Why distributing Covid-19 vaccines will be more difficult than creating them

Every day of the year, the U.S. Centers for Disease Control and Prevention and state health authorities ensure that vaccines for children, like those for influenza or hepatitis B, among others for adults, travel thousands of miles from the factory where they are produced to hospitals, doctors' offices and pharmacies, which in turn properly store the doses and distribute them to individuals.

  • These same institutions ensured that in 2009 the H1N1 vaccine reached the populations that needed it.
  • While it is doubtful that it will reach the end of October, that is the target date for preparations.

Video - How much it costs to develop a vaccine.


That speed is possible because these two candidates are not traditional vaccines, which work with biological material such as a fragment of an inactive or attenuated virus that is grown, which requires time: instead of injecting a fragment of a pathogen, they operate with the virus' genetic material, RNA, and only introduce into the body the instructions to create, in these cases, the SARS-CoV-2 spike protein, which stimulates the immune system's response.

Alternatives, which are laborious but, since the vaccine is too precious to waste, they emerge as reasonable.

Since coronavirus RNA vaccines are the first of their kind, they will prove, along with their effectiveness against SARS-CoV-2, that the genetic platform is viable.

This leaves a wide margin for uncertainty, and it cannot be ruled out that in the future, with more experience, it will be possible to move and store them at less extreme temperatures, for example if a formula made with freeze-dried versions that can be kept in an ordinary freezer thrives.

Given the novelty of the platform, the second dose has to come from the same producer as the first, 28 days after the application, in the case of Moderna, and 21 days in the case of Pfizer.

In both cases, the period is longer than the vaccines can be kept, so the second dose will have to come from a second supply batch, and in order not to mistake the origin, an intense administrative control will be necessary.

States maintain electronic immunization records for children, but in the case of COVID-19, adult physicians, who are unfamiliar with pediatric systems, will need to operate as well.

Among the issues highlighted was that CDC requires identifying information on individuals that some states' laws do not allow to be shared from their current immunization records.

But perhaps the biggest drawback to double-dosing is that it's against human nature: People forget the second dose, can't take time off work, can't find a place to leave their children, move to another location where the provider of the first dose they received can't get to, Zhang listed some examples.

Emergency use versus normal approval If vaccine distribution is rushed by authorizing emergency use instead of going through the normal Food and Drug Administration authorization process, hospitals will encounter the problem that many health insurance companies - including Medicare, the elderly, and the disabled - do not cover such options.

So until the government pays for the costs of the vaccine, its storage, and the disposable supplies to give it, they will have to pay for it directly.

Behind the two most advanced in the United States are two others that will follow: AstraZeneca, which is being researched by Oxford University, and Johnson & Johnson's.