A COVID Vaccine Could Be Ready By January. How Will Distribution Work?
Another big announcement in the race to create a COVID-19 vaccine today – early data shows a vaccine created by the drugmaker Moderna is 94.5% effective in preventing the coronavirus. This follows last week's announcement that another vaccine, made by Pfizer, is 90% effective, based on preliminary trials.
Both the Pfizer and Moderna models are a new type of vaccine, which targets the body's mRNA to produce proteins of the virus, teaching the body how to fight it.
Both vaccines are also still in clinical trial and need to be approved by the U.S. Food and Drug Administration for use. But experts say there's a chance either one (or even both) could be ready for distribution by January.
HOW WOULD THEY BE TRANSPORTED AND STORED?
Dr. Peter Chin-Hong, infectious disease specialist at UC San Francisco, explained to AirTalk host Larry Mantle Monday morning that one thing to take into consideration for vaccine distribution is the storage temperature.
The Pfizer vaccine requires storage temperatures of -70 degrees Celsius -- about -94 degrees Farenheight. By contrast, the Moderna vaccine needs a storage temp of about -20 degrees Celsius, which is -4 degrees Fahrenheit.
There are some vaccines that may come out in the future that only require refrigeration, but these two frontrunners, being mRNA vaccines, do need some pretty cold temperatures, which means we'd need distribution centers like Walgreens or CVS to have the infastructure to support complex freezing systems.
HOW WOULD DISTRIBUTION WORK?
California, Chin-Hong said, is one of five regions that have been earmarked by Operation Warp Speed to be models for vaccine distribution. "But the details are not very apparent," he said.
Why? Because vaccine distribution is part of America's national security plan, and with President Trump currently refusing to concede the election results, there's no clear hand-off to the next administration. That's a problem because President-elect Biden will take office in January, which is exactly when most of these vaccines will (ideally) be ready for roll out.
"Suffice to say, a lot of people are walking around in the dark about distribution at this point," Chin-Hong said.
WHO WILL GET PRIORITY IN LA COUNTY?
In Monday's media briefing, L.A. County Public Health Director Barbara Ferrer said the priority list for vaccines will look something like this:
- Health care workers
- Essential workers who have close contact with people at high-risk for the virus, as well as "our most vulnerable, fragile residents," particularly those in skilled nursing facilities
- Everyone else
Ferrer said the public health department has been working on a distribution plan since May to make sure that "everybody who lives in L.A. County has good information, so that they can make a decision about getting vaccinated and feel comfortable that the vaccines that are being distributed are safe and effective, and that we have a system in place so no one gets left out."
She added that health officals want to make sure that there are no "vaccine deserts" and will be using similar strategies to those they used in setting up testing centers to make sure that everyone in the county has access to a distribution center and that there is enough vaccine available for the general population.
Doses will be distributed through pharmacies and "federally qualified health centers."
WILL THE MILITARY BE INVOLVED IN DISTRIBUTION?
Yes, but we don't know any details yet.
HOW LONG WOULD IMMUNITY LAST?
We don't know yet, but participants in the clinical trials for both vaccines will be periodically monitored for antibodies, so that researchers can figure out when and if members of the public would need a booster vaccine down the road.
The drug manufacturers estimate immunity may last longer than a year, but it's unclear exactly how long.
WHAT'S THE TIMELINE FOR ALL THIS?
Moderna is promising 20 million doses by the end of 2020, which would effect about 10 million people (each person receives two doses). Pfizer is promising 50 million doses, so that's potentailly a total of 70 million doses by January.
In 2021, we could have up to 1.3 billion doses from Pfizer and a similar amount from Moderna.
In addition, there are at least 10 other companies in Phase 3 trials around the world and at least three other companies developing vaccines as part of America's Operation Warp Speed.
Still, we shouldn't be overly optimistic about when these vaccines will be distributed to everyone, Chin-Hong said:
"Having a vaccine available from the manufacturer is one thing, but the devil is in the details. Getting it from the manufacturers into the arms of the average community member would require so many steps, like, how are you going to keep the vacccine so cold? And when you defrost the vaccine, it has a short shelf life -- will you have to throw away doses if you can't use it in time? All of these things are, you know, potential barriers."
Distributing the vaccine would also require public health officials to use information technology to keep track of who's received doses (and when and where they received them).
"You can imagine being in L.A. for your first vaccine and maybe you visit your mom in New York for your second dose," Chin-Hong says. "Someone needs to keep track of all that."
The process will require a team of epidimeologists, large databases and complex machine learning to collate all of that data.
Dr. Ferrer said she's hopeful that L.A. County will be able to start administering vaccines to the general population sometime in the Spring of 2021, with this caveat:
"They've got to be approved. And then we've got to make sure that they're manufactured at a very high volume. I also want to note there's lots of other promising [vaccines] that are in development, and that may have less restrictions attached to them in terms of cold change storage requirements, needing two doses not one ... So I feel pretty hopeful that a few months from now, there [will also be] other vaccines that we may be able to use in L.A. County and across the world."
WHY ARE SOME FOLKS NERVOUS ABOUT A VACCINE?
The optics of the Trump administration promising a vaccine by the election were not ideal, Chin-Hong said. That made some people nervous about the vaccine being rushed to trial and production. The name of the government vaccine initiative, Operation Warp Speed, probably didn't help, he added.
The good news is that the vaccine isn't going to be rushed scientifically. The science itself still has to be verified in all the usual ways. Operation Warp Speed just means that the bureacracy of releasing a vaccine "is going to be minimized as much as possible," Chin-Hong said.
The data we have now suggests that even though the release of these two frontrunner vaccines isn't going to happen for at least a few months, both should be safe.
Scientists are currently studying the effect these vaccines might have on immunocompromised individuals, such as those living with HIV, as well as older people and those with other underlying medical conditions.