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How The U.S. Plans To Distribute Potential Coronavirus Vaccines

ARI SHAPIRO, HOST:

The COVID-19 vaccines now in development have very strict storage requirements, including being kept at super-cold temperatures. So how will the shots be kept cold during shipping? And who gets first access to the vaccine? NPR's Pien Huang has been looking into plans for getting a future vaccine from the manufacturer into the arms of willing people, and she's with us now.

Hi, Pien.

PIEN HUANG, BYLINE: Hey, Ari.

SHAPIRO: So let's start with those super-cold requirements. How does a vaccine that needs to be stored in really cold temperatures get moved across the country and the world?

HUANG: Yeah. Well, it depends on which vaccine we're talking about. The two vaccines that are the furthest along in clinical trials both have to be kept cold but to different degrees. So one is made by the drug company Pfizer, and that requires the coldest storage. It needs to be kept at minus 70 degrees Celsius, which is close to the temperature of dry ice. And Pfizer has spent some $2 billion building their own global supply chain. So here in the U.S., they have an assembly center in Kalamazoo, Mich., where they'll be packing vaccine vials into dry ice pods. And these pods will be loaded into boxes that can keep these ultra-cold temperatures for up to 10 days. And they'll be moved around the country in cargo planes and trucks by carriers like UPS and FedEx.

Now, the Moderna vaccine requires storage at minus 20 degrees Celsius, which is comparable more to a home freezer. And that one would get distributed by the government, at least at first. So Moderna will get the vaccines to a government site. And from there, the government will work with a private contractor to get the vaccines out to locations like hospitals, pharmacies, clinics, wherever they're requested by states.

SHAPIRO: OK. So moving from temperature to distribution, how are these vaccines going to be allocated to each state?

HUANG: Well, the government says that they'll be providing them to states for free. And governors have been asking, well, how are you going to figure out how much each state gets? And this is especially important in those first days and weeks after a vaccine is authorized, when there just won't be enough for everyone. Paul Mango, a top official at the Department of Health and Human Services, says that states' allocations will depend on the number of people in priority high-risk groups.

PAUL MANGO: It actually has very little, if anything, to do with background population in a state or jurisdiction. It has everything to do with those priorities and the number of absolute persons that are in those priorities.

HUANG: Mango says that the government is getting headcounts right now of how many hospital workers there are by state, how many nursing home residents - you know, various groups that are at high risk for COVID-19. And once the vaccine is authorized, the size of those populations in a given state will determine how many vaccines that state initially gets.

SHAPIRO: You know, different communities have different levels of health care infrastructure. How are states planning to get vaccines to people that might not have a lot of good health care in their communities?

HUANG: Right. I mean, the groups that are hard to reach are often the same groups that have been severely affected by COVID-19. And Dr. Helene Gayle recently co-chaired a committee that looked into how to distribute a vaccine fairly.

HELENE GAYLE: Communities of color, seniors and others have been disproportionately impacted by this. And so we're making sure that we're working with community-based organizations, churches, faith institutions, community health centers.

HUANG: States are starting to work with local community leaders and plan for vaccine clinics in those communities - you know, in people's workplaces, at local pharmacies, even churches. And Gayle says that this work makes it easier for people to get a vaccine and also helps ensure that they actually trust and want one.

SHAPIRO: These are such difficult life-and-death questions. Who ultimately makes the decision of who gets the vaccine first and who has to wait for it?

HUANG: Right. The government's recommendations are ultimately going to come from a group of doctors and public health experts that advise the CDC. It's called the Advisory Committee on Immunization Practices, ACIP. And they're meeting this week to talk through the different COVID vaccine candidates, but they're not going to make a recommendation until one is authorized by the FDA. When they do issue COVID guidelines, that will actually kick-start the distribution process. The government aims to get the vaccine into people's arms 24 hours after the recommendations are accepted by CDC.

SHAPIRO: NPR's Pien Huang, thanks a lot.

HUANG: Thanks for having me. Transcript provided by NPR, Copyright NPR.

Pien Huang is a health reporter on the Science desk. She was NPR's first Reflect America Fellow, working with shows, desks and podcasts to bring more diverse voices to air and online.