COVID-19 Vaccine Distribution Plan

Aug 17

A Daunting Task Ahead: How is the United States Planning to Distribute a Coronavirus Vaccine to the Initial Tens of Millions of People?

(Updated Aug 23)

Making a vaccine in record time is difficult enough. However, distributing it to millions of folks is equally challenging. The current administration has only provided limited, and often confusing, information on this front up until recently. This week, the federal government has finally requested four states and one city to draft plans for coronavirus vaccine distribution plan outlining the logistics of vaccinating people when limited doses become available. The idea is to take this plan, assess, and then roll out a formalized version of it to the rest of the country. A COVID-19 vaccine is possibly expected as early as October of this year, though most likely in January of 2021. Given this short timeframe, a solid distribution plan is nothing short of an urgency.

The Centers for Disease Control and Prevention, the Department of Defense (DOD), and other agencies initiated working on a plan with officials in California, Florida, Minnesota, North Dakota, and Philadelphia. Their goal is to develop plans to:

1. Transport vaccines to the states and territories

2. Properly and safely store vaccines, and

3. Prioritize who would receive them initially

Undoubtedly, this is a massive undertaking. In the months ahead, both federal and state and federal officials will have to sort out a number of logistical challenges, and more.

State and Federal officials must figure out how to transport and store huge amounts of vaccines to the right place, at the right time, and in the right condition. Mishandling the doses may cause premature expiration and wastage of these prized vaccines. They may be looking at leasing warehouse spaces and securing freezers and refrigerators for storage. To make matters more complex, one of the COVID-19 vaccines under development requires storage at a very cold temperature, about minus 70 degrees Celsius (minus 94 degrees Fahrenheit). Compare that to our standard freezer temperature of minus 20 degrees. Neither the states nor the doctors’ offices are expected to purchase these special freezers to store such vaccines. Doctors’ offices won’t administer such shots. So the CDC is planning for sites for mass vaccination clinics in the event the Federal Food and Drug Administration (FDA) approves this vaccine.

Shortages of needles and vials are also a big concern. We have all seen how the states competed against each other for personal protective equipment during the peak of COVID. Why would it be any different for this scenario? Whatever the plan is, the officials need to account for state-on-state competition for items like syringes, needles, and vials.

A shortage of medical-grade vials and syringes could significantly bottleneck our vaccine distribution plan. Governments and vaccine makers around the world are placing large orders and pushing the makers of vials and syringes to increase manufacturing capacity. Furthermore, there are additional concerns due to the anticipating demand for syringes for flu vaccines with the start of influenza season in the fall.

Glass manufacturer, Corning, is tapping into a $204 million government contract to accelerate construction of a 2,000-degree furnace in New Jersey that will extrude molten glass into medical-grade glass tubing, which then will be converted into vials for COVID-19 vaccines. The U.S. government is partnering with BD, a NJ-based global medical supply company, to ramp up supply of syringes. BD has a $42 million contract with the government for this initiative. Several other companies were awarded millions of dollars to expand production of syringes and glass vials.

Officials must also determine who gets the first doses. The initial doses will probably be given to high-priority groups such as front-line health-care personnel and essential workers. One would imagine that the seniors at nursing homes will also fall under the category of this priority high-risk group for COVID-19. But this determination should be an unbiased process. The good news is that the final recommendations on who is considered high priority are expected to be made by an independent advisory committee and a federal immunization advisory panel. We will see what unfolds in the coming days.

The government would also need veteran industries or commercial partners with relevant experience to handle the distribution and delivery of vaccines. Although President Trump repeatedly said that the military will deliver vaccines, the DOD recently confirmed that they will not. Rather, the military will be responsible for handling the logistics of manufacturing, including the acquisition of raw materials, setting up factories and training workers. On Friday, DOD and Health and Human Services (HHS) announced their commercial partner McKesson Corp. will be the central distributor of the vaccines and related supplies—a $178 million contract option is under execution for this. The upside of contracting McKesson is that they have the relevant experience of distributing the H1N1, or the swine flu pandemic, vaccine during the pandemic in 2009/2010. Additional supplies of vaccines will be provided to select private partners or retail clinics such as CVS and Walgreens for wider accessibility.

The plan hopefully accounts for factors such as racial and ethnicity make-up of each territory, not just population density. Statistics already show that our underserved African Americans and other communities of color are at a much higher risk of getting critically ill and dying from COVID-19. The federal government did, however, say that the amount of vaccine to each jurisdiction will be based on more than one factor.

CDC urged the states to take a few assumptions into consideration as they build out the plan. Some of these assumptions include:

Vaccines will be distributed directly to the healthcare providers
Vaccine providers must enroll with their jurisdiction’s immunization program to receive doses
Needles, syringes, and limited quantities of faces masks and face shields will be distributed to the providers by the federal government at no cost
Need for urgency and flexibility to develop a draft plan by October 1, 2020 (even if the plans are not perfect)

As of this week, we have lost about 160,000 Americans to coronavirus. We are losing this battle against the coronavirus. Vaccines are the only hope beginning to surface on the horizon. We have finally begun planning the largest vaccination campaign ever to be undertaken. Careful coordination, planning, and communication cannot be neglected. A lot is at stake in the hands of our federal government.

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