IOWA CITY — As Americans watch health care workers take the COVID-19 vaccine and wonder when they’ll be able to get it, behind-the-scenes supply chain and public health experts are tackling those questions and trying to resolve the many complexities involved in widespread distribution.
The supply chain quandaries include disseminating multiple vaccines that differ in dosage and storage needs; tracking the doses; providing security; establishing priority groups; juggling having more demand than supply; and meshing the first vaccine shipments with holiday package deliveries.
“Any one of those factors by itself is a challenge,” said Marion G. Whicker, executive director of the U.S. Army’s Integrated Logistics Support Center serving as deputy chief of supply, productions and distribution for Operation Warp Speed — the government’s COVID-19 vaccine initiative.
Whicker shared insights on how the federal initiative is tackling those quandaries during a Tuesday evening panel discussion by a consortium that includes the University of Iowa’s Tippie College of Business.
During the discussion, moderated by UI business analytics professor Jennifer Blackhurst, Whicker noted Operation Warp Speed has backed six prospective vaccines at some stage of development and tasked operatives with preparing for distribution of those eventual products — honing in on three coordination categories: the vaccine itself, recipient prioritization and supplies vs. demand.
“Now you’re talking about 18 multiple problems that you’re trying to solve, and all the while realizing this is something the American public desperately needs,” Whicker said from her federal office during the Zoom discussion that attracted over 300 viewers.
But the government has been planning and preparing for vaccine distribution for months, and Whicker said the team is up for the task.
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“Fortunately for the nation, behind the door behind me are some of the greatest logistical minds in the country, working on this every day,” she said. “People ask me, ‘What’s your biggest worry?’ It’s not the supply chain. We have the greatest people working on that.
“It is hoping that as we get these vaccines out, that the American public will want to take these vaccines, that they will trust the data and trust the science,” she said. “They’ll put all the other rhetoric aside, and then make their own informed decisions.”
Michael E. Ohl, associate professor of internal medicine for UI Health Care and another panelists heading Tuesday’s discussion, urged Americans play a key role in curtailing the pandemic.
“The real key here is achieving herd immunity,” he said. “Herd immunity is indirect protection of susceptible unvaccinated individuals against an infection that occurs when a sufficiently large proportion of the population is immune.”
That occurs when enough of a given community is immune to extinguish an epidemic.
“Above a herd immunity threshold, there just aren’t enough susceptible people for one infected person to spread the virus to,” he said. “When any one infected person transmits to less than one other person on average, the epidemic extinguishes. But below the herd immunity threshold, the infection continues to transmit and it propagates in a population.”
The take-away, Ohl said, is that “vaccination is more than an individual decision. It’s a collective and collaborative action on the part of a society,” he said. “And that’s how we have to think about it when we make decisions.”
Calculations on the degree to which COVID-19 spreads indicate herd immunity could come if about 65 percent of a population was protected. If fewer are willing to take a vaccine that’s less than 100 percent effective, however, herd immunity will remain elusive.
On the other hand, if 80 percent get vaccinated with a 90-percent effective product, for example, “Then we’re over herd immunity. That means 20 percent of the population can refuse and say no,” he said.
But who, exactly, gets to say “no” is a difficult ethical question.
“Who gets to ride for free?” he asked.
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Though no less complicated, Operation Warp Speed experts already have untangled many of the questions about how to widely distribute vaccines that have to be stored at ultracold temperatures, delivered in two doses weeks apart, prioritized to specific individuals and rolled out during a holiday season already seeing more delivery than ever before due to the pandemic.
The Pfizer vaccine — which was approved Friday — is coming, for example, in boxes that can hold it in ultracold temperatures safely for 15 days. That innovation is allowing rural health care providers and those without the special deep freezes some have acquired for mass storage to access and distribute it in their communities.
Additionally, Whicker said, UPS is even producing dry ice to support storage longer.
“So when you think about supply chain innovations, that’s a great thing,” she said.
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