- States have begun distributing Pfizer and Moderna COVID-19 vaccines to essential workers and people over 65, while other vaccine candidates from AstraZeneca and Johnson & Johnson are in the works.
- President Biden has promised to deliver 100 million vaccine doses to Americans in his first 100 days in office.
- Doctors explain the logistics of distributing a COVID-19 vaccine nationally, who will be among the first to receive it, and when to expect your dose.
Less than a year since the COVID-19 pandemic began, multiple vaccines are currently being tested and deployed around the world—the fastest such effort in history. Pfizer-BioNTech and Moderna have both received emergency use authorization (EUA) from the Food and Drug Administration for their respective vaccines, and other options using different tech, including ones from AstraZeneca and Johnson & Johnson, are inching closer to approval.
In short, the immunization effort is in full swing—although the process has been rocky due to unclear federal guidance, difficult vaccine storage, and changing presidential administrations. Despite the challenges, the vaccines offer a glimmer of hope, especially as coronavirus infections continue hit all-time highs in the U.S.
As President Biden takes office and new variants of the virus are discovered, vaccine production and distribution are poised to ramp up dramatically. Here’s everything we know about when you can expect to receive the COVID-19 vaccine.
First, what should I know about the COVID-19 vaccines?
Pfizer shared last year that its vaccine is 95% effective in keeping people in phase 3 clinical trials safe from COVID-19 infection. Pfizer’s study, which included 41,135 participants who received both necessary doses, has reported no serious side effects or safety concerns. The company should be able to produce up to 1.3 billion doses in 2021.
Moderna’s clinical trial, known as the COVE study, enrolled more than 30,000 people in the U.S. and found that its vaccine was also 95% effective at preventing COVID-19 infection in those who received two doses. Like the Pfizer vaccine, it has no reported serious safety concerns. Moderna says it can produce 500 million to 1 billion doses globally in 2021.
Both vaccines, which do not contain the actual novel coronavirus, use a newer technology called messenger RNA (mRNA) to create an immune response in people after they receive two shots. In essence, they introduce a piece of genetic code that tricks the body into producing COVID-19 antibodies. Neither mRNA vaccine can infect someone or make them sick with COVID-19.
Other options that could soon reach the U.S. rely on different solutions. AstraZeneca’s and Johnson & Johnson’s vaccines use adenovirus-vectored tech, modifying weakened cold viruses to safely trigger production of COVID-19 antibodies—and both appear to be around 90% effective, depending on the dosage. AstraZeneca will produce up to three billion doses this year, already distributing them in places like the United Kingdom and Mexico; Johnson & Johnson pledged 100 million doses within the first half of 2021, but has hit production delays. More vaccines are also in the works from other pharmaceutical companies worldwide.
None of these vaccines appear to cause any serious harm to people. However, if you have a history of a severe allergic reaction to any of the ingredients in a particular vaccine, or have a history of a severe allergic reaction to any vaccine or injectable therapy, ask your doctor if you should get the COVID-19 vaccine, per the Centers for Disease Control and Prevention (CDC).
How will the COVID-19 vaccines be handled and distributed?
“There are major logistical challenges in getting the vaccine distributed to every part of the country—and the world,” says infectious disease expect Amesh A. Adalja, M.D., senior scholar at the Johns Hopkins Center for Health Security. This includes equitable distribution and making sure that diverse populations can be reached.
First, the vaccine has to be manufactured, and then shipped to locations that have signed up to receive it. “The Pfizer vaccine requires special shipping and handling because it has to be kept very, very cold,” at a frigid -94°F, explains William Schaffner, M.D., an infectious disease specialist and professor at the Vanderbilt University School of Medicine. “It won’t go to your average doctor’s office or pharmacy—they won’t be able to store it.” Instead, it will have to be distributed to locations with specialty storage containers.
