Absence of COVID-19 Vaccine Delivery Plan Could Shake Public Trust

It appears like the long search for a vaccine that will potentially stop the epidemic is coming to an end. Two of the candidates have declared promising outcomes for their initiative: Pfizer and Moderna. Vaccinations are also scheduled to begin in the next few months.

It is positive news here. The bad news? This is only the start of a new problem. We have never experienced the need to vaccinate more of our citizens at once before. This would be the most detailed and nuanced immunization program in human history, as per Este Geraghty.

Complexities

The issues will be the detection and prioritization of disadvantaged groups for immunization, both in terms of supply chain management. If it is not enough the Pfizer vaccine should be kept below negative 70 degrees Celsius. 

Breaking the cold chain could make it worthless at some time. This alone would take Herculean efforts that require many new innovations to act in flawless coordination to distribute each dosage safely.

Even for a vaccine that involves "normal" storage temperature, experts like Moderna have already cautioned that even the United States does not have the requisite trucks and freight aircraft to transport hundreds of millions of doses at sub-zero temperatures. 

Imagine shipping it to every corner of the world's 195-odd nations, even some of the most isolated and inhospitable areas. Significant areas of Asia, Africa and South America are currently seriously missing cold-chain logistics technologies necessary for life science goods.

Longer distances would need to be traveled by air considering the urgency, rendering the sheer number of exports a problem. For example, DHL predicts the need for 15 million shipments in cooling bins, 200,000 transfers by pallet shippers and 15,000 flights through different supply chain setups, assuming 10 billion doses are to be delivered across two years.

The maximum volume of vaccine required to immunize the whole world populace would not be accessible at once to contribute to the risks. It will be developed and distributed in steps. The best and most fair approach is to first vaccinate individuals on the front lines with the greatest probability of exposure to the infection, health care staff. 

The emphasis would be on those that are more likely to have chronic diseases, such as elderly adults and others with some medical problems, as well as those in environments that may improve the spread of the virus, including those residing in nursing homes, college dorms, and hospitals. This implies many multi-location trips.

And so if it's a two-dose vaccine, worry about the same issues all over again! So far, the highest candidate vaccinations require two doses each, but they are delivered at separate times. 

Besides, one vaccine candidate needs ultra-cold storage, while the other has a more common need for cold storage. This suggests that certain areas will not be able to fulfill storage criteria for both vaccinations and that for the correct delivery of both doses, the processing of the vaccine would need to be closely controlled separately for individual delivery.

Is it going to break public trust?

Nina Schwalbe's opinion article in the Heilbrunn Department of Community and Family Health at Columbia Mailman School of Public Health, released in BMJ, calls for a nationwide vaccination plan now that vaccinations for COVID-19 are available.

Schwalbe claims that a lack of transparency on a delivery schedule sets unreasonable public standards which can damage public faith. But it won't be easy, even with a well-established plan in place, to vaccinate hundreds of millions of Americans. View the report in detail here.

The Columbian Professor states that vaccinations can not deliver themselves. Schwalbe, who is also a Principal Visiting Fellow at the International Institute of Public Health of the United Nations University, underscored that vaccinations need a secure, trusted, and open mechanism of immunization.

To resolve the medium to long-term elevated COVID-19 mortality rates, Schwalbe advises establishing reasonable standards on the position of vaccinations in the answer to COVID-19 and explicitly expressing such expectations.

She further encouraged the United States government to implement a parallel pledge to affordable health care to better support all individuals who are susceptible to underlying conditions.

Schwalbe also said manufacturers could also collaborate with communities individually to create a strategy that answers their needs and engages them to recognize logistical difficulties.

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