Three Massive Vaccine Failures: Supply Chain Disaster; Lack Of Funding; Allowing US Vaccines To Be Sent Overseas

Trump Turned Down Hundreds of Million of Vaccines, Allowed American-Made Doses to Be Sent Overseas

While UK Begins Vaccinations, US Scrambles to Ramp Up Supply 

States Lack Funds to Plan for Mass Distribution of Vaccine

As the United Kingdom begins a mass vaccination campaign to inoculate its residents against the deadly coronavirus, the United States is floundering. 

Though FDA emergency approval of new coronavirus vaccines is just around the corner, the Trump administration has utterly failed to plan and prepare for the mass distribution of the vaccine — one of the most important logistical undertakings in the history of our country. 

Pharmaceutical companies like Pfizer and Moderna are struggling to ramp up domestic supplies of the vaccine in the face of a broken supply chain. Donald Trump allowed precious, and limited, doses of vaccine to be sent overseas rather than securing them for Americans. And states lack the doses, information, and funding to protect even just their front-line workers. 

The Trump Administration Allowed Hundreds of Millions of Doses of Vaccine to Be Shipped Overseas Before Securing Enough for Americans

• • The Trump Administration Only Secured Enough Of The Pfizer Vaccine To Inoculate 50 Million Americans. “Before Pfizer’s coronavirus vaccine was proved highly successful in clinical trials last month, the company offered the Trump administration the chance to lock in supplies beyond the 100 million doses the pharmaceutical maker agreed to sell the government as part of a $1.95 billion deal months ago. But the administration, according to people familiar with the talks, never made the deal, a choice that now raises questions about whether the United States allowed other countries to take its place in line.… The vaccine being produced by Pfizer and its German partner, BioNTech, is a two-dose treatment, meaning that 100 million doses is enough to vaccinate only 50 million Americans.” [New York Times, 12/7/20]
    
  • The Trump Administration Declined Between 100 Million And 500 Million Doses Of Vaccine When Negotiating WIth Pfizer.  “The government was in July given the option to request 100 million to 500 million additional doses. But despite repeated warnings from Pfizer officials that demand could vastly outstrip supply and amid urges to pre-order more doses, the Trump administration turned down the offer, according to several people familiar with the discussions.” [New York Times, 12/7/20]
    
  • The European Union Has Secured A Supply Deal With Pfizer For 200 Million Doses. “On Nov. 11 — two days after Pfizer first announced early results indicating that its vaccine was more than 90 percent effective — the European Union announced that it had finalized a supply deal with Pfizer and BioNTech for 200 million doses, a deal they began negotiating in months earlier. Shipments could begin by the end of the year, and the contract includes an option for 100 million more doses.”  [New York Times, 12/7/20]
    

• The United Kingdom Has Already Begun Mass Vaccination Campaigns Of Its Citizens. “The U.K.’s National Health Service launched what it has called the biggest immunization campaign in its history, starting Covid vaccinations across the country. People over 80 are at the front of the line for the shot made by Pfizer Inc. and BioNTech SE on Tuesday, with tens of thousands expected to get vaccinated in the coming days. The U.K. is the first western nation to begin its program, having approved the jab last week… The U.K. has struck deals for 357 million vaccine doses from seven makers, including the Pfizer-BioNTech collaboration. It plans to combine that shot with one from AstraZeneca Plc and the University of Oxford in trials next year, according to the U.K. Vaccine Taskforce.” [Bloomberg, 12/7/20]
  

The Supply Chain Is Broken

• Trump’s Failure To Rectify Issues With The Supply Chain Has Hampered The Ability Of Companies To Scale Up Production Of The Vaccine. “The gap reflects the disconnect between Trump’s campaign promises, as well as the optimistic estimates from some drug companies, and scientific and manufacturing realities. The drop-off is a product of manufacturing problems, bottlenecks in the supply of raw materials and other hurdles in ramping up clinical-trial production of 5 liters of protein-based vaccine at a time to commercial-scale fermentation of 2,000-liter batches, the companies and the Trump administration said.” [Washington Post, 12/5/20]
  
