With a Covid-19 vaccine drawing closer, public health officials across the US are gearing up for the biggest vaccination effort in history.
It is a monumental undertaking that must distribute hundreds of millions of doses, prioritise who is first in line and ensure that people who get the initial shot return for the necessary second one.
The push could begin as early as next month, when US federal officials say the first vaccine may be authorised for emergency use and immediately deployed to high-risk groups, such as health care workers.
“The cavalry is coming,” Dr Anthony Fauci said on ABC’s Good Morning America.
He said he hopes jabs will be available to all Americans in April, May and June.
Pfizer also boosted hopes this week, saying early data suggests its vaccine is 90% effective.
But the good news came in one of the grimmest weeks of the pandemic so far.
Deaths, hospital admissions and new infections are surging across the US — and turning up the pressure to get the vaccine effort right.
In Philadelphia, the health department is counting how many health care workers and others would be among the first in the queue.
In Louisiana, officials are planning a remote exercise this week to play out different scenarios exploring how the process might unfold.
“If you get 10,000 doses, what are you going to do, versus 100,000 doses?” said Dr Frank Welch, director of Louisiana’s immunisation programme.
State and local officials are also planning for the likelihood that the first shipments will not be enough to cover everyone in high-priority groups.
Similar preparations are happening at the federal level.
Dr Welch listened in last week on a “war gaming” session by the US Department of Health and Human Services.
For the vaccination effort to get off the ground, state officials have been readying systems to track supplies and who has been vaccinated.
That information will be fed into a national network and will be critical in giving federal health officials an up-to-date picture of vaccinations around the country.
Providers such as pharmacies and doctor’s offices will also need to be able to look up records, so people do not have to return to the same place for their second shot.
More than one vaccine could also become available, and doses cannot be mixed and matched.
“We not only have to bring people back for a second dose, but need to make sure that we have very good records of which vaccine they received the first time,” said Dr Jinlene Chan of Maryland’s health department.
States already have immunisation registries, which will be used for Covid-19.
To better understand whether at-risk groups are getting vaccinated, the CDC wanted providers to report the race and ethnicity of the people they vaccinate.
But pharmacies and other providers that do not always collect that information objected.
“We have to be careful not to put too many administrative burdens on providers that are already stressed,” said Mitchel Rothholz of the American Pharmacists Association, an industry group.
He said providers have been told they will have the option to leave that information out.
Providers will also have to report vaccination information daily, which will be an adjustment for those that typically enter data weekly or every couple of weeks, state officials said.
To help people find doses in their area, the CDC wants to put information on a vaccine finder website, which will be updated each day with the latest inventory.
States are also working to expand the number of pharmacies, doctor’s offices and other providers that can administer Covid-19 vaccines, to ensure shots are conveniently available.
The Pfizer vaccine needs to be kept at -70C (-94F) which is also a factor in its delivery.
