Distribution Of The Coronavirus Vaccine Will Depend On Local Efforts

Oct 20, 2020

While the world waits for a safe and effective inoculation, this year’s flu shot can serve as a sort of dress rehearsal for when a coronavirus vaccine becomes available. That’s because everyone, from the very young to the very old, should get vaccinated in a relatively short amount of time.

Health care workers will be among the first to receive the coronavirus vaccine due to their high risk of exposure. So while it may be summer or even fall of 2021 before the general public gets vaccinated, people in the medical field could start receiving it before the end of the year.

“Our original mass vaccination plans or the plans that we’ve been looking at … for the last number of years, none of them included social distancing,” said Eric Poach, UPMC’s manager of emergency preparedness.

At a recent employee flu clinic Poach says physical distancing was accomplished by queuing people through a maze of tables

“There was never anybody besides you. There was never anybody in front of you,” he said.

UPMC also held a flu shot clinic at an employee parking lot near UPMC Shadyside. Pop-up tents were erected, and vaccine vials were stored in coolers.

Administering inoculations outdoors is safer because open air reduces the risk of transmission, and the Pennsylvania Department of Health says mass clinics could be set-up to distribute the vaccine.

But there are some big differences between the flu and coronavirus vaccines. For one, the coronavirus vaccine will have to be stored and transported at extremely cold temperatures.

Pfizer’s coronavirus vaccine, which could be the first to receive authorization, needs to be kept at -94 degrees Fahrenheit—about 20 degrees colder than the average temperature of the interior of Antarctica. 

“That’s like research-grade freezer cold. And we just don't have any existing supply chain for any product in the United States right now that has that kind of requirement,” said Penn State epidemiologist Matt Ferrari.

Once vials are removed from the freezers, Ferrari says clinicians have less than a day to inject the inoculation. He anticipates some doses will get too warm before they’re used.

“That's something that we don't think about very much in this country right now,” he said. “We have to build in what we call ‘wastage,’ and assume that every dose of vaccine that we take out of the freezer will not necessarily go into somebody.”

Another possible hurdle is that a coronavirus vaccine could require a booster shot about three or four weeks after the first dose is given, which will involve additional coordination.

“There's a lot of technology that would have to be in place. Do they sign up on their phone? How do you know when someone's actually received the vaccine? How do you know when someone's missed it?” said David Dausey, a Duquesne University epidemiologist who specializes in public health disaster preparedness.

The onus of ensuring that everyone gets the second shot falls to state and local health systems. Last week states submitted their vaccine distribution plans to the Centers for Disease Control and Prevention.

“It is important to understand that this plan will be continuously enhanced and adjusted to the various needs during each vaccine distribution phase. It is better to look at this as a framework,” said Maggi Mumma, deputy press secretary for the Pennsylvania Department of Health.

The department did not respond to requests by WESA to see the plan it submitted to the CDC. 

Because the public health infrastructure is hyper-local, Dausey worries the rollout will sow confusion.

“The CDC has very little it can do to essentially control local and state public health. Other than, you know, pulling funding or threats to pull funding,” he said. “It's not as coordinated as people think it is … It's very fragmented.”

And in the absence of a cohesive national pandemic response, Dausey said distribution could be slow, which would prolong the coronavirus’s impact.