WASHINGTON | Trucks and cargo planes are ready for the distribution of doses of COVID-19 vaccine in the United States, a complex logistics operation led by a general, but whose pace will ultimately be slower than expected in the first months.
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The General of the Army, Gus Perna, operational director of Operation Warp Speed, has been having his troops carry out for weeks, a mixture of soldiers from the Department of Defense and experts from the Department of Health, exercises to anticipate the day the United States Drugs Agency (FDA) declares Pfizer / BioNTech and Moderna’s vaccines to be effective and safe, presumably shortly after December 10 and 17, respectively.
The goal: to deliver the first batch of Pfizer vaccine doses within 24 hours to all hospitals and other sites that request it. Of the 6.4 million available doses, half will be delivered immediately, the other half reserved for the second dose three weeks later, as a precaution, a senior administration official said on Monday.
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No soldier will deliver the vials. The federal government pays the doses and gives orders to the private sector, which will take care of all the logistics.
Pfizer doses wait at its plant in Kalamazoo, Michigan. Six trucks will leave there each day loaded with containers filled with 975 vials and dry ice at -70 ° C, towards the airports where Fedex, UPS and other planes will take them – Pfizer estimates that 20 planes will transport its vaccines daily.
For Moderna, the “bottling” takes place at its subcontractor Catalent in Bloomington, Indiana, where Moderna sends large 50-liter bags of the vaccine, made in New Hampshire.
The goal is “to have the trucks literally waiting right next to the factory to be able to load them and leave as soon as the FDA has OK”, Stéphane Bancel, the boss of Moderna, told AFP.
The list of delivery locations (hospitals, clinics, partner pharmacies, etc.) is set by 64 jurisdictions (states, territories, cities) and sent to Warp Speed.
General Perna’s job is to keep up the pace of delivery, sending the same quantities of second doses, three (Pfizer) or four (Moderna) weeks after the first.
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Practical details
In the spring, the Trump administration’s target was hundreds of millions of doses by the end of 2020. The United States will finally receive 40 million in December, enough to vaccinate 20 million people.
Pfizer promised until early November 100 million doses worldwide in 2020, but has halved its forecast due to an ingredient problem.
“The production component turned out to be more complicated and difficult than what we had expected,” admitted Moncef Slaoui, chief scientist of Warp Speed, on CNN.
In recent days, the forecasts have worsened further: while officials announced on Wednesday that there would be enough doses to vaccinate 100 million people by the end of February, Mr. Slaoui postponed this deadline to “end or mid-Sunday”. March “.
Finally, once the dose packages have been delivered, how to ensure proper administration?
“We haven’t seen a detailed plan of how to take the doses out of the packets, put them in a syringe and inject them into the arms,” President-elect Joe Biden said.
These practical details are not trivial for technicians, pharmacists and nurses who will have to manage two, then three and maybe six vaccines next year. The Pfizer vaccine can be kept in its frozen box for 30 days, as long as it is refilled with dry ice every five days.
“They will have to acquire reflexes to know which vaccine must remain in the freezer, which arrives in a container, which must remain at -80 ° C or -20 ° C,” Prashant Yadav, expert in health logistics at the Center, told AFP. for Global Development.
“This complexity makes everything more difficult, because we know that the procedures are only followed when they enter the muscle memory of those who have to perform them, and not when you have to read a manual. “
All of this will be tested within eight days. On his whiteboard, General Perna wrote a tentative date for the first deliveries: December 15.
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