually there's a delay. It takes a while for people who get infected to get sick enough to maybe even die. So it is likely that we're going to hit that 500,000 death mark. And it's something that I think we're all kind of bracing for. Half a million people in this country dead from this virus is a pretty astonishing thing.

RASCOE: And part of - you know, Dr. Fauci talked yesterday. He's now the chief medical adviser for President Biden. He talked about these mutations, these mutant strains of the virus. And he said that these variants are a reason to try to make sure you're getting people vaccinated and you're wearing masks because if you can - less spread of the virus means less mutants. Is that right?

SIMMONS-DUFFIN: It's right. I mean, these new variants that are showing up in different places are concerning. And scientists are still trying to learn exactly, you know, how much more transmissible they are and whether they are more deadly - you know, how effective these authorized vaccines are going to be against them. There's a lot of open questions, and, you know, doubling down on the things that we know work, like wearing masks or even doubling your mask if you're going to be somewhere, like, on a plane for a while, socially distancing, washing your hands, the tried and true - those are all things that people need to keep practicing.

And so there's this kind of dance that public health officials are doing to make sure that we do have some sense of hope. Vaccines are rolling out. And, you know, cases have - seemed to have gone over that - the peak of this really difficult winter surge. But we do need to keep going with all of these mitigation measures at the same time and not let down our guard, as much as we would really like to at this point, you know?

RASCOE: And we talked about masking and maybe possibly wearing double masks in certain situations. The Biden administration is really leaning in on the mask issue. Biden has said over and over again, this is not a political issue. This is a patriotic issue. And he did sign this week - one of the first things he did was to sign an order requiring masks on all federal grounds and in federal buildings. And he has been wearing a mask in the Oval Office when - you know, when he is being seen signing these things, which never happened under President Trump. So they're trying to push - well, you know, it remains to be seen how much people will pick up on that. We do have a poll that NPR did that found that, you know, there is really high support for wearing masks. But that still seems to be an issue out in public at times.

SIMMONS-DUFFIN: Yeah. And I think it's interesting that the national mask mandate, which was kind of floated as something that Biden might try to do, is not something that we've seen. Instead, it's this masks on federal property, masks in interstate travel. It's kind of a more cautious approach legally and also this real sense of encouragement. You know, instead of mandating, instead of punishing, instead of enforcing, you know, there's - you know, do it for your country. It's a patriotic thing. It's not political. I think that in the public health world, there's a lot of regret around the way that mask-wearing became politicized.

KEITH: I want to move on to vaccines. The Biden administration has promised 100 million shots in the first 100 days. That would be by the end of April. How many vaccine doses, approximately, have been administered so far? Is this, like, an impossible number? Or are they kind of underselling the goal?

SIMMONS-DUFFIN: Yeah, there certainly are people out there saying that this is a bit too modest of a goal. We're already in - the average in the last week was over 900,000 shots per day. So, you know, if we have a modest increase and are hitting a million shots a day, then that's great. But it's not maybe good enough, according to, you know, a lot of public health experts who say the aim should be for 2.5 million shots a day. So far - to answer where we are right now, so far, at last check, it was over 17 million doses that have been administered. A lot more than 17 million have been delivered. And that's kind of part of this confusion over exactly what the gap is between the doses that drug makers are putting out and getting out to different states and the number of people who are able to get access to those shots.

It's - there's something wrong. I'm not sure what it is. I haven't seen really super-compelling reporting that breaks down what that gap is or what it's about. I'm hoping that the Biden administration, with this promise to be more transparent and to put out more data about vaccination, will come in and hopefully shed some light into where the chokepoints are and, you know, how the various plans that they put out to improve vaccination are going to help because, certainly, there are problems with the rollout. And a lot of ideas in the national strategy document that they put out yesterday to speed those things up, but there's still - there remains a lot of finger-pointing over who's at fault for the sluggish rollout so far and exactly what is going to be the thing that kicks it into high gear.

RASCOE: I mean, we should say politically, right now, it looks as if that 100 million shot goal is achievable, and that is likely why the goal was set because you don't want to set a goal and - especially a big goal - as soon as you start office that you - that the administration then does not meet, right? That would be a very negative way to start out your administration.

KEITH: Biden was pretty defensive yesterday when a reporter asked him if his goal maybe wasn't ambitious enough, and he snapped back on that.

SIMMONS-DUFFIN: Yeah, he has defended it and said that it is bold and that it's achievable. But I think that Ayesha's right. I mean, a lot of people I've talked to who've been involved in vaccine campaigns in the past really emphasize that overpromising is not a good idea. There's this, like, delicate balance between wanting people to be excited about getting vaccinated, ready to go, not wanting the confusion and the wait to diminish people's eagerness to participate and get vaccinated when there is an opportunity for them.