• Pfizer And Moderna Are Struggling To Procure Essential Materials To Begin Large-Scale Production. “As Pfizer began large-scale production, the company said, it encountered difficulties procuring sufficient amounts of raw ingredients. A number of specialized materials are required to create the vaccine, including nucleotides, the building block of the mRNA… Moderna’s vaccine supply chain depends critically on the availability and high quality of each component, including the lipids used to encapsulate the mRNA, bags and laboratory equipment used in production, the chemical components of mRNA itself and enzymes.” [Washington Post, 12/5/20]
• Only A Tenth Of The 300 Million Doses That Trump Promised Would Be Available By The End Of 2020 Are Projected To Be Available This Year. “Instead of the delivery of 300 million or so doses of vaccine immediately after emergency-use approval and before the end of 2020 as the Trump administration had originally promised, current plans call for availability of around a tenth of that, or 35 to 40 million doses.” [Washington Post, 12/5/20]
  

• A CNN Analysis Of 27 States Showed That None Were Receiving Enough Vaccine To Even Accommodate Their First Priority Group. “A CNN analysis of 27 states’ vaccine data showed that none were getting enough vaccine in the first shipment to vaccinate all their first priority group, including health care workers and long-term care residents. CNN was able to confirm the expected size of the first shipment of vaccine for at least 45 states, and the number of people prioritized in at least 27 states.” [CNN, 12/5/20]
  

No Funding and No Plan for Mass Vaccine Distribution

• Rather Than A Centralized Strategy For Vaccine Distribution, States Have A Patchwork Of Plans That Suggests Success Will Depend On How Well-Funded A State’s Health Department Is Or How Hard The Pandemic Has Hit. “Days before the first COVID-19 vaccine is cleared for use, an exclusive USA TODAY Network survey of health officials in all 50 states revealed a patchwork of preparations and different distribution plans that may mean wide variations in what the rollout looks like as it expands across the nation. Many states are struggling to prepare because information about what, when and how much vaccine is coming constantly changes, and extra funding to make the undertaking possible depends on Congress. Preparedness varies widely depending on how well a state’s health department is funded, how hard the pandemic has hit  and how robust its immunization system was pre-pandemic.” [USA Today, 12/8/20]
  

• States Are Struggling To Prepare Because Of Constantly Shifting Projections Of How Much Vaccine They Can Expect, And Changing Guidance From The CDC. “Two things stand out as the biggest stumbling blocks – constantly shifting information about when and how much vaccine will arrive at clinic loading docks and a grinding lack of funds to deal with it. A state can be told to expect 60,000 doses in its first shipment, only to see the number drop to 20,000 a few weeks later. One month the CDC says states don’t need to invest in ultra-cold freezers to store the Pfizer vaccine, the next there’s a run on them by bigger states, no matter what CDC says.” [USA Today, 12/8/20]
  

• Buffy Heater, Oklahoma State Department Of Health Assistant Deputy Commissioner: “There Are Many Unknowns In What Lies Ahead.” “‘A continuously changing planning environment’ is a huge hurdle, said Buffy Heater, Oklahoma State Department of Health Assistant Deputy Commissioner. ‘The vaccine plan has to be very fluid, as there are many unknowns in what lies ahead.’” [USA Today, 12/8/20]
  

• • • Pennsylvania Secretary Of Health Dr. Rachel Levine: “All Of Our Plans Are Drafts And Will Continue To Evolve.” “Pennsylvania Secretary of Health Dr. Rachel Levine said she simply didn’t know how many doses her state is expecting for its first distribution wave. ‘We heard various numbers, but we don’t know exactly how many doses we’re going to be getting, which again is why all of our plans are drafts and will continue to evolve, because it will be different depending on the doses we get,’ she said.” [USA Today, 12/8/20]
      

• Underfunded State Health Departments Are Concerned That They Won’t Have Enough Money To Manage The Logistics Necessary To Undertake A Mass Vaccination Campaign. “The other concern [for vaccine distribution] is a lack of funds. State public health systems are notoriously underfunded and now they’re being asked to mount an ‘all hands on deck’ undertaking with an already exhausted staff… States had some money from the Coronavirus Aid, Relief and Economic Security Act, known as the CARES Act. And the CDC awarded $200 million to states for vaccine preparedness in September. But it won’t go far, say public health officials.” [USA Today, 12/8/20]
  

