Medicosnext
In the United States, President Trump launched Operation Warp Speed in May 2020 to fast-track development, testing, regulatory approval, and distribution of COVID-19 vaccines. The U.S. has booked hundreds of millions of doses of vaccine candidates in advance, and at least the initial vaccinations will be available to all Americans free of charge. While most of the decision-making is left to the states, it will be a huge logistical challenge involving a complicated supply chain, with hundreds of millions of vaccine doses that have to be kept at the right temperature, and then administered twice, in order to be effective.
Once the candidate vaccine is approved by the FDA, the distribution will involve many players, including federal agencies, the military, state and local authorities, pharmaceutical companies, public and private healthcare facilities, manufacturers and suppliers of equipment needed to administer the vaccines, health-insurance companies, vaccine administration sites like pharmacies and grocery chains, and shipping and logistics companies and at least one major airline.
In the initial phase, enough doses should be available to inoculate roughly 20 million citizens. The CDC has recommended that healthcare workers, who number roughly 21 million, and residents of nursing homes and long-term-care facilities, who number roughly 2 million, should be vaccinated first. Next in line will be “workers in essential and critical industries, people at high risk for severe COVID-19 illness due to underlying medical conditions, [and] people 65 years and older,” as recommended by the Advisory Committee on Immunization Practices (ACIP). This priority group includes some 80 million essential workers and 53 million people 65 years and above.
‘Underlying medical conditions’ include illnesses that put individuals at higher risk of hospitalization or death and many underlying conditions like heart failure, cancer, or sickle-cell disease. The CDC is also considering obesity as an underlying condition. Those not in high-risk groups should be able to start getting vaccinated beginning in the early spring, with most Americans vaccinated by June.
The Pfizer-BioNTech vaccine, which was approved by the FDA on December 11, requires ultra-cold temperature of minus 70 ºC for storage and transportation, making them more difficult to distribute and administer. Moderna’s vaccine will likely be approved next, and although it also uses the same mRNA technology as Pfizer’s vaccine, the company says that it is stable at 2-8 ºC for up to 30 days. The AstraZeneca–Oxford vaccine, the third likely to be approved, is a more traditional recombinant vector vaccine. All three vaccines will require two doses, which further complicates distribution and administration. The sites for vaccine administration include hospitals, state health departments, clinics and doctors’ offices, pharmacies and some grocery-store chains, long-term-care facilities, and military treatment facilities
References:
1. New York Magazine, December 2, 2020, https://nym.ag/370qNpH
2. Reuters, December 10, 2020, https://reut.rs/2K8WQuR
