December 7, 2020 -- If the FDA authorizes the Pfizer coronavirus vaccine next Thursday, as expected, the federal government plans to ship 6.4 million doses of the vaccine within 24 hours.

Getting the vaccine from the manufacturers to American residents will require a complicated chain of private-public interactions, with the lion’s share of the responsibility falling on the state governments.

Each state was supposed to file detailed vaccine distribution plans with the FDA on Friday. It’s not clear which ones met that deadline, but many states have already announced their plans.

For instance, Virginia, in a news release issued Friday, says it expects to first receive 72,150 initial doses of the Pfizer vaccine, which will require ultra-cold storage facilities.

By the end of the month it should receive a total of 480,000 doses of the Pfizer and Moderna vaccines for health care workers and residents of long-term facilities -- the top priority groups for the vaccine.

But those 480,000 doses aren’t enough to cover the 500,000 people in those categories, the state notes. And the actual amount of vaccine heading to Virginia is “a moving target” and dependent on how quickly the vaccine is manufactured.

In California, Gov. Gavin Newsom said the state will receive 327,000 doses of Pfizer’s coronavirus vaccine by mid-December, with much more to come before the end of the month. He promised an equitable distribution.

“We will be very aggressive in making sure that those with means, those with influence, are not crowding out those that are most deserving of the vaccine,” Newsom said, according to KTVU.

New Jersey should receive 76,000 doses next week and hundreds of thousands of more doses before the end of the month. But New Jersey Gov. Phil Murphy said the state doesn’t have the money for vaccine distribution.

“The complexity of the distribution that’s still ahead of us cannot be underestimated…and the expense associated with it can’t be underestimated,” Murphy said, according to CNN.

President Trump has put most of the responsibility for COVID response on the shoulders of the government, and he’s done the same with vaccine distribution.

"It is really going to be at the level of the state," Dr. Anthony Fauci, the government’s top COVID adviser, said Friday night in a discussion of vaccines on CNN. "The individual states and localities will make their decisions and (handle) the distribution the way they normally would distribute something like influenza vaccine. That's really going to be the way ... very much locally mandated from the bottle to the arm of the person."

The CDC allocated $200 million to the states to help with COVID immunization, but some state officials say they need more help -- financially and logistically.

“We absolutely do not have enough to pull this off successfully,” Dr. Thomas E. Dobbs III, the state health officer of Mississippi, said last month, according to the New York Times. “This is going to be a phenomenal logistical feat, to vaccinate everybody in the country. We absolutely have zero margin for failure. We really have to get this right.”

States will be responsible for numerous jobs. Some of the tasks include choosing priority groups, setting up vaccination locations, communicating with the public, tracking who gets the vaccine, reminding those people to get the second shot, following up on side effects, and making sure minority groups are not left out.

President-elect Joe Biden said Friday that his transition team has talked to the Trump administration about vaccine plans and was left with many questions.

"There is no detailed plan that we've seen, anyway, as to how you get the vaccine out of a container, into an injection syringe, into somebody's arm," Biden said at an event in Wilmington, Del., according to the Associated Press.

The FDA will meet Dec. 10 to consider the Pfizer vaccine and Dec. 17 to consider the Moderna vaccine. The federal government pre-purchased millions of doses of each vaccine for immediate shipment.

Pfizer says it will ship its vaccine from Kalamazoo, Michigan, and Pleasant Prairie, Wisconsin. Air transport will be used to ship to major hubs and ground transportation to take the vaccine to “dosing locations.”

“We seek to work with governments to support distribution to their defined priority groups, and we anticipate that points of vaccination will vary but may include hospitals, outpatient clinics, community vaccination locations and pharmacies,” Pfizer said in a news release.

WebMD Health News Brief


State of Virginia. “Virginia’s COVID-19 Vaccination Priorities Announced”

KTVU. “State of California details vaccine distribution plan”

CNN. "New Jersey governor says the state doesn't have the funds to distribute a Covid-19 vaccine"

CNN. "Fauci: States will play a big role in coronavirus vaccine distribution"

CDC. "Administration Announces $200 million from CDC to Jurisdictions for COVID-19 Vaccine Preparedness"

New York Times. "Missing From State Plans to Distribute the Coronavirus Vaccine: Money to Do"

Biden predicts ‘bleak future’ if Congress doesn’t act on aid

Pfizer. “Pfizer Distribution Fact Sheet”

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