Medical experts discuss obstacles to COVID-19 vaccine distribution at Penn panel

As the United States prepares to begin the distribution of a COVID-19 vaccine, Penn hosted a panel of medical experts to discuss key issues surrounding vaccine distribution. 

The panel, called “Coronavirus Vaccine: Addressing the Challenges in Distribution and Uptake,” took place virtually on Friday and was hosted by Penn’s Leonard Davis Institute of Health Economics. The panelists included a law professor, Philadelphia’s deputy health commissioner, the director of the Vaccine Education Center at the Children’s Hospital of Philadelphia, and the strategic advisor to the CEO of the Coalition for Epidemic Preparedness.

During the event, which was moderated by Penn Nursing professor Alison Buttenheim, panelists discussed the current state of vaccine development, as well as the ethical and equity challenges surrounding who should receive the vaccine first and how to overcome widespread vaccine hesitancy.  

The Food and Drug Administration will consider Emergency Use Authorization for Pfizer and BioNTech's vaccine candidate on Thursday and Moderna’s vaccine candidate on Dec. 17. A clinical trial demonstrated that Pfizer and BioNTech's vaccine candidate is more than 90% effective in preventing COVID-19, and Moderna announced that a preliminary analysis of their trial showed their vaccine to be 94.5% effective.

Paul Offit, the director of CHOP’s vaccine education center, said it is possible that Americans could receive the Pfizer vaccine as early as Dec. 15. He estimates that two-thirds of the United States population could receive the vaccine by this time next year, allowing the U.S. to get the pandemic under control. 

Once the vaccines are approved for distribution, experts must determine who should receive a vaccine first given the limited initial supply. 

Although healthcare workers will be given top priority for receiving the vaccine because they are more likely to contract COVID-19 than the general public, panelists said it’s necessary to consider how various employees, ranging from doctors and nurses to kitchen and custodial staff, will have different degrees of exposure to infected patients, professor of law at George Washington University Dayna Bowen Matthew said.

The goal is to distribute vaccines to the “1A” group — healthcare workers with direct patient care and people who work or live in long-term care facilities — by the end of December, Offit said. 

“We needed to catalog that in a way — figure out how many there were, where they were, who they were, and how we were going to access them,” Philadelphia Deputy Health Commissioner Caroline Johnson said. 

Hospitals and health systems will be encouraged to make their own internal decisions about who will get the vaccine first because some will not receive enough doses needed to immunize their entire staff, Johnson added. 

“A lot of places are going to be expecting a certain amount of vaccine, and they’re going to get a lot less,” Strategic Advisor to the CEO of the Coalition for Epidemic Preparedness Initiatives Nicole Lurie said.

When making decisions about vaccine distribution, Bowen Matthews said there should be a “justice element” involved in distribution frameworks to account for the high number of hospitalizations and deaths in Black and brown communities. She said this could be incorporated by utilizing community health workers, increasing access to the vaccine, and making sure the people distributing the vaccine can communicate with recipients to earn their trust.

In Philadelphia, communities of color and communities that were hit the hardest by COVID-19 will be prioritized for receiving the vaccine, Johnson said.

The panelists also raised concerns about the likelihood of vaccine hesitancy as a result of the fast-paced development process and politicization of the vaccine.

Offit said that vaccine development moved so quickly because the government offered to pay for trials and the mass production of a COVID-19 vaccine, before understanding its efficacy or safety. Companies are not usually willing to assume the risk the government did by pouring money into vaccine production before learning about safety results, he added. 

Creating pervasive, positive messaging about the vaccine from trusted people of different political parties and races will be important to countering vaccine hesitancy, Lurie said. 

“At the end of the day, people take advice and guidance from the people they trust,” she said. “The message can’t just come from our political leaders and it can’t just come from our scientists, but it has to come from people in all of our communities all over the country.”