The results of the COVID-19 vaccine trials are starting to come in and they’re looking good. We could see distribution as early as December. In the history of medicine the quickest vaccine to have ever been developed took four years. This took eight months. These vaccines have the potential to be real game changers as we go into 2021. Pfizer isn’t the only one making huge strides in the vaccine race. We now have three extremely promising vaccine candidates. And at least one more on the way. But there is one pretty big problem, physically getting the vaccine to all of the over 330 million people living in the U.S.
The worst thing that could happen is we had vaccine delivered and we’re still not ready to distribute. The vaccine distribution and program implementation is going to be the most complex vaccination program ever attempted in human history. To achieve herd immunity experts say that about 70 percent of the population needs to be vaccinated or have natural antibodies. Pfizer’s vaccine requires two doses, that’s 462 million doses for herd immunity. And 660 million doses for the entire population, that will need to be manufactured, financed, distributed and administered.
And even then not even Pfizer knows how long protection against the virus will last.
How to distribute coronavirus vaccine?
How are we going to get a coronavirus vaccine to every person living in the U.S.? Especially to those in remote corners of the country and how much will it cost? Distributing a vaccine to the general public requires a whole lot of steps most of which need to happen concurrently.
- Public communication campaigns
- The ordering of equipment
- The hiring of staff
- The training of vaccine providers
- The development and rollout of technology to track inventory and ordering
Not to mention the added complexity in this pandemic of making sure that all vaccine sites are safe and won’t contribute to the spread. Typically in the U.S. our routine immunization system is run via two channels, the public sector and the private sector. But the covet vaccine is going to follow a different model. The new program is nationalized, there is no private sector, there’s no commercial access. If you have a 100 dollars you can’t go out and buy this vaccine on the open market. The federal government pays for it. The federal government is responsible for distribution of the vaccine working with state and local public health. To get the vaccine to immunization providers, who have enrolled to participate in this national vaccination program.
Challenges in COVID-19 vaccine distribution
The cdc is providing a national playbook for states to follow but industry analysts say that a lot of the onus of distribution will actually come down to the individual states and local governments. These states are going to be customizing the response to fit the needs of their population, their particular circumstances. Most states will also need to beef up their I.T systems to keep pace with distribution. One of the most complex parts of this whole rollout is just keeping up with –
- Who has had what vaccine
- How many doses and
- What are the latest stats on inventory levels
Another major issue, making sure all these different systems talk to one another. Some of those systems have not been used before. So we all have reasonable concerns that there will be some stumbling blocks.
On May 15 2020, the trump administration unveiled operation warp speed. A more than 13 billion initiative to develop manufacture and distribute a coronavirus vaccine. As of November 2020 there are four COVID-19 vaccines and large-scale phase 3 clinical trials. That’s the stage when researchers test a large number of people to compare an experimental treatment to standard therapies. And then evaluate the overall risks.
Here are the COVID-19 vaccine producers
- Pfizer developed with its German partner Biontech
- U.S biotech Moderna
- British pharma company Astrazeneca is working on another in collaboration with the university of oxford
- Johnson & Johnson is working on a one dose shot
It is worth noting that the U.S. government will pay Pfizer nearly 2 billion to produce and deliver 100 million doses of its vaccine. Pfizer’s vaccine also happens to be the first one in the pipeline for public consumption.
How COVID-19 vaccine reaches citizens
Once the FDA [Food & Drug Administration] grants emergency authorization, the CDC [Center For Disease Control & Prevention] is next on deck. They decide who gets the vaccine and when. And the agency has already come up with a prioritization model to ration those initial doses. Meanwhile as the vaccine was still in the thick of clinical trials Pfizer was making hundreds of thousands of doses at two of the company’s manufacturing sites in Michigan and Belgium.
Unlike the three other vaccine candidates Pfizer’s is especially difficult to store and ship. It needs to be kept super cold. Minus 94 degrees Fahrenheit cold in a sealed box with dry ice. The suitcase sized box something they call a thermal shipper contains anywhere from 1000 to 5000 doses. These custom thermal shippers act as mobile freezers for clinics that don’t have the necessary specialty equipment. Once that box of doses arrives at its destination the countdown clock begins.
Vaccines can last for up to 15 days in those boxes. So long as the thermal shipper is not open more than twice in a day for no longer than a minute each time. The dry ice also needs to be replenished within 24 hours after arriving at its destination. Then again five days later and another five days after that at that point the vaccine has to be thought out in a normal refrigerator where it lasts for about five days. So without ultra low temperature freezers there’s really only 20 days between shipping and injection which doesn’t leave much of a margin for error. Because of all these highly specific protocols Pfizer is opting out of the government’s suggestion to use Mckesson a third party distributor instead they’re doing it themselves.
CDC will receive vaccine orders from the States and approve those based on the number of doses CDC has allocated to that particular State. Then CDC will communicate that to Pfizer. Pfizer will then ship the vaccine to the location that the state has specified and the quantity the state has specified. And then from there the state will administer the vaccine as it sees fit and keep in mind it’s administered in two doses and given a few weeks apart.
So the role of states in coordinating delivery is hugely important. 64 States, cities and territories have released their preliminary distribution proposal and more should be coming soon.
By the time the general population is being vaccinated it’s likely the federal government will have added 20 to 30 Billion dollars to its pandemic relief pile of taxpayer money, just for the COVID-19 vaccine alone. But experts say that in all scenarios it will have been worth the investment. We have lost trillions of dollars, we’re never going to get back human lives and no amount of investment now is going to bring back those lives. But the investment of a few billion dollars in maintaining a strong public health infrastructure and getting a vaccine to the public to bring this pandemic to a close will be the best investment that we can make.