Multiple federal agencies are involved in this process, and some state officials worry about the lack of transparency and clarity in preparations for vaccine release in this emergency.
Claire Hannan, executive director of the Association of Immunization Managers, which represents state immunization program managers, said: “There is still a lot of confusion.”
General Gustav Perner, who is assisting in overseeing Operation Twisting Speed, told a senior health official in Missouri that he knew how many doses the state would receive, but would not disclose the figure. Officials say that in California, they are planning “multiple scenarios.”
A Washington State official told CNN: “We put down all the tracks and let the train continue. We are just waiting for the train.”
This anxiety is due to a severe shortage of personal protective equipment earlier this year, which caused states to clamor for the necessary supplies to deal with the pandemic, thus weakening the trust between states and the federal government.
The vaccination program is administered nationwide by the Centers for Disease Control and Prevention, the U.S. Department of Defense, and Operation Warp Speed. The federal government is committed to accelerating the development of drugs, vaccines, and other measures to respond to the coronavirus pandemic. .
The distribution director of Operation Warp Speed told CNN on Thursday that the federal government’s vaccine distribution system is “ready.”
Paul Ostrovsky said: “We are administering the flu vaccine without exaggeration. It is no different. We want to make the distribution of this vaccine as easy as a normal flu vaccine.”
Ostrovsky told CNN that “Operation Distorted Speed” will not play a role in deciding how many doses of coronavirus vaccine to send to each state, saying that the distribution to the state is “actually a policy decision.” .
Ostrovsky said policymakers will determine how many vaccines each state gets.
Hannan said that once any vaccine is approved by the US Food and Drug Administration for emergency use, the vaccine will be shipped to the states, but it is not clear how much each state will receive, which makes it difficult for states to plan for distribution.
“States keep asking,’Do I take 5 million doses or 250,000 or 10,000 doses?” Because this is the key to planning-they really need to know how much they can get,” Hannan told CNN, adding that despite them Constantly changing, but some states still received “estimates.”
National immunization managers said they heard conflicting information about the decision-making process behind the distribution. Hannan said: “They may be talking at the “warp speed” operation, and then they are told one thing, then they are talking to someone from the CDC, and then they are told other things.
Perna said on Friday that the vaccine will be “distributed in proportion to the population to ensure that we distribute the vaccine fairly and reasonably.”
Pena said at a press conference in the Rose Garden of the White House: “We need the planned state to receive the vaccine.” “We are working closely with the CDC, 64 jurisdictions and states to ensure that the vaccine can be delivered safely and quickly. First, give it to those who need it. Then, we plan to ensure that the vaccine spreads exponentially across the country. There is no vaccine in this place.”
Kurt Seetoo, program manager for the Immunization Center of the Maryland Department of Health, told CNN that the CDC provided estimates to the state, but the details of the distribution are still unclear.
Seetoo said: “We are waiting to see how many vaccines we will provide and make sure to deliver them to our hospitals and local health departments to contact medical staff and people at high risk of serious illness.” “Waiting for the game.”
Assuming that the initial data is valid and that the vaccine is safe and effective for the FDA, Pfizer is expected to distribute its vaccine first. This adds a certain level of complexity because Pfizer said it will not be able to use it in the federal government’s vaccine distribution system, which has signed a contract with the medical and pharmaceutical supply company McKesson, but will distribute its vaccines directly.
The Minister of Health and Human Services, Alex Azar, stated that shipments from Pfizer will “start in increments of approximately 20 million doses, starting in late November and continuing every month.” However, when CNN asked, Pfizer did not give specific numbers, but only said that countries that have reached an agreement with Pfizer will provide 50 million doses worldwide.
What will the states do after vaccination?
Paul Mango, deputy chief of staff responsible for policy at the Department of Health and Human Services, said the federal government will allocate vaccines based on back-end calculations that take into account how many people in a state are considered priorities, such as nursing home residents or frontline health workers. .
But the government will not decide where the vaccine will eventually be marketed. That’s where the state enters.
Missouri State Health and Senior Services Director Randall Williams told CNN that he had a one-on-one conversation with Perna last week to discuss how many coronavirus vaccines Missouri will receive and what to expect in the coming days and weeks.
Williams said Pena, who he described as “very frank”, knows how many vaccines Missouri will get but will not share.
If all goes well, Williams predicts that people in Missouri can start getting vaccinated from “mid-December to the third week.” Williams said that most of his conversations about vaccines were conducted through HHS, the Centers for Disease Control and Prevention, and the National and Territory Health Officials Association (not the White House), adding that Perna gave him a cell phone to keep in touch.
Like Missouri, the states have outlined their priorities and acknowledged that there will be limited supplies and the need to provide vaccines to those most in need.
The California Department of Public Health stated that its vaccination plan “is being implemented in several stages: vaccination; limited doses available; more doses available; and adequate doses for the entire population.”
As they waited for information about storage and processing requirements, the department said it was “actively planning multiple scenarios.”
Doug Schultz, a spokesperson for the Minnesota Department of Health, told CNN that in addition to not knowing when or how many vaccines the state will receive, the state needs more federal assistance. In order to receive and distribute the coronavirus vaccine correctly.
“In terms of resource requirements, we lack the public health personnel needed to plan and implement response measures. We also need more funds to promote vaccines, meet IT needs, and purchase other items that may be needed to maintain and monitor the cold chain of vaccines once they are shipped to the state. “, Schultz told CNN.
Dr. Helene Gayle, who served as the co-chair of the committee dedicated to the equitable distribution of coronavirus vaccines to the National Academy of Sciences, Engineering, and Medicine, said that they concluded that the most direct way to distribute vaccines is by population size.
Gail said: “Basically, we recommend that states allocate a certain amount based on population.” “We have a bit of numbers and realized that even if you try to do this through Covid prevalence and all other ways, there is no way to overcome this complexity. How much does it matter, it may be simpler, more direct and less manipulated.”
When the committee made recommendations to federal agencies, Gale was surprised that the chaos between the states persisted.
She said: “Always, the absence of the usual national framework and level of guidance has caused confusion.” “Our recommendations are actually based on the best evidence, and we clearly hope that there will be no political interference.”
Difficult to issue
The emergence of Pfizer as a leader in vaccines adds another layer of complexity to national planners. Pfizer’s vaccine must be stored in an environment of approximately minus 75 degrees Celsius or minus 103 degrees Fahrenheit-far below the requirements of the most widely used vaccines.
The challenges of cold storage may also limit access to the first potential coronavirus vaccine.
Ostrovsky said: “We will push these vaccines where we know they can be stored, or refill them with dry ice when necessary during the entire administration process.” “We will not send Pfizer vaccines to the countryside. Waiting for places, no matter what, they can’t manage.”
In order to help the states, Ostrowski said that CDC’s strike team is being deployed to ensure “the state’s preparedness for vaccines is maintained”, adding that states have obtained permission to use major chain pharmacies such as Walgreens, Costco and CVS. Said: “These vaccines are very good at managing vaccines.”
The package delivery company UPS will also ship dry ice nationwide to help healthcare institutions and providers store Pfizer’s Covid-19 vaccine.
CNN’s Betsy Klein and Annie Grayer contributed to this report.