And I think especially, you know, vaccination campaigns, this - walking that line of an ambitious, bold, achievable goal, something to push for and something that you might actually be able to hit, is tricky, certainly. There's, like - there's a lot of - it's not just about political messaging. It's also about, you know, the navigating that very complicated public health universe, people's expectations and their - the communication around it. It's all complicated and difficult to navigate.

KEITH: All right. Well, we are going to take a quick break. And, Selena, we are going to let you get back on with your work and maybe a weekend...

SIMMONS-DUFFIN: Yeah, woo-hoo (ph).

KEITH: ...If you're lucky (laughter). All right, and when we come back, we will talk about a hurdle that many presidents have tried and failed to clear - comprehensive immigration reform.

And we're back, and Kelsey Snell has joined us now. Hey, Kelsey.

KELSEY SNELL, BYLINE: Hi there.

KEITH: All right. So let us do a quick pop quiz. Some of this may predate your time on the Hill, but let's try anyway. First, there's the Gang of Six, specifically the 2018 one...

SNELL: Yes.

KEITH: ...And then the Gang of Eight from 2013, I think...

SNELL: That's right.

KEITH: ...And the so-called Grand Bargain from 2007.

SNELL: Tam, I think we've got a theme going.

(LAUGHTER)

RASCOE: Are these bad, like, Western movies? Or what's going on here?

(LAUGHTER)

SNELL: The Senate loves a gang. And in this case, they love a failed gang who are attempting to get comprehensive immigration reform (laughter).

KEITH: The gang who can't shoot straight. No, I mean, it's just, like, comprehensive immigration reform is something that has proven elusive, going back to President George W. Bush, who really wanted to get something done and couldn't get it done through Congress. And now we are how many presidents later, and, Ayesha, President Biden has a proposal of his own.

RASCOE: Yes. You know, he laid out this plan first day in office. It would provide a path to citizenship for an estimated 11 million undocumented immigrants living in the U.S. It would fast-track citizenship for the young DREAMer immigrants, those who are brought to the country by their parents, and some other - you know, some other people who are in the country illegally or people who are in the country, such as farm workers or people who did receive temporary protected status. That's people who fled wars. They would be able to get green cards immediately and could apply for citizenship after three years.

There is also - this plan would also call for aid to places like El Salvador, Guatemala, Honduras under this idea that if you help the countries themselves, then the people within the countries won't flee the countries looking for more opportunities or a better life. It would also - interestingly enough, it would replace the term alien in U.S. immigration laws and use non-citizen instead of alien.

SNELL: That's been kind of a sleeper major priority for Democrats. It's not something that they talk about a ton because they have a lot of bigger top-line issues that they're pushing for. But it's something that I've actually heard people talk about a lot - is that they feel like the federal government needs to change the language around immigration in order to change the policy approaches.

KEITH: So, Kelsey, why has it been so elusive?

SNELL: There are a lot of answers to that question, but the primary one is that immigration is tremendously complicated. It's tremendously regional, and it is tremendously personal for a lot of people. And it has been very, very, very difficult to get enough people on the same page on a sufficient number of policy ideas to move comprehensive immigration reform. And - you know, but that's kind of where it falls apart - right? - is, like, you - they want to be able to get enough people together on big-picture stuff. But they can't even really get enough people together on the small-bore things, in part because it's become a really, really big and weaponized political cudgel in campaigns, as we saw in particular with President Trump.

RASCOE: And part of the issue is always this idea of, what do you do with the people that are here and undocumented?

SNELL: Right.

RASCOE: Right? It seems like that is the key thing that people cannot seem to agree to because there's always this idea that if you provide a pathway to citizenship, then that is amnesty. And that's a bad word.

KEITH: And amnesty is another one of those words, I assume, that Democrats would like to banish from their vocabulary because it sounds really scary.

RASCOE: Yes.

KEITH: And it's a word that gets thrown around a lot as soon as you start talking about immigration.

SNELL: And when you start talking about particularly the pathway to citizenship for DREAMers, that is when things get so complicated that sometimes people just shut down entirely. You know, I mentioned that there are regional things about this as well. And that's when you start to talk about enforcement and the way the border is patrolled, the way that - you know, particularly the southern border - the way that airport enforcement happens. There are little bits and pieces of immigration reform that people may forget are, you know, part of a comprehensive package or are typically talked about in a comprehensive package but that can really set off fights that make it very difficult to overcome.

KEITH: Often we have had divided government, but right now, by the narrowest of narrow margins, there is not divided government. Democrats control the House and the Senate and the White House. Does that mean that this has any better chance of happening?

SNELL: In short, not really (laughter). I mean, that narrowest of narrow control in the Senate is part of the problem. Listeners are going to hear us talk about the filibuster a lot. They should prepare for that because the filibuster is at the core of whether or not pieces of the Biden agenda get through Congress. And as long as there is a 60-vote requirement to get through that first procedural vote on any piece of legislation, it will never really be a question of can Democrats pass this because it will always be, can Democrats get enough Republicans on board?

