A Blog by Jonathan Low

 

Aug 2, 2020

In Major Change, US Vaccine Distribution To Be Managed Jointly By CDC and Defense Department

Healthcare experts question why the Administration is attempting to create a new distribution system when the existing one, run only by the Centers for Disease Control, has worked well for decades - and given that the Administration's approach to managing the virus, such as its effort to route virus updates around the CDC, so far is not considered a success.

The concern is that this is an effort to politicize vaccine distribution and reward only those the Administration favors. JL 

Sarah Owermohle reports in Politico:

Nationwide distribution of any coronavirus vaccine will be a “joint venture” between the Centers for Disease Control and Prevention, which typically oversees vaccine allocation. The plan breaks with the longstanding precedent that CDC distributes vaccines during major outbreaks, such as bad flu seasons, through a centralized ordering system for state and local health officials. The Department of Defense “is handling all the logistics of getting the vaccines to the right place, at the right time."
Nationwide distribution of any coronavirus vaccine will be a “joint venture” between the Centers for Disease Control and Prevention, which typically oversees vaccine allocation, and the Department of Defense, a senior administration official said today. 
The Department of Defense “is handling all the logistics of getting the vaccines to the right place, at the right time, in the right condition,” the official said in a call with reporters, adding that CDC will remain in charge of tracking any side effects that emerge post-vaccination and “some of the communications through the state relationships [and] the state public health organizations.”
The plan breaks with the longstanding precedent that CDC distributes vaccines during major outbreaks — such as bad flu seasons — through a centralized ordering system for state and local health officials.
“We believe we’ve actually combined the best of both,” the official said. A second senior administration official stressed the agencies would be working as “one team” to distribute hundreds of millions of doses if any of the vaccines in development are approved in the coming months.

Private companies are also likely to join the effort. The first official said the government is bringing in people to integrate CDC IT capabilities with “some new applications that we’re going to need that the CDC never had.”
The background: The Pentagon will be guiding not just distribution logistics but also manufacturing and “kitting,” the process of safely packaging a vaccine with its necessary equipment such as syringes and needles.
“The DoD is handling all of those logistics — that is where their comparative advantage is,” said the first senior official. “And the CDC, some of their IT systems, relationships with the states following post-vaccination will belong to them.”
Pentagon chief spokesperson Jonathan Hoffman told reporters earlier in the day that distribution would be “a collaborative process” between the private sector and the military.
Operation Warp Speed, the government's coronavirus vaccine and drug accelerator, is examining “how do we take advantage of the commercial capability of the private sector to handle things like distribution, and where will either DoD step in to help manage that process, or if necessary, will DoD be required to step in and actually physically deliver items itself,” Hoffman said.
The debate: The comments come just one day after McClatchy reported that neither the White House nor Warp Speed officials had formally asked the Pentagon to help with vaccine distribution. While the White House said Defense is ready to assist, an HHS official told McClatchy Wednesday that their involvement would be the exception, not the norm.
State and local government groups have already raised concerns about Pentagon involvement and using new methods in coronavirus vaccine distribution. The CDC “already leads and maintains a highly effective system of vaccine ordering and distribution,” groups including the Association of State and Territorial Health Officials wrote in June. “With time of the essence we strongly recommend against designing new and untested systems of vaccine distribution.”
The state and local officials also questioned whether military involvement in vaccine administration would undermine already shaky public confidence in vaccines.
What’s next: Senior health officials told reporters that they are in constant discussion about first-priority populations for receiving possible coronavirus vaccines, including the elderly and medically vulnerable, but that those plans will depend on which candidates are ready first.
Two vaccines entered the final stage of human trials this month and several more are readying for the sweeping phase three stage. Results are expected later this year or early 2021. In the meantime, an expert committee has been convened by the National Academies of Science to discuss a distribution framework.

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