Benzinga
Medically necessary: postponing second doses would reshape the vaccine supply chain
This is an excerpt from the February 25, 2021 edition of Medically Necessary, a health supply chain newsletter. Register here. Good afternoon. Medically Necessary is a Matt Blois newsletter on the health supply chain – how we provide medicines, devices and medical supplies to healthcare professionals and patients. Postponing the second dose would reshape the vaccine supply chain. The debate: Some scientists argue that the United States should postpone the second dose of the COVID-19 vaccine and instead administer it to people who have not yet received the injection, hopefully providing some protection to more people. Preliminary data from the UK and Israel suggest that a single dose of the Pfizer vaccine (NYSE: PFE) provides good, but not perfect, protection from COVID-19. This strategy has not been tested in randomized, controlled studies, so there are many uncertainties. A big assumption: scientists who often ask for delays in second shots often assume that the supply chain will successfully deliver all these additional doses, but that is not entirely clear. Currently, 11 states and Washington, DC, have not yet administered 10% to 20% of the first doses they received from the Centers for Disease Control and Prevention, suggesting that vaccine delivery may not be the only problem. Most states administered more than 90% of the first doses. American territories are lagging behind. The Virgin Islands administered less than 70% of the first doses. American Samoa and Guam delivered less than 80%. The backstory: The federal government initially planned to retain a reserve of COVID-19 vaccines to ensure that second doses were available in time. In January, the federal government began launching second doses to increase the supply of vaccines. (This change came before the policy was announced, confusing many state officials.) Although the federal government has stopped reserving doses, it has always aimed to deliver the second dose of the vaccine on time – three or four weeks after the first injection. The CDC recommends administering the second dose on time, if possible, but in January it started allowing a six-week break in exceptional circumstances. British authorities decided in December to postpone the second dose of the AstraZeneca (NASDAQ: AZN) and Pfizer vaccines to extend the supply. It is not just about supply: the limited supply of COVID-19 vaccines is a major problem that slows down implementation, but there are also other bottlenecks in the supply chain. Complicated information technology systems have caused major headaches and delayed distribution in many states. At first, the lack of health professionals to administer the vaccine contributed to delays, according to a Reuters report. Pharmacies are also struggling to hire enough staff, according to The New York Times. Mark Sawicki, CEO of cold chain logistics company Cryoport Systems, said that delaying the second dose would certainly increase the number of people receiving at least one dose, but would not automatically make the supply chain more efficient. “You still have the same number of doctors and pharmacists who are giving vaccines on a global basis,” Sawicki told FreightWaves in early February. “You cannot arbitrarily manufacture twice as many people to administer the doses.” As vaccine distribution continues, the United States is taking steps to address some of these problems. The federal government has mobilized thousands of people to help states administer vaccines. Supply is very important, however. Tinglong Dai, a health operations researcher at Johns Hopkins University, said increasing the number of doses available would reshape the supply chain. “You almost need to have enough doses to be able to mobilize many people to administer the doses,” he told FreightWaves. “The more supply you have, the more demand you can create because you can get more people to provide the services.” There are currently not enough doses to send vaccines to all pharmacies in the United States, so these potential delivery points are not used. The increased supply would allow more vaccination sites, increasing the country’s ability to deliver vaccines. Will this happen? So far, the American authorities have not shown much enthusiasm to postpone the second doses. The Biden government’s COVID-19 strategy says the White House is exploring “dose-saving strategies that have the potential to substantially expand the supply of vaccines”, but White House officials also said there is not enough data to support the postponement second doses. “What we have now, and what we need to keep track of, is the scientific data we have accumulated,” White House COVID-19 advisor Anthony Fauci told NBC’s “Meet the Press” program in February. Earlier this week, the director of the National Institutes of Health, Francis Collins, wrote a blog post expressing some optimism about giving people who have recovered from COVID-19 a single chance, based on previous data showing that they have an especially strong immune response. “This policy is already being considered in France and, if implemented, would help to extend the supply of vaccines and to vaccinate more people sooner. But any serious consideration of this option will require more data, ”wrote Collins. The change is coming: most vaccine clinics now know how many doses they will receive in the next three weeks, according to Prashant Yadav, a supply chain researcher at Harvard Medical School. “It’s almost that level where second doses can be reserved … [with] inbound delivery, “wrote Yadav in an email. But there is very little room for error. This type of planning becomes much easier when delivery is predictable. With an emergency use approval for the COVID-19 vaccine from Johnson & Johnson (NYSE: JNJ) on the horizon (continue reading) and indications that Moderna (NASDAQ: MRNA) and Pfizer are accelerating production (continue reading), vaccine administrators may soon have that predictability. Johnson near emergency approval A Johnson & Johnson scientist in Leiden, The Netherlands (Credit: Johnson & Johnson) A new Johnson & Johnson COVID-19 vaccine is about to receive emergency approval from the US Food and Drug Administration. FDA analysis released this week revealed that the company’s vaccine is safe and effective, and a community FDA will meet on Friday to determine whether the data warrant emergency approval. Logistically easier: The Johnson & Vaccine Johnson will be much easier to distribute. The vaccine is administered in a single dose sin, compared to two injections for both vaccines currently approved in the USA. The Johnson & Johnson vaccine also has less stringent temperature requirements for transport and storage. It has a shelf life of three months when stored at normal refrigeration temperatures, around 36 to 45 degrees Fahrenheit. Moderna’s vaccine should be sent at less than 4 Fahrenheit, and Pfizer should be sent and stored at less than 94 Fahrenheit. Ready to go: During a press conference on Wednesday, White House COVID coordinator Jeff Zients said he recently updated governors on vaccine distribution plans. He said the United States would use the same allocation process for the Johnson & Johnson vaccine that it is using for current vaccines. “We will not waste time putting this life-saving vaccine in the arms of Americans,” said Zients. Analysts predict a major boost in vaccine supply. See more from BenzingaClick here to see Benzinga’s First Earnings As Public Company trading options, DoorDash exceeds revenue forecastsDrilling Deep: Battery Technology Racing Ahead; The same is true of the price of diesel © 2021 Benzinga.com. Benzinga does not provide investment advice. All rights reserved.