Now, beyond that, beneath the layer of that - so if they were to, you know, do away with the filibuster, as some progressives are pushing Democrats to do right now, that would actually require Democrats to confront some of the disagreement within their own party about some of the finer points of immigration. So while you may have a lot of agreement on the treatment of DREAMers, there are still differences, and they're differences that have never really had to be addressed because comprehensive immigration reform has never gotten particularly close to being voted on.

RASCOE: It's almost like when Republicans controlled the House, the Senate and the presidency and then had to try to figure out how to do away with Obamacare. And they (laughter) realized...

SNELL: They agreed on getting rid of it, not so much on the replacing it part.

RASCOE: Well, you're right. They agreed on getting rid of it, but they couldn't agree. They had to deal with their disagreements on how to replace it, right? You know, they kind of caught that car that they had been chasing.

You know, and - but the Democrats also have to deal with, you know, all these different time priorities. They are dealing with a lot right now. There's a pandemic. There's an economic crisis. You know, Biden just has to get his cabinet, you know, confirmed. And then you also have impeachment, right? There's that, that people may have forgotten about. There's still an impeachment of former President Trump that has to happen. And House Speaker Nancy Pelosi is sending over the article of impeachment to the Senate on Monday.

SNELL: Yeah, there's only so much oxygen in Washington. And this is - any one of these things could absorb it all on their own. And so the idea that they're going to be able to kind of accomplish every single thing on Biden's wish list in a short period of time - I have never seen that be possible. I could be surprised, but I don't see how it's possible.

KEITH: All right. Well, we are going to leave that there for now. It's time for a quick break. And when we come back, Can't Let It Go.

And we're back. And it is time for Can't Let It Go, the part of the show where we talk about the things from the week that we just can't stop thinking about, politics or otherwise. And I have to say that I've been really sad that we couldn't do Can't Let It Go for the two - first two Fridays of this year because everything was terrible. And I am so glad that we are doing it today. Kelsey, why don't you kick us off?

SNELL: Well, mine is a little bit of politics, a little bit otherwise. And it is the fashion at the inauguration. I have missed this. I have missed red carpets. I have missed fashion shows. And there was mask fashion. There were jackets. There was the giant bird on Lady Gaga.

RASCOE: A giant bird, yes.

SNELL: The giant bird...

RASCOE: (Laughter).

KEITH: Put a bird on it.

SNELL: You know, here we are on Friday, and I'm still over here scrolling through pictures being, like, oh, I didn't even notice that dress. And, like, I could have had the world's longest conversation about the tones, the jewel tones that were on display. I'm just here for talking about some dresses.

RASCOE: It was - and, you know, and Jennifer Lopez was in all white. She wasn't in a dress. She had that white...

SNELL: Suffragette white.

RASCOE: ...Pantsuit. Yeah.

SNELL: (Laughter).

RASCOE: She was in the white. And she took some pictures, her and - what's her fiance name?

SNELL: A-Rod.

RASCOE: A-Rod, A-Rod.

KEITH: (Laughter).

RASCOE: Alex Rodriguez.

KEITH: He - you know, he played, like, a little - like, a sport of some kind, a sport ball.

RASCOE: He played something. He played, like, baseball or something.

KEITH: (Laughter).

RASCOE: He did something like that. But, you know, J-Lo - I know her.

(LAUGHTER)

RASCOE: And they took those pictures in front of the Capitol. Like, it was...

SNELL: They were having a moment on the Capitol.

RASCOE: It was some glam.

SNELL: So I was this morning reading all about the - you know, the monochromatic colors that were on display there. I mean, there was purple and teal and Michelle Obama's incredible - like, what would we call that? Like, it was, like, a Merlot color.

RASCOE: It was plum.

SNELL: It was beautiful.

RASCOE: It was, like, a plum kind of. Yeah.

SNELL: I mean, I was just glad that I could have a moment in my week where all I did was talk about dresses...

(LAUGHTER)

SNELL: ...And jackets.

RASCOE: Well, along the lines, Kelsey...

SNELL: Yeah.

RASCOE: ...Of exactly what you're talking about, I cannot let go of, at inauguration, not only the clothing, but there were some hairstyle statements.

SNELL: Oh, yes.

RASCOE: And there was a particular hairstyle statement with the former first lady, Michelle Obama. Her hair was laid. It was...

SNELL: It was incredible.

RASCOE: It was a - she looked like the - you know, the "Charlie's Angels."

SNELL: (Laughter).

RASCOE: It was - it had that...

SNELL: Yeah, it did.

RASCOE: ...Farrah Fawcett, and she had the plum jumpsuit. And so apparently - I did not realize this before then. I am late, clearly. But...

