State leaders are grappling with how they would obtain and distribute a future COVID-19 vaccine. During a meeting with state lawmakers Wednesday, health officials and medical and pharmaceutical experts described a lack of national coordination and logistical challenges to distributing vaccines, while legislators questioned who will be able to get the vaccine first.
Even before there is a COVID-19 vaccine, the federal government has agreed to buy millions of doses.
“It's our expectation that the U.S. government will indeed be procuring these doses in the hundreds of millions from the various companies if they are successful, of course, with clinical trials and FDA approvals,” said Phyllis Arthur, vice president of infectious diseases and diagnostic policy for Biotechnology Innovation Organization, a trade organization.
From there, Arthur said, the Centers for Disease Control and Prevention would be responsible for distributing the vaccine to the states.
However, the details are still being worked out.
“Right now we do not exactly know what the national-level coordination will look like,” said Wilbur Chen, who specializes in infectious diseases and vaccines at the University of Maryland Medical System and is on both Gov. Larry Hogan’s COVID-19 task force and the CDC’s Advisory Committee on Immunization Practices.
He said he does not anticipate that healthcare systems like the University of Maryland will initially buy vaccines in an open market, but rather, that the state government will allocate them. Whether the state itself will have to compete in an open market with other states is less clear.
“I really don't want this to be that free market environment where every state had to fend for itself,” Chen said. “I think people at higher levels are probably trying to plan as best as possible to avoid that situation.”
After getting the vaccines, the next challenge will be transporting them across the state and storing them, a task made more difficult because they will need to be refrigerated. One vaccine under development by Pfizer needs to be stored at negative 70 degrees Celsius.
“I'm expecting that there's already a national run on refrigeration units of all sorts,” Chen said. “There may be a national run on dry ice and liquid nitrogen and other ways to maintain cold temperature.”
The state is looking into buying some cold storage capacity, said Jinlene Chan, deputy secretary for public health services at the Maryland Department of Health, as well as other supplies, such as syringes and alcohol wipes.
That said, it could be a while before many of those supplies are needed because the initial supply of vaccines will be limited.
The first batch is slated to go to healthcare workers, first responders and people who live or work in congregate care facilities.
A few legislators pushed to expand the groups prioritized for a vaccine.
Sen. Delores Kelley, a Baltimore County Democrat, questioned why teachers, sanitation workers, or daily public transit users are not being prioritized.
“I hope you are considering essential workers of all kinds and not just those that have formally been included in the operational definition,” Kelley said.
But Chan said there may not be enough doses even for those groups that are part of what’s been classified as “phase one.”
She said it could be a year or longer before a vaccine is widely available.
Even then, just having an available vaccine won’t be enough to mitigate the pandemic, said David Marcozzi, an emergency medicine professor at the University of Maryland School of Medicine and a member of Hogan’s COVID-19 task force. He pointed to a recent Goucher College poll, in which nearly half of Maryland residents said they would not get a COVID-19 vaccine if it were available today.
Marcozzi said building public trust in the future vaccine is “fundamental” to its success.
“Vaccines do not save lives,” Marcozzi said. “Vaccinations do.”