Why the Covid-19 vaccine is more scarce than the flu shot

In a nutshell, there are fewer makers and distributors of the Covid-19 vaccine. It must be frozen at ultra-cold temperatures, which makes it difficult to ship and store. Full immunization requires two shots, compared to one for flu. And because the serum is brand new, healthcare providers should allow extra time to monitor patients for potential side effects.

All of this must be documented to ensure that the scarce vaccine is not wasted; allergic reactions are recorded; and second doses, to be administered within a certain time frame, are properly administered.

“The challenge is that state health departments must closely monitor doses while in battle,” said Litjen Tan, chief strategy officer of the Immunization Action Coalition, an organization that disseminates information on vaccines in conjunction with the Centers for Disease. Control and Prevention. . “With the flu shot you get it and you go away.”

Currently, only Pfizer and Moderna produce Covid-19 vaccines available in the US, although versions from other manufacturers, including Johnson & Johnson and AstraZeneca,

are planned.

In comparison, at least four large companies make flu shots, which are delivered directly to healthcare providers by three large distributors and several smaller ones.

Only one distributor, McKesson Corp.

, supplies Moderna’s Covid-19 vaccine to the federal government. Because Pfizer’s vaccine must be frozen at more extreme temperatures, the company packages it in dedicated thermal shippers and works directly with FedEx and United Parcel Service to ship it.

“There are pros and cons to having a sole distributor,” said Josh Michaud, deputy director for global health policy at the Kaiser Family Foundation, a nonprofit focused on health issues. “It is easier for the government to work with one company. They don’t juggle multiple contracts and points of contact. “

As the distribution of the Covid-19 vaccine increases, there will be “a strong argument” for expanding the number of distributors, he said. McKesson is big, but can he reach every corner of every state? Others have relationships with doctor’s offices and medical institutions. “

Flu vaccine manufacturers also have a head start.

Because the mechanisms for making and distributing flu vaccines are well established, health care providers can order injections in January or February that will be administered in the fall and winter. Production begins six to nine months before distribution, which is then completed in stages over a period of approximately four months. This season’s distribution began in August.

In contrast, the first Covid-19 vaccine was approved for emergency use by the Food and Drug Administration on December 11, and distribution began on December 14. The states are learning how much Covid-19 vaccine they will receive about a week in advance. .

“It’s more of a just-in-time management strategy,” said Crystal Tubbs, an assistant director of pharmacy at The Ohio State University Wexner Medical Center, who administers approximately 2,000 Covid-19 vaccines per day. ‘We are told five to seven days in advance how much vaccine we will receive the following week. Then we schedule appointments. “

Flu vaccine can be refrigerated, while the Covid-19 vaccine must be stored at extremely low temperatures.

Moderna’s vials contain 10 doses of vaccine and must be frozen at minus 4 degrees Fahrenheit. Pfizer’s bottles contain five or six doses and must be frozen at minus 94 degrees Fahrenheit.

“We’re terribly cold,” said Dr. Tan. “That doesn’t mean it can’t be done, but we have to slow down. We need to be more aware and considerate. “

Once the vials have been pierced, all doses must be used – or discarded – within six hours.

Once a person has been vaccinated, they should be monitored for 15 minutes or, if they have a history of allergic reactions, for 30 minutes to make sure they are not responding badly.

Immunization is not complete until a second dose has been administered, and the final injection must be within 21 days for the Pfizer vaccine and 28 days for the Moderna product.

Because the Covid-19 vaccine is given to a population with no previous resistance to the deadly disease, the goal is to inoculate as many people as possible.

“With the flu vaccine, about 50%, or maybe slightly more, of the US population is vaccinated within a season,” said Dr. Michaud. “With the Covid vaccine, the ultimate goal is to achieve a herd immunity level from vaccination. Nobody knows exactly what that is, but it is at least 70%. “

So far, the US isn’t even close.

Of the 55.9 million doses of Covid-19 distributed Thursday, only 33.9 million were administered, according to the CDC.

That includes 27.2 million people, or less than 10% of the population, who have received at least one injection, and 6.4 million, or about 2%, who have been fully immunized.

The agency also estimates that 83.1 million people, or about 25% of the country, are infected with Covid-19, although it is unclear how long their immunity will last.

Meanwhile, enough flu vaccine has been distributed to inoculate more than 58% of the population, and 53% of all adults have received it, according to the study results.

Write to Jo Craven McGinty at [email protected]