castevens

Just for clarification, we still need to consider the intricacies of the concept of a vaccine “coming out next month”. Let’s say FDA approval of a vaccine was granted a month from today (and ignore the fact that zero of the currently leading Phase II vaccinations will have sufficient safety and efficacy data to meet that threshold).

The manufacturer would need to scale up purchasing of raw materials to create >200 million vaccinations. And that assumes that the entire first wave of vaccinations are intended ONLY for Americans. This will surely cause a shortage in the supply chain for whatever raw materials are necessary. The preemptive scale-up of plastic syringes will help this a lot, but doesn’t address the actual raw materials needed for the medicine itself. The vaccine will be in short supply for months.

Once some actual vaccinations start coming off the “completed” end of the conveyer belt, they need to be distributed to wholesalers (Cardinal, AmerisourceBergen, etc) for distribution to clinics and hospitals. This will be a logistical challenge and I’m not sure how they will determine how many to send where. Likely high risk areas first. Similar allocation strategies we’re seeing with Remdesivir right now.

Once they distributors have them, a similar logistical challenge will be to distribute to health systems. And the health systems themselves will need to scale up nurses and pharmacists and other healthcare professionals to actually administer the vaccinations, as well as figuring out spaces and schedules to bring in patients. It will take many months to administer >200 million vaccinations.

All that said, even when the “last person” gets vaccinated sufficient to achieve a theoretical herd immunity, there’s STILL another two weeks before that person will confer immunity to the virus.

Thanks for doing this!

How do you feel that the rollout has been going so far? It feels like there have been issues with purchasing, distribution, storage, prioritization, scheduling, and administration at most/all places. Do you think this is a product of lack of preparation on the state and/or national level, or some other explanation?

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