With the U.S. on the verge of approving a vaccine, a lot of logistical information is now being released to the public. Not much yet on exactly WHO will get the first doses, which is likely to be very highly politicized, but a lot is coming out about HOW the vaccine will be distributed. Might be of interest to you folks, as again, it could shed some light on how distribution will work when the vaccine reaches whatever country you're planning on being in.
Here are some key points and highlights from a
story in USA Today.
1) The entire process will be overseen by the CDC. The U.S. Government will purchase all of the initial doses and will not charge for them. It is unclear whether the individual clinics will be allowed to charge an administrative fee and, if so, whether insurance companies will be reimbursed for this.
2) The initial doses (expected before the end of the year) will be in very short supply, but the CDC expects "significantly more" will be available by January 2021. It appears frontline workers, medical staff and high-risk individuals will be first in line. It is expected that the Moderna and Pfizer vaccines will be approved first.
3) Individuals who receive the vaccine will also receive a vaccination record card, to ensure they get the proper follow-up inoculation either 21 or 28 days later.
4) Medical offices, hospitals and clinics that wish to administer the vaccine will have to enroll with the CDC and show proof that they have the necessary staff and equipment to do so. When a vaccine becomes available, those entities would have to submit a request through their state Department of Health, which would then verify that those offices are in compliance with CDC requirements and submit the order to the CDC.
5) The CDC is contracted with McKesson, the largest pharma distribution company in the U.S., to handle nationwide distribution and supply of all vaccines. Orders submitted to the CDC would be shipped within 24 hours. Nationwide chain pharacies like CVS and Walgreen's will work directly with the CDC. Military allocations will go through the Dept of Defense.
Here's the interesting part...DISTRIBUTION. This is going to be a logistics nightmare.
6) The Moderna vaccine must be stored at -4F. The Pfizer vaccine must be stored at -94F. The Moderna vaccine will be stored either at a manufacturing plant or at a McKesson distribution center. When an order arrives it will ship directly to the facility. It comes as a frozen liquid in a 10-dose vial with no preservatives. It will be stored in either a freezer or container with dry ice. It can be stored for up to two weeks at normal refrigeration temperatures. Once at room temperature it must be used within six hours. Two doses are required, 28 days apart.
7) The Pfizer vaccine will be much more challenging. The CDC will send orders directly to Pfizer, which will then ship to vaccination sites. It will require special shipping containers with dry ice being topped off every few days. It comes in five-dose vials with no preservatives. It can be stored at normal refrigeration temperatures for only 48 hours, and once at room temperature must be used within six hours. The Pfizer vaccine will be shipped in specially-designed containers, the size of a pizza box, containing 195 vials, equal to 975 doses; one shipping container will hold five of those boxes, or 4,875 doses, and facilities wishing to store these boxes will need to have "sub-80" freezers, usually found at large hospitals and research facilities. The Pfizer vaccine must also be diluted with a specialized liquid, like sterile water, and the two doses must be given 21 days apart.
It will be interesting to see how this plays out over the early months of 2021, as the challenges presented by the top two vaccines, in contrast with the much simpler shipping and storage requirements of the Novavax vaccine--which is also showing slightly better results in Phase I/II testing--might shift focus and demand quite drastically, particularly in areas of the country/world where shipping a vaccine will take much longer and advanced storage facilities are not as commonplace or even available at all.
In any event, it looks like the U.S. truly is going to be the world's guinea pig. Should be an interesting new year.
