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December 10, 2020 10:00 AM, EST

Report Covers Critical Issues for State Leaders Ahead of Vaccine Distribution

Nurse holding syringeA pharmacist holds a syringe in a clean room where doses of COVID-19 vaccines will be loaded into syringes at Mount Sinai Queens hospital in New York. (Mark Lennihan/AP)

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Governors should assess their capacity for transportation and address logistical issues as early as possible as they brace for COVID-19 vaccine distribution, according to the National Governors Association.

NGA released a report Dec. 9 that highlighted strategies and challenges associated with distribution of the long-awaited vaccine. The report was developed with input from the Duke-Margolis Center for Health Policy and the COVID Collaborative, a group of health, education and economy experts. The authors analyzed all publicly available state and territorial COVID-19 vaccination plans.

State and local officials will play a vital role in last-mile considerations for vaccine distribution. Responsibilities will include receiving vaccine allocations from the federal government, managing the frameworks for ordering and distributing the vaccines, and supporting the administration of the vaccines at health care facilities.

Supporting an Equitable Distribution of COVID 19 Vaccine by Transport Topics on Scribd

“Ensuring effective distribution and administration of vaccines involves complex management and logistics,” the report states. “States and the federal government have experience and processes upon which to build. However, the scale, pace and other dynamics of COVID-19 vaccine distribution and administration present new and complicating factors.”

According to the report, eight states plan to involve the National Guard for transportation and logistics efforts, if needed. In Illinois, members of the trucking industry stand ready to assist with vaccine distribution needs. Illinois is expected to receive an initial delivery of 109,000 doses, according to Illinois Department of Public Health Director Ngozi Ezike, who delivered remarks during a Dec. 4 update. In Illinois, the first vaccines will be directed to the 50 counties with the highest death rates per capita.

The Illinois Trucking Association has been coordinating with state officials on coronavirus relief efforts since March. ITA Executive Director Matt Hart explained the transportation network is waiting for Food and Drug Administration approval of the vaccine and the manufacturers to provide the doses.

“We’re hopeful that we’re just days away from the plans of starting to do the vaccine distribution,” Hart told Transport Topics. “We’re ready. The plans are in place.”

Temperature control is a particular consideration for vaccine transportation and storage needs. The report notes the Moderna vaccine must be stored at minus 4 degrees Fahrenheit. The Pfizer vaccine requires “ultra-cold storage” at temperatures between minus 112 and minus 76 degrees Fahrenheit.

The report states that vaccines requiring ultra-cold temperatures are a challenge because they need specialized freezers and dry ice. Each shipment of vaccines is expected to contain at least 975 doses.

Many jurisdictions still are assessing provider capacity for cold and ultra-cold storage, according to the report. Storage capacity that can accommodate these freezing temperatures is especially challenging in some rural areas.

Missouri officials plan to distribute ultra-cold vaccines only in large metropolitan areas during Phase 1 and will monitor the ability to expand as vaccines become more widely available. North Dakota intends to use dry ice to transport and temporarily store ultra-cold vaccine loads in areas without freezers.

“Initial shipments of ultra-cold vaccine will arrive in temperature-controlled containers utilizing dry ice to maintain conditions for 10 days,” the report notes. “States will be responsible for procuring any replacement dry ice necessary to maintain vaccines beyond 10 days.”

In recognition of dry ice as a key commodity, some states have hatched plans for its procurement. Indiana leaders developed a strategy to engage dry ice vendors in a bidding process. Idaho and New Mexico created curated lists for providers on where they can procure dry ice.

NGA reports states have received $200 million from the federal government to assist with vaccinations. However, more federal funding is needed for activities such as building data systems, supporting mass vaccination clinics, ensuring “cold-chain” storage and transportation, procuring supplies and hiring workers, the report notes.

In addition to funding, states will rely on federal guidance for challenges associated with data reporting, vaccine storage and provider enrollment and training.

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