The Moderna vaccine, however, seems as if it will be handled “the way normal vaccines are handled,” Dr. Schaffner says. That means it can be shipped on dry ice and stored in regular freezer temperatures (-4°F) in pharmacies and doctor’s offices.
And that’s not the only good news: Adenovirus vaccines are much less fragile than mRNA ones, and both options nearing approval remain viable at temperatures between 36 and 46°F, or normal refrigerator temperatures. Johnson & Johnson’s vaccine is stable for up to three months at those temperatures; AstraZeneca’s, up to six months.
The vaccine will be free, he notes, because it was funded by taxpayer dollars. However, there may be administration costs for providers, like doctor’s offices and pharmacies. (It’s unclear at this point if insurance companies will cover that.)
Vaccine distribution is never as easy in real life as it sounds on paper. Under Operation Warp Speed, states were largely left to handle distribution and inoculation themselves, with little guidance from the federal government. Confusion seems to have led to an underwhelming vaccination effort. While more than 37 million doses have been distributed, per the CDC, just over 2 million Americans have received both doses—two shots are needed to efficiently fight the virus.
Who will get the COVID-19 vaccine first?
The CDC has released initial framework for this. Here’s what distribution is expected to look like, provided there are no issues with supply:
- Phase 1a: Healthcare workers and long-term care facility residents will be the first to receive the vaccine.
- Phase 1b: Essential workers, including teachers, police, firefighters, utility workers, corrections officers, and transportation employees, will be next.
- Phase 1c: This includes adults with underlying conditions that put them at significantly higher risk of severe COVID-19 disease or death. Older adults (age 65 and up) are also included in this group.
Top government officials, including President Biden and Vice President Harris, are also receiving the vaccine to ensure continuity of government.
The CDC has not addressed distribution beyond phase 1. However, the National Academies of Sciences, Engineering, and Medicine released framework for this in October. That framework also put teachers, school staff, and workers in the food supply chain in phase 2. It also included the following phases:
- Phase 3: This group includes young adults, children, and workers in industries such as colleges and universities, hotels, banks, exercise facilities, and factories “that are both important to the functioning of society and pose moderately high risk of exposure because there are likely to be some protective measures implemented in these work settings.”
- Phase 4: This includes everyone else in the U.S. who did not have access to the vaccine in previous phases.
When will the COVID-19 vaccine be widely available?
Again, first and second rounds of the vaccine are currently being distributed, says Thomas Russo, M.D., professor of medicine and chief of infectious disease at the University at Buffalo in New York. Doctors, nurses, grocery store workers, people over 65, and other high-risk individuals have all begun the vaccination process in some parts of the country, and the framework has varied among states.
Most people, however, will likely have to wait until later this year to be vaccinated. “It is unlikely that the general public will have access to the vaccine until late spring to summer of 2021,” Dr. Adalja says. “It is very likely that there will be multiple vaccines that receive emergency use authorization and are distributed to individual states for vaccine programs.” That means the vaccine you’re able to receive may be different from the one your relative who lives across the country receives.
The incoming Biden administration plans to dramatically ramp up the vaccine rollout, too. Before taking office, President Biden unveiled a coronavirus relief package that includes a pledge to vaccinate 100 million people within his first 100 days. The president also plans to invoke the Defense Production Act, which was previously used to produce N95 masks, to stimulate vaccine production. Other new policies include opening more immunization sites and encouraging vaccination for essential workers and those over 65. Operation Warp Speed itself is also being scrapped in favor of a more unified federal response.
The change in pace can’t come soon enough, as the fumbled rollout results in vaccines being thrown away or left to spoil. There is no data on just how many doses have failed to reach Americans, but new reports suggest that the number could be alarmingly high as hospitals and healthcare providers struggle to keep up with storage requirements and rising cases.
For now, public health officials are still sorting through the details—but moving quickly as deaths continue to surge in the U.S. “By March and April there will be more widespread availability. At least, that’s what I hope,” Dr. Russo says. “But I’m an optimist.”
Additional reporting by Jake Smith
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