Overcoming the Top Challenges of COVID-19 Vaccine Distribution

Experts believe there will be various challenges with effective COVID-19 vaccine distribution in the US.

A new Kaiser Family Foundation report outlines the government’s COVID-19 distribution plan and offers ways to combat the pressing issues that a vaccine approval may bring.  

Currently, there are seven promising COVID-19 vaccines in clinical trials from top pharmaceutical companies, including AstraZeneca, Johnson & Johnson, Merck, Moderna, Novavax, Pfizer, and Sanofi/GSK.

But there are many questions regarding the roles of federal, state, and local governments, financing and coverage of a vaccine, and how to address racial disparities, communication, and public trust through a distribution plan.

Currently, the government has a rough plan of what vaccine distribution could look like in the US once one is approved in early 2021.

On August 4, the CDC provided state and local health departments with action steps to inform development of COVID-19 pandemic vaccination plans. 

Then in mid-September, CDC said jurisdictions are required to develop and submit vaccination plans by October 16, 2020. And the Trump Administration’s Operation Warp Speed (OWS) provided Congress with a federal vaccine distribution strategy at the end of the month. 

The documents provided four necessary tasks to guide public health programs on how to strategically plan and operationalize a vaccination response to COVID-19. 

But even with a plan in mind, experts still have many outstanding questions regarding potential issues. The issues considered characteristics of potential vaccines and the complexity of the pandemic itself, including health and economic impacts. 

One vaccine concern cited in the KFF report was the inadequacy local governmental distribution networks for COVID-19 vaccine distribution because the networksare mainly versed in delivering childhood vaccines and not adult vaccines. 

Researchers stressed that governments must significantly expand their distribution channels and partnerships for vaccine administration to reach target groups with a COVID-19 vaccine.

Additionally, when a COVID-19 vaccine is approved, there will only be few doses available early on, so the doses will need to be rationed. 

But the rollout for these vaccines will be unpredictable. Therefore, it is important that flexibility is implemented and realistic expectations by federal officials on initial supply are set forth.

Another major issue with current vaccines is that several of them must be preserved at extremely cold temperatures, which requires specialized equipment not readily available at many sites.

But one solution to combat this issue is to implement a distribution approach that involves distributed networks of federally managed cold chain sites and use of mass vaccination to reach target populations, KFF stated.

Currently, many of the leading vaccine candidates require two-doses for immunization and will require careful tracking of doses and follow-up with each individual. But this presents its own set of challenges.

To address this issue, the CDC and local jurisdictions are currently in the process of implementing a new vaccine tracking system to monitor COVID-19 vaccine administration and help with multiple dose tracking.

Finally, vaccines may be released on an accelerated schedule and some may be administered under an emergency use authorization without having gone through a full safety review initially. 

Therefore, the government is planning on implementing enhanced safety monitoring to track vaccine adverse events, researchers noted. This will ensure the safety of the vaccines and establish evidence of any adverse events in the months following administration. 

The pandemic has had devastating health and economic impact and disproportionate impact in some communities, particularly communities of color.

A KFF report released last week found that 49 percent of Black Americans would not get a COVID-19 vaccine even if it was determined safe and effective. 

But one simple way to combat this issue is effective outreach strategies developed in partnership with and directed toward communities of color. This will be critical to building public trust and willingness to get vaccinated, researchers stated.

Communication and trust of all Americans are also major issues in the current pandemic, specifically regarding a COVID-19 vaccine.

Nearly half (51 percent) of Americans said they would definitely or probably get a COVID-19 vaccine if it were available today, a September KFF report found.  The most common reasons given by the participants included the safety and efficacy of the vaccine.

Researchers explained that a multi-pronged communication approach, including efforts to counter the public perception that politics is driving the vaccine approval process, will give Americans more confidence that the vaccine will be safe and effective.