The frustration that vaccines are not showing up in the quantity, and on the schedule, that states were promised continues to grow. The distribution was called a logistical nightmare months ago, and despite a stack of promises from Donald Trump, that nightmare is coming to pass as federal sources utterly fail to get the vaccine where it’s needed in the appropriate quantity. As a result, three weeks after the first vaccine became available, the rate of vaccination is still running well below the rate of new COVID-19 cases. Getting 80% of the populace vaccinated at the current rate would take a decade … only it wouldn’t matter, because long before then the vaccine would have ceased to function for most of those previously vaccinated.
Handling of the vaccine has been so dreadful that Texas is being forced to throw away thousands of doses because they were allowed to get too warm in transit. Meanwhile, concerns about keeping vaccines frozen have other shipments on hold. Based on current data, Joe Biden’s nominee for surgeon general has indicated that the odds of the vaccine reaching the general public by spring are actually getting worse. Plans to vaccinate 20 million Americans by year’s end now seem to be “out of reach.”
As Bloomberg reports, at least three shipments of the Moderna vaccine had to be rejected after they arrived in Texas with signs that they had overheated en route. Considering that Moderna’s vaccine can tolerate a much greater temperature range than that of Pfizer/BioNTech, which requires deep cold to remain viable, this seems like a serious oversight. Most of the transportation for Moderna’s vaccine was subcontracted to Texas-based pharmaceutical distributors McKesson Corporation, which made the news in 2017 after whistleblowers called the company out on its role as the nation’s largest distributor of opioids.
While those lost doses were replaced by federal sources, doing so meant tapping into supplies meant for other locations. In addition to the shipments that were lost in transit, more doses of vaccine were delayed after it was found that temperature sensors were either in error or reporting improper storage temperatures.
The concern around cold storage is just one of the reasons for logistical difficulties over the last month. However, none of this should have been a surprise. Both Pfizer and Moderna made the temperature ranges required by their vaccines clear months ago. It should have been no surprise that cross-country shipping of these materials was going to create a demand for dry ice, or that equipment for generating very low temperatures was needed at storage facilities.
As Kaiser Health News reported on Dec. 24, the problems with the vaccine rollout are almost endless:
- Dozens of states didn’t receive nearly the number of promised doses
- Millions of doses sat in storerooms because no one from Trump’s Operation Warp Speed task force told companies where to ship them
- Failure to provide cold storage facilities means that the vaccines are being held far from where they are needed
- Uneven regulations mean that some states—like Florida and Texas—have diverted vaccine from front-line workers to other populations
- Badly written rules mean that in some locations, emergency room doctors were passed over in favor of administrators “even though they work from home and don’t treat patients”
While Operation Warp Speed CEO Gen. Gustave Perna has expressed personal failure and accepted blame for the vaccine issues, Kaiser notes that “it’s really mostly not his fault.” Instead, the problem lies with a fragmented, privatized, profit-based healthcare system that lacks all central authority. Combine that with a federal response that has in all cases done little more than create “recommendations” that states can overlook, and it’s a perfect formula for chaos.
It didn’t have to be that way. Trump could have invoked the Defense Production Act both to help produce and distribute vaccines. He could have issued not “CDC guidelines” but executive orders mandating how vaccines were to be delivered and prescribing the order of care. If he really wanted to use the military, it might have been medics providing vaccinations at thousands of pop-up sites. However, as Kaiser notes:
Instead of a central health-directed strategy, we have multiple companies competing to capture their financial piece of the pandemic health care pie, each with its patent-protected product as well as its own supply chain and shipping methods.
For Moderna and Pfizer, the payday comes when they hand over the vaccine to the federal government. Delivering it to individual facilities, and seeing that it gets into American arms, is really not their concern. Unfortunately, it also doesn’t seem to be Trump’s concern.