By Chris Adams
Aug. 10, 2020 – Researchers are racing to develop a vaccine for the coronavirus, but even once they have one, a major challenge looms in getting it to doctors’ offices, clinics and patients around the world.
The world’s public health professionals need to be getting ready now, well before a vaccine is developed, the executive director of the American Public Health Association told National Press Foundation fellows.
“The nation needs to be concerned about not just the vaccine being made, but how do you get it? Who’s going to buy it? How do you procure it?” asked Dr. Georges Benjamin. He spoke in a briefing with two other public health experts, who described the challenges faced at local, national and international levels to bring a still-undeveloped vaccine to 8 billion people.
They will also have to deal with the vaccine lag: How to keep people up to date on all the immunizations they needed before coronavirus came along. Families in lockdown have skipped all but essential errands; that means many have put off getting the 17 different vaccines they or their children need to stay health and comply with school mandates.
The medical establishment does have history of quick rollout of new vaccines. The most recent example was in 2009-2010, when an H1N1 flu swept the globe and the United States. While not nearly as lethal as COVID-19, the disease caused by the coronavirus SARS-CoV-2, the U.S. Centers for Disease Control and Prevention estimated there were 60.8 million cases, 274,304 hospitalizations and 12,469 deaths in the United States from that flu.
Dr. Julie Morita, now executive vice president of the Robert Wood Johnson Foundation and previously commissioner of the Chicago Department of Public Health, said that cities built on an existing framework provided by the federal Vaccines for Children Program to push the vaccine to healthcare providers.
“We identified and enrolled and distributed vaccine to healthcare providers spanning the spectrum of age,” she said. Chicago officials built on the children’s program to target adult providers, people who didn’t have regular access to healthcare providers, and healthcare providers who might not want to administer the vaccine or have the capacity to do so. The city also held mass immunization clinics for patients and residents who didn't really have healthcare providers.
Over 13 weeks ending in 2010, the city received an allocation of about 1.2 million doses of vaccine and distributed more than 1.1 million of those doses. Nationally, 138 million doses were distributed, Morita said.
Dr. Rahul Gupta, senior vice president and chief medical officer of March of Dimes and a former state health commissioner in West Virginia, pointed to other challenges facing the rollout of a coronavirus vaccine:
- Transportation: Creating a delivery system to get it to rural areas in the U.S. or developing nations and conflict zones around the world.
- Shortages: Ensuring enough vaccine in high-population centers in the U.S. and working around national efforts to hoard vaccine for internal use.
- Cost: Preventing price-gouging in the U.S. and other developed countries and helping impoverished people around the world pay for something they otherwise couldn’t afford.
All of those logistical challenges come as public health officials continue to battle efforts to question the safety of vaccines. Launching a vaccine on the public and simply saying “Trust us – take this” might backfire.
“A lot of the work for building trust in supply systems begins not when a vaccine is ready, but before that,” Gupta said. “That time is now, and we’re clearly not there.”