The author of the following article is a non-clinician
As post-election woes continue, and the "that’s so 2020" saga rages on, the world welcomed positive news recently as both Pfizer and Moderna announced that their forthcoming vaccines for the COVID-19 virus were not only nearing the end of their trials but was also found to be as much as 90%-plus effective.
However, as has been the case with most things this year, once the good is digested, reality begins to set in and so too will begin the roller coaster ride of challenges that must be addressed when trying to inoculate the world.
The two vaccines leading the way consist of messenger RNA which instructs cells to make a "coronavirus spike-like" protein, allowing the immune system to practice targeting the virus, and prepare to handle infection.
While extremely impressive and a testament to the scientists within the pharmaceutical industry, this RNA type of vaccine has never been tried on a large scale, and has a bit of a catch; the vaccine itself must to be stored at extremely cold temperatures (Pfizer’s around -95° Fahrenheit and Moderna’s at -4° Fahrenheit).
To put this into perspective, Antarctica’s temperature averages -50° F, most of the year, so in essence, Antarctica is too warm for Pfizer’s vaccine. Moderna’s; however, can be held in your standard kitchen freezer that nearly every medical facility has.
Given the stability of Moderna’s vaccine and its ability to be more broadly stored and shipped, one might ask why the concern over Pfizer’s more challenging vaccine?
Moderna is currently capable of producing 500 million doses per year, and while they are working on doubling that by 2022, given those number, they years away from producing enough vaccines for the planet.
Pfizer, however, claims that they can manufacture 1.3bn doses per year.
With nearly 8 billion people throughout the world, and a combination of both herd immunity and vaccination needed to eradicate the globe from COVID, we cannot depend on just one (or even two) manufacturers.
Pfizer has production capability significantly greater than that of Moderna, thus we must prepare for how we can properly utilize their vaccine as well.
With regards to Pfizer’s vaccine, beyond just storage is also the challenge of transportation. Once the vaccine is outside of the -95° sub z temp, it must be used within five days.
While shipping a container filled with vaccine and kept cold utilizing dry ice is certainly an option, as any child of the 1980’s and 1990’s knows, dry ice can be explosive, thus transportation by air is limited.
This "cold chain" of distribution is complicated, but fortunately the US has experience with this. NASA regularly transports liquid hydrogen for rocket fuel which needs to be kept at -253°., and the agricultural industry transports tens of billions of pounds of beef all across the world which has to remain frozen as it travels across oceans and continents.
The ability to transport things at this specific temperature has been done and the infrastructure to do so on a global scale is in place, but mapping out the network to accomplish both simultaneously is the challenge. Given its more challenging constraints, specifically within the U.S., a priority should be to focus on sending Pfizer vaccines to metro facilities with the required specialized freezers, and the Moderna vaccine to rural areas and smaller clinics.
Having an effective vaccine is one thing, but a plan for distribution and utilization is another.
First, we must identify major urban areas that have the facilities to store the vaccine safely. In Kalamazoo, Michigan, Pfizer has turned a stretch of land, roughly the size of a football field, into a staging ground outfitted with 350 large freezers, ready to take delivery of millions of doses of the vaccine as they are produced at the local manufacturing facility. This same level of preparation must take place across the already identified 64 vaccination jurisdictions throughout the U.S.
Second, we must prioritize who gets the vaccine first. Likely we’ll see a focus on those considered at-risk along with frontline health workers, but beyond that there will need to be a process.
And third, we’ll need a way to track who has received the vaccine. In order to be effective, according to both manufactures, one must receive two doses approximately one to two months apart.
That’s a big database and likely a real challenge for a country that can’t seem to create a system to efficiently count election ballots. Both Pfizer and Moderna claim efficacy rates exceeding 90%, but this is based on a controlled group who’s properly being tracked.
To achieve these results on a larger scale, we must be able to do the same.
The greatest foreseeable challenge to this vaccine, however, isn’t transportation or storage; its confidence. The American people, by and large don’t trust the process. Recent surveys have shown that only half of all Americans would be willing to take a vaccine and even fewer are willing to have their children do so.
Our elected leaders using the vaccine as a political football certainly hasn’t helped the situation, and as stated before, wide use will be required in order to move past this pandemic.
To have a vaccine in less than a year (a process that often can take as long as a decade) and have a 90% efficacy (many vaccines are less than 60% effective) is unheard of.
The mobilization of the private sector laid out by the Trump administration under Operation Warp Speed, not only encouraged vaccine development, but also increased production of vials, syringes, transport containers, and the gathering of chemicals and resources for mass-production.
This has certainly set us up for success, but we have a long way to go. A detailed plan is essential, but so is transparency and unity from our leaders.
This virus doesn’t have a political agenda, neither should solutions to eradicating it.
Seth Denson is a Business & Market Analyst, Author, and Entrepreneur. He co-founded one of the nation’s most successful consulting firms and authored the best-selling book, The Cure: A Blueprint for Solving America’s Healthcare Crisis which takes a deep dive into the business structure of our U.S. healthcare system and how we can reform it while maintaining our free-market. As a regular on-camera contributor, Seth has garnered a national presence discussing a range of topics including business and economics, politics, faith, and fatherhood. Originally from West Texas but with international business experience, Seth’s ”no-bull” approach blends metropolitan thinking with good old-fashioned Texas straight-talk. Reads Seth Denson’s Reports — More Here.
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