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Trump administration officials released a detailed road map Wednesday of their plans to speed doses of a coronavirus vaccine into the arms of millions of Americans, as a top health official warned that Congress has yet to provide about $6 billion to help states prepare for what is expected to be the largest vaccination campaign ever undertaken.
Robert Redfield, director of the Centers for Disease Control and Prevention, told a Senate panel that his agency, which is playing a lead role in vaccine distribution, does not have the critical funds that states need for the distribution, which will take place in phases. Those state efforts include maintaining vaccines at temperatures of minus-70 Celsius (minus-94 Fahrenheit), which will require special freezers and dry ice, systems to ensure people get the correct doses at the right times — most vaccine products require two shots — and multiple scenarios for giving shots at hospitals, pharmacies, mobile clinics and doctors’ offices.
The CDC has about $600 million in dwindling relief money, but states urgently need additional resources, Redfield said, responding to questions from Sen. Roy Blunt (R-Mo.), who chairs the Senate appropriations subcommittee on Labor, Health and Education.
Administration officials have been seeking $6 billion for the past two months, but bipartisan talks aimed at getting a deal on broad coronavirus relief, including money for HHS and the CDC, fell apart last month, and prospects for reviving them are uncertain. Lawmakers have failed to reach agreement on the size and scope of the bigger-ticket items, such as aid to state and local governments and extending unemployment benefits.
“We need to get resources to states now,” Redfield said. “They cannot do it without resources. In my professional opinion … it’s going to take somewhere between $5.5 [billion] to $6 billion to distribute this vaccine. It’s as urgent as getting these manufacturing facilities up.”
Blunt, a member of the GOP leadership, replied: “If you have the vaccine and don’t have the plan or resources to distribute it, it’s a huge failure on the part of Congress.”
Officials sent a strategy paper to Congress describing coronavirus vaccine distribution efforts, and a 57-page “playbook” the CDC sent to states and localities giving additional guidance for the nuts-and-bolts preparations underway since August. Administration officials have told states to be ready to distribute a vaccine or vaccines as early as November on the assumption that one or more would be approved by the Food and Drug Administration by year’s end or early next year.
Redfield told the panel he expected a vaccine to start being available in November or December. Officials have said the limited initial doses will go first to health-care workers and other high-priority groups, including other essential workers, and those at increased risk for severe illness, such as nursing home residents and people with underlying medical conditions.
As soon as the FDA approves a vaccine, “we will have vaccines moving to administration sites, within 24 hours,” said Lt. Gen. Paul Ostrowski, who oversees logistics for Operation Warp Speed, the administration’s efforts to fast-track development of coronavirus countermeasures. Ostrowski, with the Defense Department, and officials from the Department of Health and Human Services spoke during a briefing Wednesday with reporters.
Operation Warp Speed has been working for months on multiple distribution scenarios. Planning has been complicated because of uncertainty over the timing of FDA approval and the different dosage and storage requirements of prospective vaccines.
President Trump has said repeatedly that the Defense Department would be involved in vaccine distribution. But a top HHS official said Wednesday that federal officials will not be involved in giving shots. “For the overwhelming majority of Americans, no federal official will touch a dose of vaccine before it’s injected into Americans,” said Paul Mango, deputy chief of staff for policy at HHS.
Mango said officials are also working to ensure that the vaccine will not cost Americans “a single dime out of pocket,” adding that “we’re getting very close to that aspiration right now.”
It will be up to officials in individual states and territories to decide which groups to focus on and to prepare for scenarios of high and low demand for the vaccines, according to the CDC guidance.
The CDC playbook also recommends that states “create visual maps of these populations,” including places of employment of essential workers. The federal government will release a dashboard to help states map these populations, the playbook said.
The CDC laid out a distribution scenario for the last quarter of the year when a limited supply of one or two vaccines might be ready to be given to priority groups. Officials described scenarios for “vaccine A” and “vaccine B”; how many doses may be available by the end of October, November and December; storage requirements; and minimum order amounts.
Vaccine A, which is the product being developed by Pfizer, needs to be stored at minus-70 degrees Celsius (minus-94 Fahrenheit) and requires two doses, 21 days apart. About 2 million doses would be available by the end of October; 10 million to 20 million by the end of November; and 20 million to 30 million by the end of December. The minimum order is about 1,000 doses.
Vaccine B, if approved, can be stored at minus-20 degrees Celsius (minus-4 Fahrenheit) and requires two doses, 28 days apart. A total of about 26 million doses of vaccine B would be available by the end of the year, most of them in December. The details match the product being developed by Moderna.
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