Five percent of all produced COVID-19 vaccine will be held back for emergencies and states will have the option of trading vials within the government’s ordering system to get the kind they want.
Those are just a few of the details we’re learning about how the vaccine will move around the nation as distribution comes closer, potentially as early as Friday or Saturday.
Paul Ostrowski, who leads supply, production and distribution for the federal government’s Operation Warp Speed, walked USA TODAY through the process.
Here’s what else we know: Operation Warp Speed, the White House COVID-19 initiative, plans to only ship half of all vaccine available each week. The other half will be held in storage and be released just before the second dose is due for those vaccinated the first time.
Two vaccines are in the final phases of the Food and Drug Administration emergency authorization process, with Pfizer and its partner BioNTech’s coming before the agency this week, followed by Moderna next week.
How will vaccine be shipped?
Because of the ultracold storage requirements of the Pfizer vaccine, it is being stored either at Pfizer production facilities or what are known as “freezer farms,” storage sites filled with row upon row of ultracold freezers about the size of a large home refrigerator, said Ostrowski.
Pfizer will ship its vaccine using UPS and FedEx as its main distributors. Moderna’s vaccine distribution is being coordinated by McKesson, the nation’s largest medical supply distributor.
Within 24 hours of the first vaccine being authorized by FDA it will be shipped to all 50 states and outlying U.S. territories.
“If they approve it on Friday, then we will ship on Saturday. If they approve it on Sunday, we will ship on Monday,” Army Col. R.J. Mikesh, Operation Warp Speed information Technology said at a briefing Monday.
How much vaccine is there?
As of last week, 6.4 million doses of Pfizer’s COVID-19 vaccine were ready to ship, said Gen. Gustave Perna, co-leader of Operation Warp Speed in charge of logistics.
Of that, 5% will be held back for a safety factor, said Ostrowski.
“The vendor is going to keep it in case we have a truck that goes down, we have vaccine that gets lost, a natural disaster hits or the power goes out,” said Ostrowski, who, until July, had been director of the Army Acquisition Corps.
That leaves 6.08 million doses of vaccine, which will then be split in half, half to ship out and half to remain stored, he said.
The Pfizer and the Moderna shots both require two doses, given 21 and 28 days apart, respectively. Operation Warp Speed wants to ensure there is always vaccine available for the second dose.
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“When we’re at about the 18th or 19th day, we’re going to move that product from Prizer’s location to the actual administration sites so that everybody that received their first dose has their second dose,” Ostrowski said.
That means that in the first round of vaccine deliveries, 3.04 million doses will be shipped. These are being divided up between the 50 states, the District of Columbia and six U.S. territories, with some also going to the departments of Defense and State, the Veterans Health Administration, the Bureau of Prisons and the Indian Health Service.
What’s the delivery schedule?
Once the initial doses have shipped, the system will begin regular deliveries.
Each week, whatever vaccine the authorized manufacturers have made will be divided. Half will be stored and the other half shipped out, said Ostrowski.
Each Thursday, Operation Warp Speed will ask vaccine producers how much vaccine they have made during the week. On Friday, staff will meet and decide how many doses can be allocated.
States will put in their orders on Saturday and deliveries will happen on Monday morning, said Mikesh.
Vaccine shipments will get what Ostrowski called “white glove” service.
“These packages are monitored in terms of temperature and also tracking. We’ll know where they are at all times,” he said.
For the Pfizer vaccine, each package about the size of a carry-on suitcase, must be signed for by the receiving pharmacy, hospital or clinic. The temperature controls will be inspected to make sure it has been held at the correct temperature during transit and the vials counted to make sure they’re all there.
UPS, FedEx and McKesson all have 24-hour hotlines sites can call if there are delivery troubles. In addition, Operation Warp Speed will have staff available 24/7, he said.
“We have two operations centers, one in Washington and one in Atlanta, both with 24-hour hotlines,” Ostrowski said.
How does OWS track doses?
Operation Warp Speed created a software system called Tiberius that allows states and local jurisdictions to order and track vaccine. It records all allocations of COVID-19 vaccines to states, territories, cities and federal entities, said Col. Deacon Maddox, OWS Chief of Plans, Operations and Analysis.
It works in conjunction with the Centers for Disease Control and Prevention’s Vaccine Tracking System, known as VTrckS,which has been distributing vaccine for children for a decade.
The systems also will allow networks to know who got their first shot and what kind it was and when they should get their second.
“Say you got your vaccination from a public health center in New York on Dec. 15 and now 21 days later you’re in Florida because you’re a snowbird and you who up at CVS,” Ostrowski said.
“We need to be able to pull up your name so we can show that it’s you and that you get the right vaccine,” he said.
Those systems will store as little personal information as possible to protect privacy. They won’t include Social Security numbers or driver license numbers, said Maddox.
“The only number that it would ask for is a date of birth,” he said.
Lower-tech systems also will be in place. Each dose of vaccine will come with a card that tells the recipient which vaccine they got and when they should come back for their second dose.
They’ll also be encouraged to take a picture of the card with their phone in case they lose their card.
“It’s backup to a backup to a backup,” Ostrowski said.
How can states trade vaccine?
Tiberius will also include an exchange system where states can trade vaccine, said Maddox. This is important because the initial allocations are based only on how much vaccine there is and the population of a state.
Idaho, for example, could have limited ultracold storage capacity, so might prefer to trade it’s allotment of Pfizer vaccine for the Moderna’s, since its cold requirements are less. A state like Massachusetts, with dozens of hospitals, might be fine with a higher proportion of Pfizer vaccine.
The exchanges “provide a way for jurisdictions to coordinate and negotiate to move vaccine,” said Maddox.
Such flexibility also could help a place such as Washington, D.C., where many workers live in surrounding states. Jurisdictions could use the exchange to more appropriately portion out vaccine where it’s needed.
“There are instances where jurisdictions are going to need to talk to each other because they have daytime, nighttime populations that have big disparities,” he said.
The federal government doesn’t want to be involved in making those trades. “That is a jurisdiction decision,” Maddox said.