When a COVID-19 Vaccine is finally ready, who will get it and how will it be distributed?

While we don’t really know when a COVID-19 vaccine will arrive, but we’re starting to know how it will be distributed. USA Today conducted interviews with logistics experts, immunization professionals and pharmaceutical distribution specialists, together with recent U.S. Centers for Disease Control and Prevention planning documents, to get a clearer picture of how coronavirus vaccines will get from manufacturers into the arms of millions of Americans. Here’s what they found out (so far):

The swift and so far positive effort to create vaccines to fight COVID-19 has been remarkable but it’s only half of the work, said Tinglong Dai, a professor of operations management who studies health care analytics at the Johns Hopkins University. “It’s just incredible. I think the vaccine supply chain is one of the most mind-bogglingly complex supply chains ever built,” he said.

The process will be run by the CDC, which for decades has overseen vaccine distribution in the United States and ran the last national vaccination effort during the 2009 H1N1 influenza pandemic. At least at the beginning, vaccine is expected to be in short supply, though CDC planning documents say significantly more will be available by January 2021.

CDC is still finalizing who will be eligible to be vaccinated first, but from meetings of its Advisory Committee on Immunization Practices, it appears front-line medical workers, first-responders and people at high risk for severe disease will get first dibs.

Here’s how it would work

Medical offices, clinics, hospitals, pharmacies and other groups that want to vaccinate people for COVID-19 need to first enroll in the U.S. COVID-19 vaccination program They’ll sign an agreement with CDC and prove they have the space, the necessary equipment and properly trained staff to administer the shots.

Because the requirements for storing, handling and administering the shots are so challenging, the government will prioritize getting vaccine to sites that can reach large numbers of priority populations and vaccinate lots of people quickly, CDC documents say.

When a vaccine becomes available, a vaccination site will request doses through a state agency, usually its department of public health. That’s how it was generally done during the 2009 nH1N1 influenza pandemic, said Julie Swann, a professor of industrial and systems engineering at North Carolina State University who was a science advisor to the CDC at the time.

The department of health would confirm the site was OK’d to distribute the vaccine. At that point, if vaccine supplies are limited, the state could determine how much vaccine to allocate to that specific site, perhaps less than was requested.

Next, the order will be electronically transmitted to the CDC. The CDC also could make decisions about how many doses to allocated to a given site, if vaccine supplies are limited, said Moore.

CDC will then transmit the order to its contracted partner McKesson, the largest pharmaceutical distribution and technology company in the United States. It already has distribution centers located across the country and is building more for COVID-19.

Vaccine orders will be shipped within 24 hours of approval depending on supply, CDC’s planning documents say.

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