How the US, UK, and China plan to deploy vaccines

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The vaccines are coming. The UK became the first country in the West to approve a covid-19 vaccine for emergency use on December 2, specifically the Pfizer and BioNTech vaccine, which has completed phase 3 trials. But states United, the EU and many other countries should follow suit in the days and weeks to come. The imminent arrival of the vaccines not only means that countries face a huge logistical challenge to distribute them – which is complicated by the fact that the two most promising vaccines require ultra-cold temperatures – but they also have to make tough choices as to who gets them first.

Here is how different countries make their decisions about distributing vaccines to their populations.

United States

How many doses will be available? Up to 40 million doses are expected to be offered in the United States by the end of 2020, of which 25 million will come from Pfizer-BioNTech and 12.5 million from Moderna, according to Reuters. Since the vaccines each require two doses spaced several weeks apart, that will be enough to immunize 20 million people – but not all shipments will come at the same time. The first shipment would cover 3.2 million people, with 5 to 10 million additional doses delivered each week thereafter.

Who will get it first? In the United States, each state is responsible for creating its own vaccine distribution plans. They are supposed to follow the general guidelines of the CDC’s Interim Guide to Covid-19, which was shaped by the Advisory Committee on Immunization Practices (ACIP) with the contribution of the National Academies of Science, Engineering and Medicine.

ACIP met on December 1 and voted on the recommended first phase of the distribution plan. This is known as 1a and will prioritize 21 million healthcare workers and 3 million adults in long-term care facilities, such as nursing homes, which are particularly vulnerable.

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The following phases will add more people to the list: 1b will prioritize other essential workers, such as school staff, while 1c will prioritize adults over 65 and others with other medical problems that increase the risk of serious complications from covid.

Phase two would cover people who work in schools, transport, collective housing facilities, such as nursing homes and other places with high concentrations of people. Phase three includes young adults and children – with the goal of stopping super spread events – as well as other essential workers not previously covered. Phase four would include everyone.

But the CDC’s guidelines leave a lot to interpret and implement for state and local governments.

Even in phase 1, different states have different definitions of essential workers, for example. ACIP has yet to discuss anything beyond phase 1, leaving many questions open on how to prioritize the rest of the population. An analysis of 47 published state plans of the Kaiser Family Foundation found that about half explicitly mentioned race and health equity as a prioritization factor.

China

How many doses will be available? Chinese scientists say the country will have 600 million doses ready this year, the South China Morning Post reports. Wang Junzhi, a member of the National Vaccine Task Force, told reporters on Dec. 4 that the doses of inactivated vaccines would be ready to launch before the end of the year. He said a “major announcement” on vaccine trials was expected in the coming weeks.

Chinese COVID-19 vaccine

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China has five vaccine candidates from four manufacturers in phase three clinical trials, including pioneers Sinopharm and Sinovac Biotech. Although none of them have yet been approved for commercial use, they have been administered in so-called “pre-tests” in China, where the number of coronaviruses is low, and are also subject to phase three trials in 15 countries abroad.

Who will get it first? This question has already been answered. Emergency clearance was granted to the two main candidates at the start of this year: since June, an unknown number of members of the People’s Liberation Army have received gunfire, and key city workers have started shooting. get vaccinated in July. In total, around one million people have so far received emergency clearance vaccines, including employees of state-owned companies, Huawei employees in 180 countries and Chinese diplomats.

“Emergency Use Authorization, Based on China’s Vaccine Management Law, Allows the Use of Unapproved Vaccine Candidates Among People at High Risk of Infection for a Limited Time,” Zheng said. Zhongwei, director of science and technology development. Center of the Chinese National Health Commission, in an interview with China’s National Television Station on Aug. 22.

President Xi Jinping pledged to make the vaccine available worldwide as a “global public good”. In October, China joined the Covax Facility, a global alliance of 189 countries that pledged to equitably distribute vaccines. The United States is not part of this group.

The priority countries for the distribution of China’s five candidate vaccines are primarily those that have hosted trials, which in turn are shaped by China’s strategic interest. These include Brazil, Indonesia and Turkey, which have signed agreements for 46 million, 50 million and 50 million doses of Sinovac, respectively; and Mexico, which has an agreement with CanSino Biologics for 35 million doses.

Little is known about how the Chinese government prioritizes vaccine distribution nationally, although local reports suggest that individual provinces are considering purchasing vaccine doses, which will cost RMB 200 per dose ( about $ 30). The state insurance plan will not cover. the cost.

UK

How many doses will be available? Great Britain approved the Pfizer / BioNTech vaccine for emergency use by the general public on December 2. It will begin vaccinating its population of 67 million people through the state-run National Health Service, with the first vaccinations to be administered to the highest priority people from December 7 40 million doses of Pfizer vaccine; since each person needs two doses, they therefore have enough to immunize about a third of the population. He also purchased 100 million doses of AstraZeneca / Oxford vaccine, 7 million doses of Moderna vaccine and smaller amounts of other candidate vaccines, bringing the total he purchased to 355 million – in short, more than enough to vaccinate everyone.

Who will get it first? The UK’s decision was based on a group called the Joint Committee on Vaccination and Immunization (JCVI), an independent committee of academics and medical experts tasked with advising government ministers. For its phase one delivery, it divided the population into nine different groups, recommended to vaccinate them in this order of priority, which the government adopted:

  • Residents and staff working in nursing homes for the elderly
  • Anyone over 80 plus health and social service workers
  • Everyone over 75
  • Anyone over the age of 70 plus “clinically extremely vulnerable” people, which does not include pregnant women or those under 18.
  • Everyone over 65
  • Adults aged 18 to 65 in a risk group. This includes people with chronic illnesses, diabetes, learning disabilities, morbid obesity, or severe mental illness.
  • Everyone over 60
  • Everyone over 55
  • Everyone over 50

JCVI has publicly explained its thinking in a 25-page document document stating that “the current data clearly indicates that the greatest risk of mortality from covid-19 is increasing age.” He has yet to announce any plans beyond the first phase.

Somewhere else

Russia: Russia became the first country in the world to approve a vaccine in August 2020. President Vladimir Putin himself announced that his Sputnik V vaccine was cleared on August 11, even before Phase 3 trials began. these are still ongoing, but the country is already preparing to launch mass vaccinations, with Putin order officials to start making the necessary preparations just hours after the news of the UK approval was heard. Vaccinations would start with health workers and teachers. They will be free and the Kremlin says they will be carried out on a voluntary basis. Russia also says it will have up to 500 million doses ready for export.
Other countries: Options are limited for many low- and middle-income countries, as the richest nations in the world – including the 27 EU member states as well as Canada, the United States, the United Kingdom, the ‘Australia and Japan – have already pre-ordered half of the expected global supply. 92 of these countries have joined the Covax Facility, which has secured 700 million doses and aims to cover 20% of the population in low- and middle-income countries by the end of 2021.

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