Congress members, health officials and organizations want to send Arizona’s expiring Johnson & Johnson Janssen vaccines to struggling Sonora, Mexico, but they are running into bureaucratic and legal roadblocks.
After the Johnson & Johnson Janssen vaccine was halted temporarily because of potentially causing severe blood clots in 15 patients — all women, three of whom died — trust in the COVID-19 vaccine nationwide plunged, said Will Humble, executive director of the Arizona Public Health Association.
“There are still people that like the J and J vaccine, but the demand for it really dropped,” Humble said. “And you can’t send it back to the testing center; once you have it, you have it.”
The Johnson & Johnson Janssen vaccines are set to expire six weeks from June 23, their original expiration date, according to the Food and Drug Administration.
Though Humble and others, including Sen. Kyrsten Sinema, D-Ariz., and Rep. Raúl Grijalva, D-Ariz., want to use the excess supply to help Sonora, the Mexican state south of Arizona, the state can’t do it. The federal government controls the supply.
The Public Readiness and Emergency Preparedness, or PREP, Act is preventing Arizona from shipping the vaccines across international borders. According to the U.S. Department of Health and Human Services, under the PREP Act, “vaccine contracts with manufacturers prohibit the use, or authorization of use, of vaccines outside the U.S. and its territories. Sharing of vaccine internationally would violate these contracts.”
Sonora is working to contain COVID-19, the disease caused by the new coronavirus. Only 17% of Sonora’s population of 385,000 people have been vaccinated so far, Gianco Urias, Sonora’s Ministry of Health, told The Arizona Republic in a phone interview.
Sonora is in the third phase of the national vaccination plan, which means only Sonoran residents 40 and above are eligible.
In contrast, about 49% of Arizona’s population and 50% of the U.S. population had received at least one dose as of Friday, according to ADHS and Centers for Disease Control and Prevention data.
Unlike Sonora, every person, regardless of demographic, is eligible for the COVID-19 vaccine in Arizona.
Grijalva, who represents a border congressional district, said there are three reasons the United States should send the expiring Johnson & Johnson Janssen vaccines to Sonora.
The main reason, Grijalva told The Republic is the “public health of Arizona residents.” The secondary reason is the public health of Sonoran residents.
“We’re not talking about robbing Peter to pay Paul here,” Grijalva said in a phone interview. “Arizona residents are not going to be denied access nor limited.”
“If COVID-19 continues to circulate and connect, with our international border, then the risk of transmission on this side of the border is going to persist,” Grijalva said.
As a sort of “corollary benefit,” as Grijalva put it, more vaccinated Sonoran residents means it is more likely the border will reopen. Land ports of entry have been closed to all but “essential” travel since March 21, 2020.
The border shutdown has disproportionately affected Mexican citizens. While U.S. citizens and legal permanent residents have been able to cross the border, as usual, Mexican nationals with tourist visas are not allowed to cross into the United States at land ports of entry, though they are still allowed to take flights from Mexico into the United States.
As a result of the restrictions, border businesses have experienced a drop in profits and, in some cases, have closed.
“Cross border travel is needed for the economy, but cross border travel is difficult when we don’t get a handle on the vaccination rate in Sonora and create a better environment for that commerce to occur,” Grijalva said.
‘It’s just a shame to waste it’: Some of Arizona’s COVID-19 vaccine supply expired in June
How the idea gained momentum
Six weeks ago, Humble was notified by the county health director of the extra Johnson & Johnson Janssen vaccines. His first thought was to send them to Sonora.
“I thought of Sonora right away because they’re our partners,” said Humble, a former state health director.
Humble said it would be “super bad optics” for the HHS to deny waiving the PREP Act.
“After they (waive the PREP Act), the logistics would be pretty simple: All you need to do is get the vaccine, maintain the cold chain, get it to the consulate, or a single consulate in Arizona, who could then take custody of it, and move it across the border and get it to the Sonoran health department or the hospitals or however they’re gonna use it down in Mexico. So the barriers aren’t logistics at all; the barriers are administrative.”
Humble reached out to Sinema, who then sent a letter to HHS in late May. The movement has since gained traction. On May 28, the Arizona Border Counties Coalition sent a letter to the HHS, signed by multiple health officials, including Humble, and congressmen. And, on June 11, Grijalva sent a letter to HHS.
“We’re just trying to emphasize to the secretary that there is some urgency,” Grijalva said.
