How will the Pfizer COVID vaccine be distributed in the US?

 The federal government is preparing to ship out millions of doses of the Pfizer COVID vaccine after it received FDA approval on Friday. 

Health and human services secretaryAlex Azar said the US could receive 20 million doses per month. 

Pfizer says the vaccine it has been developing with German partner BioNTech SE is 90 percent effective against COVID-19 and it expects to have safety data as soon as next week to apply for emergency use authorization.

Dr Anthony Fauci, based on Pfizer's initial findings, said he expects the doses of the vaccine to be available for certain high priority groups in December and that the general population could get the vaccine by April. 

Massive vaccine campaigns are nothing new but stamping out the coronavirus is a distinctly new challenge due to three factors: The short time frame for vaccinating a huge number of people, the fact that most vaccines will require two doses and the very low temperature at which some of the vaccines must be stored. Pfizer's vaccine needs to be stored at -94 degrees Farenheit.

So with all the positive news of potential vaccine breakthroughs, what is the government's plan to effectively distribute the jab to Americans once it's available? 

The efforts to provide vaccinations to 300 million Americans is being led by US Army general Gus Perna, who has been put in charge of Operation Warp Speed - the program created by the Trump administration to produce and coordinate the distribution of the COVID-19 vaccine. 

Here's what we know so far:

The US government plans to start vaccinating Americans next month if Pfizer has its COVID-19 vaccine approved by Food and Drug Administration health regulators as quickly as expected

The US government plans to start vaccinating Americans next month if Pfizer has its COVID-19 vaccine approved by Food and Drug Administration health regulators as quickly as expected

Who will get the vaccine first and when will it be rolled out?

HHS secretary Alex Azar offered up a timeline on Tuesday regarding who would be the first to receive the COVID-19 vaccination if they can start rolling out the jabs next month as planned. 

The elderly in nursing homes and assisted living facilities will likely be the first to the vaccinated.  

Adults with underlying medical conditions that put them at risk of severe COVID-19 illness and people over 65 years of age could also fall into this initial category, according to  according to Operation Warp Speed's strategy plan.  

Inoculations of healthcare workers and first responders will follow, with a goal to complete those shots by the end of January. 

Azar said he expects to have enough vaccinations for 'all Americans' by the end of March to early April. 

A final priority list is still being determined by the CDC's Advisory Committee on Immunization Practices that will based, in part, on vaccine efficacy data from the various trials, including Pfizer and Moderna.  

How many shots will you have to get and how much will it cost? 

The COVID-19 vaccine will need to be taken in two doses about three weeks apart to be fully effective.

While there could be multiple vaccines available by next year, they are not interchangeable if they have been developed by different companies. 

This means the second dose needs to be from the same manufacturer as the first dose.  

Operation Warp Speed's strategy plan details that those providing the vaccine should be giving out vaccine record cards that details the manufacturer. Record cards can also serve as a reminder about getting the second dose.

Congress and President Donald Trump have already enacted legislation that calls for the vaccines to be free to all Americans.  

HHS secretary Alex Azar offered up a timeline on Tuesday regarding who would be the first to receive the COVID-19 vaccination if they can start rolling out the jabs next month as planned 

How many will the US have available? 

The government already has a $1.95 billion contract for 100 million doses of the Pfizer vaccine, which is enough to inoculate 50 million people, with an option to acquire 500 million more. 

The government also anticipates vaccines from other companies soon, including Moderna Inc, which is expected to announce interim results of its vaccine trial at the end of the month. 

The government will also secure 100 million doses of Moderna's vaccine after paying $1.5 billion. 

Where will Americans be able to get COVID-19 vaccinations?

The government will be allocating vaccine supplies to states which will then be responsible for administering the jabs. 

The government is organizing a free distribution of the vaccine to US states and territories, with each jurisdiction to decide how to distribute the doses to hospitals, pharmacies, doctors or even universities.  

In the early stages of the roll out, the CDC has recommended that states make vaccines available at large hospitals and health systems, pharmacies, mobile vaccination providers, occupational health settings for large employers, critical access hospitals, rural health clinics, community health centers and other central locations that can provide vaccination services for a broad area.

The CDC says it has existing agreements with CVS and Walgreens to assist with on-site vaccinations at long-term care facilities.  

Operation Warp Speed has indicated they want vaccinations to be available at all healthcare professionals who are licensed to administer vaccines, including pharmacies. 

The pharmacies that have already signed on to provide vaccinations, according to the CDC, include: Walgreens, CVS, Walmart, Rite Aid, Kroger Co., Albertsons and Costco. 

Pfizer has already created a staging ground at its Michigan facility (pictured above) complete with 350 large freezers to hold the vaccines, which need to be stored at -94F, once they're created and ready to ship

Pfizer has already created a staging ground at its Michigan facility (pictured above) complete with 350 large freezers to hold the vaccines, which need to be stored at -94F, once they're created and ready to ship

The Trump administration has paid $1.95 billion for 100 million initial doses of the Pfizer vaccine. Pfizer says it could have up to 50 million doses available by the end of this year if approved

The Trump administration has paid $1.95 billion for 100 million initial doses of the Pfizer vaccine. Pfizer says it could have up to 50 million doses available by the end of this year if approved

BioNTech and Pfizer say 90% effective vaccine has few side effects
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Who is in charge of shipping out the vaccinations and how will they be handled?

While US Army general Gus Perna is coordinating the distribution of the vaccine, the military will not be involved in shipping out the vaccine to the locations where the jabs will be administered. 

Vaccines made by Moderna and other candidates will be shipped directly from the manufacturer by medical supply company McKesson Corp.  

McKesson, who has been contracted by Operation Warp Speed for distribution, was also contracted by the government to distribute H1N1 vaccines during that pandemic in 2009-2010.   

Pfizer has already said it will distribute its own vaccine from its facilities in Kalamazoo, Michigan and Pleasant Prairie, Wisconsin.

The drugmaker has already created a staging ground at its Michigan facility complete with 350 large freezers to hold the vaccines once they're created and ready to ship. 

Pfizer's ship-out will include a precise, clockwork-like dance of containers, trucks and planes.

The vaccine needs to be stored at -94 degrees Fahrenheit, so thermal shipping containers will each be filled with dry ice and 975 vials of the vaccine which each contain five doses, for a total of 4,875 doses.

Every day six trucks will take the doses to air carriers such as FedEx, UPS or DHL, which will deliver them across the US in one to two days and across the globe in three.

The company expects an average of 20 daily cargo flights worldwide. 

FedEx had to obtain special permission from civil aviation authorities to transport so much dry ice, which could pose a danger to the crew should it accidentally undergo 'sublimation' and pass from a solid to a gas, the company 

Once the boxes have reached their final destination, they can be opened only briefly just two times a day. The vaccines can remain in their boxes for two weeks meaning hospitals will not need a special freezer. 

Moderna's vaccine can be stored at -4 degrees Fahrenheit, which is the temperature of a normal freezer. 

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