Vaccine deliveries are making history
At Novant Health in Winston-Salem, N. C., the new ultracold freezers are ready — enough to eventually house more than 500,000 doses of the first coronavirus vaccine approved in the United States.
In LosAngeles, Cedars-Sinai Medical Center has installed extra security cameras to protect the secret location of its soon-to-arrive supply of the vaccine.
In Jackson, Miss., the state’s top two health officials are preparing to roll up their own sleeves in the coming days and be the first toget the shots there as cameras roll, hoping to send the message, “We trust it.”
The Food and Drug Administration’s emergency authorization Friday night of the vaccine developed by Pfizer and BioNTech has set in motion the most ambitious vaccination campaign in the nation’s history, a challenge of staggering proportions choreographed against a backdrop of soaring infection rates and deaths. This weekend, 2.9 million doses of the vaccine are to begin traveling by plane and guarded truck fromPfizer facilities in Michigan andWisconsin to designated locations, mostly hospitals, in all 50 states.
The first injections are expected to be given by Monday to high-risk health care workers, the initial step toward the goal of inoculating enough Americans by spring to finally halt the spread of a virus that has killed nearly 300,000, sickened millions and upended the country’s economy, education system and daily life.
The rapid development of the vaccine, and its authorization basedondata showing it to be 95 percent effective, has been a triumph of medical science, but much in this complicated next stage could go wrong.
The Pfizer vaccine needs to be kept at minus 94 degrees Fahrenheit, and the special boxes it is being shipped in can be opened nomore than twiceaday, in order to maintain the deep freeze. Side effects, like achiness or headache, could cause some of the nurses, doctors and others who are first in line for the vaccine to miss a day or two of work, challenging overburdened hospitals.
States say they have only a fraction of the funding they need from the federal government for staffing to administer the shot, for tracking who has received both doses of the vaccine— a booster is needed three weeks after the initial injection — and for other crucial pieces of the effort.
“Our teams are on standby,
ready to pivot,” said Dr. Anne Zink, Alaska’s chief medical officer.
Most of the state’s allocation will be delivered to a central location and then flown in small amounts, often in tiny planes, to farflung hospitals and clinics that will need to quickly administer it.
Preparations for this moment have been months in the making. Military planners have looked at a range of potential obstacles, from large-scale protests that could disrupt traffic to poor weather conditions. In an emergency, officials are prepared to use military airplanes and helicopters to deliver vaccines to remote locations.
On Saturday morning, vials of vaccines were being packed and prepared for shipping at Pfizer facilities, with employees from the Centers for Disease Control and Prevention on site to make sure there were no mishaps, according to a senior CDC official. Pfizer said the first shipment would leave its Kalamazoo, Mich., facility early Sunday.
FedEx and UPSwill transport the vaccine throughout most of the country, and each delivery will be followed by shipments of extra dry ice a day later. Pfizer designed special containers, with trackers and enough dry ice to keep the doses sufficiently cold for up to 10 days. Every truck carrying the containers will have a device that tracks its location, temperature, light exposure and motion.
For all the planning, and contingencies, there is still a good deal of confusion. States are receiving initial allocations according to a federal formula based strictly on their adult population. Butmany hospitals say they still don’t know exactly how much they will get or when the shipments will arrive.
“It’s really been a lot of the unknowns about the logistics,” said Dr. Jeffrey A. Smith, chief operating officer for Cedars-Sinai.
Other hospital systems are reeling from the news that their initial allocations will be much smaller than they had hoped. The Cleveland Clinic, one of the 10 hospital groups in Ohio that
are receiving the first batch of vaccines, is expecting only 975 doses in an initial shipment, even though it has more than 40,000 employees around the state.
“We’re going to have a lot less vaccine than we have people wanting it,” said Dr. Robert Wyllie, Cleveland Clinic’s chief of medical operations, adding that the systemwould first vaccinate workers in the intensive care units at four hospitals that are experiencing the highest volumes of COVID patients.
One reason for the shortfall in initial supply is that federal officials recently decided to send out a little fewer than half of the 6.4 million doses they had initially planned for the first wave.
On a call with reporters Wednesday, Gen. Gustave F. Perna, the chief operating officer for Operation Warp Speed, said he was taking a cautious approach to doling out the vaccine, setting aside for subsequent shipments another 2.9 million doses for booster shots, which are given threeweeks later, as well as an emergency reserve supply.
But that careful strategy has come under criticism from others, who have argued that the vaccine must be deployed as quickly as possible, given that infections are raging out of control, hospitals are overflowing and thousands of people are dying a day. The FDA released data this past week showing that Pfizer’s vaccine begins to offer some protection from the coronavirus even before people get their second doses.
“We knowthe first dose is partially protective,” Dr. Scott Gottlieb, a former FDA commissioner and a board member of Pfizer, said on CNBC on Friday. “We need to get as much protective immunity as possible into the general public.”
Pfizer has said it can provide up to 25 million doses to the United States by the end of this month.
Additional vaccines are in the pipeline. Moderna recently applied for emergency authorization for its vaccine. The company said it is “on track” to produce 20 million doses by the end of this month.