DJ Why the Covid-19 Vaccine Is More Scarce Than the Flu Shot
Manufacturers of flu vaccine effortlessly distributed a record 193 million shots this season, even as makers of the Covid-19 vaccine have labored to deliver fewer than 60 million doses and states have struggled to get the shots into arms.
The disparity makes the Covid-19 response look like a train wreck -- but differences between the flu and coronavirus vaccines explain some (if not all) of the difference.
In a nutshell, there are fewer makers and distributors of the Covid-19 vaccine. It must be frozen at ultracold temperatures, making it difficult to ship and store. Full immunization requires two shots, compared with one for the flu. And because the serum is brand new, health-care providers must allow additional time to monitor patients for potential adverse reactions.
All of this must be documented to ensure the scarce vaccine isn't wasted; allergic reactions are captured; and second doses, which must be administered within a certain time frame, are properly executed.
"The challenge is that state health departments have to exquisitely monitor doses as they go in arms," said Litjen Tan, chief strategy officer of the Immunization Action Coalition, an organization that distributes information about vaccines in partnership with the Centers for Disease Control and Prevention. "With the flu shot, you get it and go away."
Currently, only Pfizer and Moderna manufacture Covid-19 vaccines available in the U.S., although versions from other manufacturers, including Johnson & Johnson and AstraZeneca, are planned.
In comparison, at least four major companies make flu shots, which are delivered directly to health-care providers by three major distributors and multiple smaller ones.
Only one distributor, McKesson Corp., delivers Moderna's Covid-19 vaccine for the federal government. Because Pfizer's vaccine must be frozen at more extreme temperatures, the company packs it in special thermal shippers and works directly with FedEx and United Parcel Service to move it.
"There are advantages and disadvantages to having a sole distributor," said Josh Michaud, associate director for global health policy at the Kaiser Family Foundation, a nonprofit focused on health issues. "It's easier for the government to work with one company. They're not juggling multiple contracts and points of contact."
When distribution of the Covid-19 vaccine increases, there will be "a potent argument" to expand the number of distributors, he said. "McKesson is large, but is it able to reach into every corner of every state? Others have relationships with doctors' offices and medical establishments."
Manufacturers of flu vaccine also have a head start.
Because the mechanisms for making and distributing flu vaccine are well-established, health-care providers are able to order shots in January or February that will be administered in the fall and winter. Production begins six to nine months ahead of distribution, which is then completed in phases over a period of about four months. This season's distribution began in August.
In contrast, the first Covid-19 vaccine was authorized for emergency use by the Food and Drug Administration on Dec. 11 and distribution began on Dec. 14. The states learn how much Covid-19 vaccine they'll receive about a week in advance.
"It's more of a just-in-time management strategy," said Crystal Tubbs, an associate director of pharmacy at Ohio State University Wexner Medical Center, which administers about 2,000 Covid-19 vaccines a day. "We're told five to seven days ahead of time how much vaccine we'll get the following week. Then we plan appointments."
Flu vaccine can be refrigerated, while Covid-19 vaccine must be stored at extremely cold temperatures.
Moderna's vials contain 10 doses of vaccine and must be frozen at minus 4 degrees Fahrenheit. Pfizer's vials contain five or six doses and must be frozen at minus 94 degrees Fahrenheit.
"We're talking brutally cold," Dr. Tan said. "That doesn't mean it can't be done, but we have to slow down. We have to be more deliberate and thoughtful."
After the vials are punctured, all of the doses must be used within six hours -- or discarded.
Once someone is vaccinated, they must be monitored for 15 minutes or, if they have a history of allergic reaction, for 30 minutes, to ensure they don't react badly.
The immunization isn't complete until a second dose is administered, and the final shot must occur within 21 days for the Pfizer vaccine and within 28 days for the Moderna product.
Because the Covid-19 vaccine is being given to a population with no previous resistance to the deadly disease, the goal is to inoculate as many people as possible.
"With the flu vaccine, around 50%, or maybe a little more, of the U.S. population gets vaccinated in a season," Dr. Michaud said. "With the Covid vaccine, the ultimate target is to achieve a herd-immunity level of vaccination. No one knows exactly what that is, but at minimum, it's 70%."
So far, the U.S. isn't even close.
Of the 55.9 million Covid-19 doses distributed as of Thursday, only 33.9 million have been administered, according to the CDC.
That includes 27.2 million people, or less than 10% of the population, who have received at least one shot, and 6.4 million, or about 2%, who are fully immunized.
The agency also estimates that 83.1 million people, or roughly 25% of the country, have been infected with Covid-19, although it's unclear how long their immunity might last.
Meanwhile, enough flu vaccine has been distributed to inoculate more than 58% of the population, and according to survey results, 53% of all adults have gotten it.
Write to Jo Craven McGinty at Jo.McGinty@wsj.com
(END) Dow Jones Newswires
February 05, 2021 05:30 ET (10:30 GMT)
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