Science is making incredible progress toward a COVID-19 vaccine, but as approval nears – potentially as early as December – worry has shifted to the complexity of distribution.
Overall, hopefulness was the theme of USA TODAY’s vaccine panel this month. After five months, the panel’s countdown clock to a widely available vaccine skipped forward another hour, to 8 a.m.
Companies and observers generally expect at least one COVID-19 candidate vaccine soon will receive a regulatory thumbs up. Dr. Francis Collins, director of the National Institutes of Health, joined the chorus Tuesday when he told NPR he was “guardedly optimistic” one or more of the candidates will be judged safe and effective by the end of the year.
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But reality is setting in about how hard it will be to get an approved vaccine into the arms of everyone who wants it – twice.
“The initial vaccine supply and the distribution and vaccination programs will not live up to the public’s desire for immediate, widespread access to a safe and effective vaccine,” said Dr. Kelly Moore, associate director of immunization education at the Immunization Action Coalition.
Health care workers and first responders are likely to be prioritized for an approved vaccine, followed by high-risk elderly.
Even those limited groups account for as many as 150 million Americans, said Dr. Paul Offit, a vaccine expert at Children’s Hospital of Philadelphia. Unless three vaccines win approval simultaneously, it’s unlikely enough doses will be available right away.
The two leading vaccine candidates have to be delivered in different ways, adding to the difficulty of getting the right vaccine into the right person. Both require two doses, but the Pfizer-BioNTech vaccine shots are given 21 days apart, while Moderna’s second shot is delivered at 28 days.
Moderna’s vaccine must be kept frozen. Pfizer’s has to be kept even colder – at minus-78 degrees Fahrenheit, the temperature of dry ice – meaning it needs different shipping and storing protocols.
Another variable is whether the vaccines will be equally effective in groups such as the elderly. Studies underway may show one vaccine is more effective than another among high-risk populations, adding even more complexity.
“It’s going to be hard,” Offit said, to get the right vaccine into the right person’s arm at the right time. And then to do it again with a second dose.
For the past five months, USA TODAY has asked a dozen or more experts in all aspects of vaccine development to gauge the progress on a COVID-19 vaccine.
We asked panel members to place vaccine development on a 12-hour clock, on which midnight, the starting point, is the moment in early January when the world became aware of the virus known as SARS-CoV-2, and noon is the time a vaccine will become widely available.
In late June, panelists put the time at 4 a.m.,