• States Need Funding To Pay The Staff That Will Prepare For And Provide Vaccinations. “‘A very large proportion of our staff time has gone into this,’ [Nevada Immunization Program Manager Shannon Bennett] said. ‘Typically we have around 20 state full-time staffers. Right now we’re in the low 30s.’  Those people have to be paid, said Tiffany Tate, executive director of the Maryland Partnership for Prevention, a nonprofit that supports the state’s immunization coalitions…. The coordinator who spends days checking the credentials of everyone hired to give shots also must be paid, as well as the person organizing the schedule and the staffers answering hotline questions and billing insurance companies to get reimbursed for giving the shot. Given Pfizer’s estimate that each immunization should take 10 minutes, it would take $136 million to simply pay for the staff time necessary for the state of Maryland to give everyone there the two-dose vaccine. ‘We’re not ready for that,’ Tate said.” [USA Today, 12/8/20]
  
• States Need Funding To Pay For Supplies, Space, And Logistics. “It’s not just finding the space and hiring extra people to give the injections, though that’s expensive enough… It’s also buying the orange cones to mark out lanes for people waiting in their cars and outdoor tents.” [USA Today, 12/8/20]
• • Even Though Vaccine Distribution Will Cost Anywhere Between $6 Billion And $13.3 Billion, Only $340 Million Has Been Allocated Thus Far. “While the Trump administration has spent more than $10 billion supporting the development of COVID-19 vaccines, just $340 million has been allocated to agencies below the federal level to help with distribution efforts that will cost anywhere from $6 billion to $13.3 billion, according to various estimates. Health care workers, nursing home residents and other priority groups could be vaccinated as soon as this month, according to estimates by Trump officials. But the administration has not planned for the subsequent vaccination of hundreds of millions of Americans in the general population next year or how to pay for it.” [The Hill, 12/5/20]
    

• State Officials Are Calling On The Federal Government To Supply The Funds Necessary For The Vaccine Campaigns. “Conducting a mass vaccination campaign in the middle of a global pandemic costs millions and the money is going to have to come from the federal government. Mississippi is very straightforward. It will need $30 million to distribute [the] vaccine statewide, and state Health Officer Dr. Thomas Dobbs was confident the needed funds will come from the federal government. Others are less convinced. Federal funding is essential for the vaccine initiatives, said Kentucky Gov. Beshear. ‘I can’t overstate how bad it would be if Congress doesn’t act and they basically say, “You’re on your own,”’ he said.” [USA Today, 12/8/20]
  

• • Dr. Thomas E. Dobbs III, State Health Officer Of Mississippi: “We Absolutely Do Not Have Enough To Pull This Off Successfully.” “‘We absolutely do not have enough [money] to pull this off successfully,’ said Dr. Thomas E. Dobbs III, the state health officer of Mississippi. ‘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.’” [New York Times, 11/22/20]
    
  • Dr. Mandy K. Cohen, Secretary of Health And Human Services In North Carolina: State Needs $30 Million For First Year Of Vaccine Distribution. “Dr. Mandy K. Cohen, the secretary of health and human services in North Carolina, said her state had received just $6 million for distributing and promoting the shot. She expects $3 million more by the end of the year and called the money ‘a down payment’ for what is likely to be $30 million worth of work over the first year of vaccine distribution.” [New York Times, 11/22/20]
  • Dr. Nirav Shah, Director Of The Maine Center For Disease Control And Prevention: “The Speed At Which We Vaccinate The Population In Maine Is Directly Dependent On The Funding.” “Dr. Nirav Shah, director of the Maine Center for Disease Control and Prevention, said that more than anything, insufficient funding would slow the rate of vaccination, particularly among disadvantaged populations that are harder to reach. ‘The speed at which we vaccinate the population in Maine is directly dependent on the funding,’ he said. ‘We will still get the job done, but it will take longer if I can’t train the people to give it.’” [New York Times, 11/22/20]