COVID-19 Vaccine: Distribution and Administration

The development of two vaccines for COVID-19 that have received Emergency Use Authorization happened at “warp speed.” 

Sadly, the plan for vaccine distribution has not been well planned out. The goal was to vaccinate 20 million people by the end of 2020. We are running behind this schedule. (see here.) For the purposes of this blog, I’m going to focus on distribution and administration in the US. 

Where are we with vaccinations in the US?

  • As of 1/20, the CDC estimates that about 14.3 million people have received at least one dose of a COVID-19 vaccine.
  • About 2.2 million individuals have been fully vaccinated.
  • Some 36 million doses have been delivered by the federal government.
  • Both manufacturers are trying to ramp up supplies. But, there has been little support at the Federal level to support the needed “warp speed”. 
  • According to Leana Wen, MD, “If the goal is to reach 80% of Americans vaccinated with a 2 dose COVID-19 vaccine, it will take 10 years at our current pace. We are currently at 1 million vaccinations a week. To get to herd immunity by June 2021, we need to be at 3.5 million vaccinations a day.”

While the vaccines were being developed and studied in clinical trials, individuals from the CDC, the Department of Health and Human Services (HHS), healthcare institutions and medical ethicists, were weighing in on who should be vaccinated first. 

There is overall agreement that those at the highest risk should be offered the vaccine first. The CDC has proposed the following template for deciding the order in which individuals will be vaccinated.

  • Phase 1a: Healthcare workers and long-term care facility residents.
  • Phase 1b: Essential workers (education, food/agriculture, utilities, first responders, corrections officers, transportation).
  • Phase 1c: Adults (age 16-64) with high-risk medical conditions, adults >65 years old, other essential workers (food service, housing, construction, finance, IT, public safety, public health).

And what if you don’t fall into one of these groups? “…As vaccine availability increases, vaccination recommendations will expand to include more groups (”

These recommendations by the CDC were just that, recommendations. Things got muddy really quick with deciding who actually got vaccinated because:

  • Individual states, counties, and cities have enacted different policies and procedures with who has access first.
  • The process for getting a vaccine differs from location to location—sometimes at the city level, sometimes at the county level, sometimes at the state level. So what is happening where you live may be totally different than what is happening where your parents live.
  • In many locations, all processes for registering and making appointments for vaccines were dependent on technology (smartphones, websites). Because of the demand, websites were quickly overwhelmed and crashing. And the target population, seniors, were often struggling with how to use the websites to register for their vaccinations. 
  • The Pfizer vaccine must be kept in special freezers that are not always available. This has impacted distribution by limiting it to facilities with cold storage availability.
  • In some cases, vaccines are not distributed or administered in the number that was first expected. People may not show up for their appointment or someone decides to decline the vaccine and a facility has vaccines leftover. Who gets those doses? This is also being handled in different ways in different areas.

As hard as we try, there is no fair, equitable, just, fully accessible way to distribute and administer these vaccines. Someone will always be unhappy about “their place in the line.” These are impossible scenarios that we are now forced to try to muddle through. 

So what can I do?

  • Start local. 
    • Some health systems are beginning to vaccinate high-risk patients, including people with cancer. Talk with your oncologist about the plan at your treatment center. If your center has a patient portal, keep an eye out for registration information.
    • Contact your city or county based health department or look for announcements online and via social media. Many cities have online registration and appointment making systems in place. 
    • Ask tech-savvy friends, family members, a social worker, or your local Area Agency on Aging for help with navigating online systems and technology. Understand that there is a great demand to register for vaccines and systems are often overwhelmed. 
    • All of this is subject to change at any time. As more vaccine doses become available and our national vaccine strategy becomes more clear, there may be other opportunities to get vaccinated in your area. 
    • Beware of vaccine scams. Yes, they are happening. You should not be receiving unsolicited emails or phone calls to register for a vaccine. You should not be asked for credit card information to “hold a place in line.” If it sounds too good to be true, it probably is. Always go back to your healthcare provider or local health department about current processes in place for your area.

Christina is a clinical oncology social worker and the psychosocial content editor at OncoLink. Christina blogs about resources available to the cancer community, as well as general information about coping with cancer practically, emotionally, and spiritually. Christina is also an instructor at the Penn School of Social Policy and Practice. In her spare time, she loves to knit and volunteer with her therapy dogs, Linus and Huckleberry. She also loves to travel, cook and is an avid Philly sports fan.

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