The FDA’s emergency use authorization of both the Pfizer and Moderna vaccines clears the way for nationwide distribution and administration. While it will not be a magical, cure-all solution, it is a critical step in getting control over the pandemic and resuming a more normal life. Decision-making and logistics have been left largely to states, but it is expected that the Biden administration will change the federal government’s approach. Biden has already assembled a pandemic task force and released his plan to confront the pandemic, hoping to vaccinate at least 100 million Americans within his first 100 days in office. Below is a brief overview of some of the logistical hurdles that lie ahead.
Who Will Get the Vaccine First?
With the vaccine in short supply, states will have to make difficult decisions about who should get it first. The CDC’s Advisory Committee on Immunization Practices (ACIP) released a set of guidelines to help states make their distribution decisions. They have determined health care workers and long-term care residents to be the highest priority group (“phase 1a”), and it is estimated that this population represents about 17.6 million people. Within this group, the ACIP has also provided guidance on sub prioritization, which can be found here.
Though not officially finalized, the next priority group (“phase 1b”) is non-health care essential workers, such as grocery store workers or delivery drivers, followed by people over the age of 65 and those with preexisting conditions (“phase 1c”). It is important to note that questions remain on which underlying medical conditions put individuals at higher risk of hospitalization and/or death as a result of coronavirus. There are an estimated 87 million essential workers, 53 million senior, and 100 million individuals with high-risk medical conditions. The size of these groups will make the next stages of prioritization much more difficult.
Regarding the general public, those not in high-risk groups may be able to get access to COVID-19 vaccines in early spring. Experts are optimistic that most Americans will be vaccinated by June, though only time will tell.
These recommendations are not binding, so governors will have the final say. Access will vary by location. Thus far, states have largely followed ACIP’s Phase 1a recommendation to prioritize health care workers and long-term care residents, with slight variation from state to state.
Other Logistical Challenges
Vaccinating even a portion of the U.S. population will be a challenge, which makes mass immunization a herculean task. For starters, the health-care system is under extreme strain as COVID-19 cases continue to surge. Creating vaccine administration sites, finding a suitable place to store the vaccine, and ensuring that there all enough healthcare workers to administer the vaccine are a few of the many obstacles the health-care system must overcome. The supply chain itself is full of potential bottlenecks too. Many pharmaceutical companies’ manufacturing operations are overseas. Shipping companies, like FedEx and UPS, must find a way to ship massive quantities of vaccines at the proper temperature. Critical items, like vials and syringes, will also need to be manufactured at a rate higher than normal too.
Underpinning these challenges is an American public deeply divided and fatigued. As we enter our second year of social distancing and uncertainty, maintaining our resolve feels impossible at times. There is an end, and each day we get one step closer to resuming our normal lives.