SNELL: (Laughter).

RASCOE: She gets her hair done at a local hair salon in Arlington, Va.

KELSEY SNELL AND TAMARA KEITH: Oh.

RASCOE: And people were online saying, yes, Michelle's hair looked like it was, you know, laid. It was touched, you know, by someone whose hands were fortified by God.

KEITH: (Laughter).

RASCOE: They were saying - they were just going - you know, everybody was going on and on. And so I started following this woman on Instagram because I'm, like, OK.

SNELL: I'd imagine it might be a little tough to get one of those appointments.

(LAUGHTER)

RASCOE: You're not getting in that seat. You are not getting in that seat.

SNELL: You might.

RASCOE: (Laughter) I mean...

SNELL: You are the - I mean, I feel like you are a superstar. I would imagine that they would...

RASCOE: Oh, wow.

SNELL: ...Make the time for you.

RASCOE: Oh, my goodness.

SNELL: Right?

RASCOE: I don't know.

SNELL: You got to drop in and be like, do you not know who I am (laughter)?

KEITH: Tell her that you're really big on a podcast.

RASCOE: (Laughter).

KEITH: See if you can get her to do your hair.

SNELL: We'll see her work.

RASCOE: Yeah, where people don't actually see me. But she does - but she has a signature bouncy curl.

SNELL: Oh.

RASCOE: So that's what she's known for - a signature bouncy curl. And so that is part of - yes.

SNELL: It's pretty incredible.

RASCOE: It's really nice. It's really nice.

KEITH: (Laughter) Speaking of signature bouncy curls, none other than style influencer Vermont Senator Bernie Sanders, who has launched, like, a million memes - Bernie Sanders, the man of a million memes.

RASCOE: Yes.

SNELL: Can't escape it.

KEITH: He showed up at the inauguration looking like he was...

RASCOE: (Laughter).

KEITH: ...You know, going to mail an envelope in.

RASCOE: (Laughter).

KEITH: He's going to go to the post office in a snowstorm or something (laughter).

RASCOE: Yes. He...

KEITH: And...

RASCOE: Everyone said - they kept saying he looked like he was stopping by Joe's thing. Then he was going to go to do something else after, like go to the post office afterwards.

KEITH: Yeah because you've got to have the right number of stamps.

RASCOE: (Laughter).

SNELL: I mean, that envelope did not have stamps on it yet.

KEITH: Right.

SNELL: So he still had steps to go.

KEITH: You've got to go to the - so - but it was - there's just this picture of Bernie Sanders sort of sitting cross-armed, cross-legged with these - with a mask that's a little disheveled and these, like, gigantic mittens. And it turns out that these mittens were made by a second-grade teacher in Vermont. She was making mittens for her daughter's preschool teachers. And Bernie's, like, daughter-in-law or something owns the preschool. And she made these mittens back in 2016. She was a little sad that he had lost in the primary and made him mittens, and he's been wearing them ever since.

RASCOE: (Laughter).

SNELL: I will say that a yarn brand has posted on Instagram their own version of the meme, so that's where we're at in the cycle of this meme.

KEITH: It has taken over my chat group with all the neighbors that we started at the beginning of the pandemic. And it's just, like, Bernie Sanders doing MMA, Bernie Sanders...

RASCOE: (Laughter).

KEITH: ...On the deck of the "Star Trek" Enterprise. Like...

RASCOE: Yes. Yeah, that's one of my favorites. It was him and, like, the Muppets, the balcony where the two old guys sit in the balcony with "The Muppet Show." Like, I mean, that was my other one of my favorites. But he's just everywhere. It's his every - and then they've incorporated him into other memes that everyone knows about. It's crazy. But I - it cracks me up every time.

KEITH: All right. That is a wrap for today. If you all have not seen the Bernie Sanders memes, get out from that rock.

RASCOE: You live under a rock.

SNELL: I was, like...

RASCOE: Yes.

SNELL: Come out from under your rock.

RASCOE: (Laughter).

KEITH: Hit up the Googles.

(LAUGHTER)

KEITH: Our executive producer is Shirley Henry. Our editors are Muthoni Muturi and Eric McDaniel. Our producers are Barton Girdwood and Chloee Weiner. Thanks to Lexie Schapitl, Dana Farrington and Brandon Carter. Our intern is Claire Obi (ph). I'm Tamara Keith. I cover the White House.

RASCOE: I'm Ayesha Rascoe. I also cover the White House.

SNELL: And I'm Kelsey Snell. I cover Congress.

KEITH: And thank you for listening to the NPR POLITICS PODCAST.

(SOUNDBITE OF THE BIGTOP ORCHESTRA'S "TEETER BOARD: FOLIES BERGERE (MARCH AND TWO-STEP)")

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