The Race to Distribute a COVID-19 Vaccine
Wednesdays with Woodward webinar
January 14, 2021
As the world continues to fight the pandemic, new hope arose in December 2020 when both the Moderna and Pfizer-BioNTech COVID-19 vaccines received Emergency Use Authorization from the U.S. Food and Drug Administration (FDA). Former FDA Commissioner Dr. Mark McClellan joined Wednesdays with Woodward to provide an update on the fast-tracked rollout, discuss the unique distribution challenges and share his outlook for containing the global pandemic.
An Unprecedented Achievement
Dr. McClellan lauded the extraordinary pace of COVID-19 vaccine development, “having millions of shots in arms” in less than a year from the virus’s initial outbreak. Additionally, both the Moderna and Pfizer-BioNTech vaccines have set a high bar, he said, with more than 94% efficacy in preventing COVID-19 symptoms. He emphasized that we will not know for several months whether these vaccines prevent asymptomatic carriers from infecting others. For that reason, Dr. McClellan urged everyone to continue to wear masks, wash hands and social distance, even after being vaccinated.
Based on the number of doses ordered, and depending on the results of trials from Johnson & Johnson and Novavax, Dr. McClellan expected that vaccines would be available in the United States for anyone who wanted to be vaccinated by the end of the second quarter of 2021. Additionally, he anticipated that there will be hundreds of millions of doses available worldwide this year.
Adapting the Distribution Strategy
Dr. McClellan underscored that the country has never seen an implementation program on this scale before, which aims to vaccinate the vast majority of the U.S. population, with multiple vaccines available, requiring multiple doses, in the midst of a global pandemic. Initially, the U.S. Department of Health and Human Services (HHS) recommended that states prioritize vaccine distribution to front-line health care workers and nursing home residents. However, Dr. McClellan shared that hospitals, nursing homes and public health agencies, which had already been stretched thin addressing the “peak levels” of COVID cases, have fallen behind in administering the vaccine.
On January 12, 2021, HHS announced a change to the distribution strategy, recommending that states open the process to anyone over 65 years old and to others with certain high-risk health conditions. Already, the pace of vaccinations has picked up, Dr. McClellan explained, rising from some 200,000 vaccinations per day initially to nearly 800,000 per day. He expects the country to administer 1 million doses per day for each of the first 100 days of the new presidency, the stated goal of the Biden administration, starting as soon as next week.
Addressing Vaccine Hesitancy
While initial groups have been enthusiastic about receiving a COVID-19 vaccine, there are still many Americans who are “vaccine hesitant,” Dr. McClellan noted. These views are disproportionately represented among rural, low-income and minority populations for a number of reasons, he shared, and those populations are also some of the hardest hit by the pandemic. Dr. McClellan expects we will see disparities start to emerge, with high rates of vaccination among some populations, and bigger gaps in others.
“We’re not really going to have this pandemic under control until we get to high levels of immunity in every group and population. So there is some hard work ahead,” he said.
New, highly contagious coronavirus strains found in England and South Africa have been, in part, responsible for driving faster distribution strategies in the U.S., according to Dr. McClellan. He explained that the COVID-19 vaccines work by attacking different recognizable parts of the SARS-CoV-2 virus and thought it likely that current vaccines would be effective against the existing strains. That said, as viruses constantly mutate, over time, current vaccines are likely to be less effective. Dr. McClellan recently shared his recommendations for addressing COVID-19 variants in a Jan. 10, 2021 op-ed in The Wall Street Journal, co-authored by Scott Gottlieb.
Presented by the Travelers Institute, the Duke-Margolis Center for Health Policy, the Partnership for New York City and the Small Business & Entrepreneurship Council.
Joan Woodward, President, Travelers Institute; Executive Vice President, Public Policy, Travelers
Mark McClellan MD, PhD, Former Commissioner, U.S. Food and Drug Administration; Robert J. Margolis Professor of Business, Medicine, and Policy, and founding director, Duke-Margolis Center for Health Policy, Duke University