Vaccine rollout is an administrative problem, not a distribution issue and is expected to go away

Chief executives of the companies that have led the charge in developing vaccines for Covid-19 and their distribution were unanimous in their assessment Wednesday that the vaccine rollout problems were temporary and would recede fairly quickly. They were all speaking on a panel at the third day of the virtual J.P. Morgan Healthcare Conference.

“One of the things I have noticed is a little bit of confusion in the language between distribution and administration [of the vaccine]…” said Brian Tyler, CEO of McKesson, whose company is the largest distributor of the seasonal flu vaccine. “The distribution has gone quite well and I think it’s now that last inch of getting it from provider sites into people’s arms.”

Tyler explained that the first step is up to local decision-makers and companies like McKesson have to wait to get a specific request through the government’s Operation Warp Speed program and the CDC. After the requests are made, OWS and CDC make allocation decisions, which then get turned to orders which then filter down to McKesson.

“We receive that order, we walk into the dedicated facilities that we built that are securely storing this vaccine. We do the pick, pack and ship, believe it or not in a freezer to maintain the temperature controls of this vaccine and we work with our partners, UPS and Fedex to ship those products out to provider sites usually within 24 hours,” Tyler said. “And I believe our accuracy rate right now is in excess of 99.99 percent, so I’d say the distribution component has been remarkably well…”

Tyler noted later that the company only delivers Moderna’s vaccine as Pfizer is directly managing its own distribution through partners like UPS, Fedex and others.

But he noted that that the process needs to be refined to compress the time it takes to bring it to providers and then delivered to people. The initial plan by the CDC was to have people vaccinated in waves starting with the people with high exposure – frontline health workers, those living in long-term care facililties and essential workers. However, on Monday, the agency announced thatit was recommending people over 65 should be vaccinated immediately and would release all reserved doses.

Stephane Bancel, CEO of Cambridge, Massachusetts-based Moderna, which developed one of two vaccines currently with emergency use authorization in the U.S., described the problems in the vaccine rollout as “teething problems” that should be short-lived. He also added a caveat saying that Moderan is not involved with administering the vaccine, stressing the company’s stance from a day earlier where its chief medical officer declared that he considers the job complete when the vaccine is delivered.

“I think because of very tight supply, the allocation was a big struggle, and I think in some places people spent too much time thinking about allocation …versus shooting vaccines in arms,” Bancel said. “As more and more supply is available and as we use the enterprises like CVS Health and other pharmacy chains and stadiums and other things for vaccination, I think the numbers are going to go up significantly.”

CVS Health’s incoming CEO, Karen Lynch, explained that more than 40,000 long-term care facilities selected the pharmacy retailer to vaccinate their residents and the states then decide allocation.

“So once the states turn or activate those nursing homes, we’re able to go in with our pharmacy techs, our pharmacists and nurses and put the shots in the arms of those in the individual nursing homes,” Lynch said.

She added that once the federal program for mass vaccination open ups, it would create a more direct distribution into pharmacies nationwide.

“That will open up the ability for acceess of individuals to go to their community-based pharmacy so that we can have more people getting vaccinated,” she said. “We have the capacity to do 20-25 million vaccinations a month through all of our retail locations and what that means is we can do a million a day.”

Angela Hwang, group vice president of Pfizer Biopharmaceuticals group, noted that Pfizer has distributed 30 million doses to date to about 10,000 vaccination sites. [The U.S. meanwhile has vaccinated only 9 million.]

“Consistent with what you’ve heard [on this panel] it’s gone remarkably well,” Hwang said before going on to list all the steps the company has taken to secure, store, monitor and track the vaccine boxes making sure that they are kept in the requisite low temperature. However, unlike Moderna’s Bancel, Hwang said that Pfizer is also invested in the successful administration of the vaccine.

“We have also provided a tremendous amount of training and support at the points of vaccination because we believe that our job ends when the vaccine is administered not just when we drop off,” Hwang said.

This was a slight jab at the stance that Tal Zaks, Moderna’s chief medical officer took on Tuesday when he said that he considers the job done when the vaccine is delivered at the provider site. Though to be fair, unlike Pfizer, Moderna is only a decade-old organization with the Covid-19 vaccine as its first commercial product.

The comments from the different CEOs appear to lay the blame somewhat on the federal and state level since its CDC and OWS that make decisions on allocation. Meanwhile, Moncef Slaoui, the face of OWS and the U.S. vaccine effort, who was also on the JPM panel Wednesday, appears to have reportedly resigned, a development that was not addressed during the panel. He appeared to talk in broad generalities about the vaccine effort.

“Where things need to improve is in the capacity of the healthcare system in general without getting into the politics of whether it should be the states or the federal level…,” Slaoui said. “We need to improve the speed with which we are able to deliver these vaccines in the arms of people. That’s our no. 1 key area going forward. I would say other areas that require absolute continuous focus are to continue to streamline and optimize the supply chain.

Photo: Pornpak Khunatorn, Getty Images

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