Gaps Feared if Hospitals, Pharmacies Sole Covid Vaccine Source

The U.S.'s vaccine distribution plan relies too heavily on hospitals and chain drug stores to ensure everyone in the country has access, the head of the National Urban League said.

Drug store representatives say they are up to the task once enough vaccines are available to distribute widely. But that claim may be hard to back up. There are about 40,000 drug stores signed up to participate in an expanded vaccine rollout that started this week.

With hundreds of millions of Americans needing shots, each retail location would have to immunize thousands of people. Having so many people dependent on one pharmacy will create logistical problems, said Marc H. Morial, president and chief executive of the urban advocacy group and a former New Orleans mayor. Most of those people would need to return for a second dose.”

“This is logistically not possible,” Morial said during an online event on Covid-19 and vaccines hosted by BlackDoctor.org and the Black Coalition Against Covid-19. Once vaccine distribution moves into the general public phase, there’s going to be public frustration without broader access.

“You’re going to have the indignity of long lines. You’re going to have community confusion across the board,” he said.

What About ‘Deserts?’

Morial’s concerns about access also spark questions about equitable distribution of the Covid-19 vaccine—some communities are far from health facilities where they can easily get a shot.

For example, a recent University of California, Irvine study identified “pharmacy deserts” in Los Angeles County, communities where the nearest pharmacy was at least a mile away. Some of these deserts included areas with denser populations, more Black and Latino residents, and greater poverty, potentially making it harder for these residents to get vaccinated.

Yet so far pharmacies and hospitals are considered the default providers of Covid shots.

“As the COVID-19 vaccines start rolling out, pharmacists will be key to the rapid and equitable distribution and administration of doses, just as they have been with COVID-19 testing,” said Jan D. Hirsch, founding dean of the UCI’s School of Pharmacy & Pharmaceutical Sciences, said in a statement.

Morial is calling on President-elect Joe Biden’s administration to broaden the distribution effort by standing up community sites at places such as libraries and schools. The incoming White House team met with the National Urban League several times and indicated they are responsive to recommendations made over several meetings, he said.

The Biden camp has proposed a $25 billion manufacturing and distribution plan, but it’s unclear if that plan includes new sites. The transition team didn’t immediately respond to a request for comment, but officials said Friday that the incoming administration will distribute more of the Pfizer Inc. and Moderna Inc. vaccines rather than hold back some of the supply to ensure people are able to get their second doses.

“I’m hopeful and will be urging with as much vigor and force as I can muster that the incoming administration make fast and radical changes to the distribution plan,” Morial said.

Beyond Health Workers

The first few weeks of rolling out Pfizer and Moderna vaccines fell far short of initial U.S. plans to vaccinate 20 million Americans by the end of 2020. States have administered about 29% of the shots that have been distributed, with about 6.25 million vaccinations so far, according to Bloomberg’s vaccine tracker.

Florida health officials Friday opened a state-operated drive-through vaccination site in Miami’s Hard Rock Stadium in Miami. Morial said he’d like to see more of that. “There has to be more effort to get beyond chain pharmacies and hospitals.”

Health and Human Services Secretary Alex M. Azar and Food and Drug Commissioner Stephen Hahn both said this week they want states to open up who they give vaccines to beyond just health-care workers.

Retail pharmacies can have the capacity to administer 100 million vaccine doses over 30 days when such supply levels are available, Steven C. Anderson, president and CEO of the National Association of Chain Drug Stores, said Friday in an email.

The drug store group is calling on the government to activate a now-dormant program to allow retail pharmacists to start giving shots to the next group of people eligible under Phase 1b, which includes adults 75 and older as well as front-line essential workers such as police officers, grocery store clerks, and public transit workers.

Retail pharmacies say they’re equipped to offer the Covid-19 vaccine to the next eligible candidates because they’re experienced with both the annual flu shot and more specialized vaccines such as the H1N1 shot. But the task is much broader for Covid-19. The Centers for Disease Control and Prevention estimates fewer than 81 million doses of the H1N1 vaccine were administered over a seven month period, which is far short of the doses needed to stop the current pandemic.

Pharmacies and their teams can be part of efforts to build mass vaccination or drive-through clinics to provide even greater capacity, Anderson said.

“Pharmacies and public health have a proven track record of working together to set up mobile clinics and mobile pharmacies during times of need ranging from flu outbreaks to hurricanes, and working together in pandemic preparedness exercises over the last decade,” he said.

The HHS recently extended funding for community testing sites into the spring, a program that runs through retail pharmacy chains, including CVS Health Corp., Rite-Aid and Walgreens Boots Alliance Inc. The funding extension highlights an acknowledgment by federal pandemic responders that some areas of the country are harder to reach and need to be funded.

Morial noted shortcomings in the HHS’s testing system and said the vaccine rollout should happen more smoothly.

“The testing regime that the outgoing administration undertook was insufficient to quickly ramp up testing or to allow for testing to be available without confusion and without long lines to those that wanted it,” he said. “We have got to use common sense and logistics in order for this to do well.”