Lining Up the Shot(s)
BY RANDY LOVING, CFA
As the world’s greatest race to develop a vaccine for coronavirus is entering its final phase, we are starting to see preparations for distributing the vaccine. Near the end of August the Centers for Disease Control, who runs vaccine distribution in the US, sent out a letter to state departments of health asking to fast track the approval of vaccine distribution sites so that they are ready for November 1st.
Fortunately, this was not the beginning of the planning for the vaccine. In June, the US spent $350 million on vials and syringes. That’s good since the top two vaccine candidates in the US will need them. In total, the US has supported development of seven candidates with about $10.3 billion in funding. Two drugs that are important to the US are currently in phase three testing. These are the drugs being developed by Moderna and Pfizer. Both offer unique challenges to distribution and both need to be cold. Really cold.
The Moderna drug needs to be stored at -4 degrees Fahrenheit in order to not have shelf life issues. The drug has a 2-week shelf life once it has been moved to a regular refrigerator. Each vial will hold ten doses and goes bad in six hours once the first dose has been administered. Compare this to the Pfizer drug and distribution looks simple. The Pfizer drug is stored at -94 degrees Fahrenheit – incidentally the same temperature at McMurdo Station in Antarctica on Memorial Day. It has a two-day shelf life and a six-hour shelf life once the first of each vials five doses has been administered. In addition, the Pfizer drug needs to be mixed with a sterile liquid like medical grade water to activate. Each of these vaccines – and six of the seven the US has provided funds for – requires two shots.
The difference in handling needs will likely affect who gets which vaccine. We know that healthcare workers and first responders will be first in line once the vaccines are available. The Pfizer drug will be shipped directly to the distribution location – for this drug likely a healthcare facility due to the need for significant refrigeration. This is likely the drug for frontline workers and anyone living around a larger city.
By comparison, distribution of the Moderna drug will be simple and can be handled by McKesson, who the Government has contracted with to distribute the drugs. Most pharmacies and other existing healthcare facilities can handle the storage requirements. Because McKesson as an established distribution network, this drug is likely to go out to lesser-populated areas.
The US has supported five other drugs beyond these. Most of these five will be available in 2021, including one that does not need refrigeration. As this piece is being written, the Astra Zeneca vaccine has paused its trial due to the adverse reaction of one of the studies patients. The US has financially supported this drug, but none of the potential supply has been figured into any of the CDC’s planning. In short, it is one of our country’s back-up plans.
The vaccines are on their way and fortunately, the CDC has been busy planning for their distribution. That’s good news and should allow for the economies gradual re-opening to continue.
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