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story.lead_photo.caption Health and Human Services Secretary Alex Azar speaks during a news conference on Operation Warp Speed and COVID-19 vaccine distribution, Tuesday, Jan. 12, 2021, in Washington. (AP Photo/Patrick Semansky, Pool)

WASHINGTON (AP) — Facing a slower-than-hoped coronavirus vaccine rollout, the Trump administration shifted gears Tuesday to speed the delivery of shots to more people. The move came as cases and deaths surged to alarming new highs.

Health and Human Services Secretary Alex Azar announced a series of major changes to increase supply of vaccines, extend eligibility to more seniors and provide more locations for people to get shots. Administration officials describing the new policies conveyed a notable sense of urgency.

One change will have some teeth to it. Azar said, going forward, the federal government will base each state's allocation of vaccines partly on how successful states have been in administering those already provided.

"If you are not using vaccines that you have the right to, then we should be rebalancing to states that are using that vaccine," Azar said at news conference.

That won't happen overnight, not until officials try to sort out whether lags in reporting could be the reason for what appears to be subpar performance. Currently, the government allocates vaccines based on state population.

Azar also said the government will stop holding back the required second doses of the Pfizer-BioNTech and Moderna vaccines, practically doubling supply. Both those shots require two doses to achieve optimum protection.

Additionally, Washington is urging states to immediately start vaccinating other groups lower down the priority scale, including people age 65 and older and younger people with certain health problems.

The move to increase the supply of vaccines better aligns the outgoing administration with the new Biden-Harris team. On Friday, President- elect Joe Biden said he will rapidly release most available vaccine doses to protect more people. He said he supported immediately releasing vaccines that health authorities were holding back out of caution, to guarantee they would be available for people needing their second dose.

"This next phase reflects the urgency of the situation," Azar said. "Every vaccine dose sitting in a warehouse rather than going into an arm could mean one more death that could have been avoided."

Initially the government had been holding back second doses as a safety precaution against potential shortfalls in production. Now, officials said they are confident the needed supply will be there. And people needing a second dose will have priority.

"This is not a supply issue at this moment in time," Vice President Mike Pence told governors on a White House call. A recording was provided to the Associated Press.

Azar also gave states the green light to designate more places where people can get shots. Those locations can include tens of thousands of pharmacies, federally supported community health centers that serve low-income communities, and mass vaccination sites already being set up in some states.

The flurry of changes raised questions for some local officials, still trying to get vaccination campaigns into full swing.

As of Monday morning, the government had distributed about 27.7 million doses to states, U.S. territories and major cities. However, only about 9.3 million people had received their first shot, according to the Centers for Disease Control and Prevention's online tracker. That means only about 34 percent of the available vaccines had been administered.

Initially, the shots were going to health care workers and nursing home residents. Those 75 and older were next in line. However, problems arose even in vaccinating that limited pool of people. Some hospital and nursing home workers have been hesitant to get the vaccine. Scheduling issues created delays in getting shots to nursing homes.

Some states, including Arizona, have or are planning to open up mass vaccination centers, aiming to inoculate thousands of people a day in a single location. In Florida, Gov. Ron DeSantis opened up vaccinations to people 65 and older. In other states, local health authorities have started asking residents 65 and older to register, in anticipation the vaccination campaign would be expanded.

Although Azar said the shift in strategy was a natural evolution of the Trump administration's efforts, as recently as Friday he had raised questions about whether Biden's call to accelerate supplies was prudent.

On Tuesday, he also sought to deflect blame to the states for the slow uptake of vaccines. Azar said some states are being "overly prescriptive and trying to micromanage every single dose of vaccine," leading to bottlenecks.

Azar also criticized what he called "the hospitalization of vaccine distribution," saying "we have too much vaccine sitting in freezers in hospitals."

State and local officials are sure to point out it was the federal government that recommended putting health care workers at the front of the vaccination line.

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