Health and Human Services has not responded to the letter and did not immediately respond to The Republic’s interview requests.
What the Biden administration is doing
While the Biden administration is mainly focusing on sending the vaccines to other states in need, it is also shipping vaccines across the border, assistant White House press secretary Kevin Munoz told Tucson television station KOLD.
“We wanted to make sure there were plenty of vaccines in the United States, and there are already enough, so now we are focusing on sending many of these doses to our neighbors,” Munoz told KOLD.
On June 3, the Biden Administration announced an allocation plan to share the first 25 million doses globally. Vice President Kamala Harris and Mexican President Andrés Manuel López Obrador met June 8.
This meeting led to the creation of a binational working group, which, according to their website, is “meant to study the conditions necessary to reopen the United States-Mexico border to everyday trade and travel.”
On June 15, the Biden administration sent approximately 1.35 million Johnson & Johnson Janssen vaccines to Mexico, the second-largest donation since March 2021, when it sent 2.5 million doses.
According to Mexican officials, those vaccines will be distributed among the 39 border communities, with a particular focus on 18 to 40-year-olds in its northern border cities, but will only cover about one-third of that particular demographic.
President Andrés Manuel López Obrador said on June 17 that the vaccinations are starting in Baja, California, then will be distributed eastward along the border to 10 cities in Sonora over the following 10 days.
“We need to end the pandemic everywhere,” Munoz told KOLD. “And more importantly, the virus doesn’t know any borders.”
When asked by The Republic whether Sonora will be a focal point moving forward, however, the White House did not make Munoz available for an interview.
Here is what’s happening in Sonora
When asked whether the United States plans on sending the soon to be expiring Johnson & Johnson Janssen vaccines to Sonora, Gianco Urias, Sonora’s Ministry of Health, declined to comment, citing the sensitive nature of the information.
“I don’t have a lot of information about any donation that could happen,” Urias said. “However, I think that any vaccine, as long as it meets all standards of quality and that it doesn’t put society at risk, would be welcome in Mexico and in Sonora. I know there are agreements being worked out now, but I don’t know what the status of those talks are. But if it’s a vaccine that is safe and meets all health standards. … I think it would be great for our state.”
Urias said that Sonora has received 980,000 vaccines so far, including Pfizer, AstraZeneca, SinoVac, and CanSino, the latter of which are Chinese-manufactured vaccines.
While Sonora is receiving more doses from around the world each week, Urias said, the number depends entirely on the allotment provided by the federal government in Mexico.
The vaccines Sonora’s health department does receive are concentrated in its large cities, Urias said. Sonora’s health department has worked in conjunction with the Arizona-Mexico Commission to roll out their vaccines.
While some Sonoran residents are wary of the COVID-19 vaccine, the heat is the main issue when it comes to getting vaccinated, Urias said, along with “a lack of space.”
“With the temperatures right now in Sonora, sometimes up to 47 or 48 degrees centigrade (116-118 degrees Fahrenheit), we find ourselves fighting against the weather,” Urias said.
Another issue is vaccine hesitancy, Urias said.
“I think we need to work very closely with all media to create more awareness among our residents and convince people to get vaccinated and get their loved ones vaccinated,” Urias said. “I think the worst thing we can do is get confident and lower our guard, thinking that nothing will happen.”
In the coming weeks, Urias said, the Sonoran Health Department and the Arizona-Mexico Commission will begin “vaccinating about 95,000 that work at maquilas through a pilot program, mainly in Sonora’s border cities.”
Whether those vaccines are coming from the United States or Mexico’s federal government is unclear, Urias said.
“It’s information that the industry is managing,” Urias said.
One of Sonora’s upcoming vaccination programs consists of the rollout of a pilot program to vaccinate workers at manufacturing plants along the Arizona border. This program, Urias said, could start as soon as late July, and would involve workers at 150 manufacturing plants in San Luis Rio Colorado, Nogales, and Agua Prieta.
The outcome of the state’s vaccination council decision next Thursday will determine how many COVID-19 vaccines Sonora will receive for their border cities, including Sonora.
With a majority of the businesses closed in Sonora since March 2020, Urias described the prospect of the potential vaccines coming in, and, in turn, the border reopening, as “very motivating.”
“I think there’s a lot of hope, I think that it’s very important for Mexico, and especially for Sonora, to have its door to its neighboring country open,” Urias said.