The 2020-2021 season of the Vaccine Dinner Club is devoted to discussions of pandemic diseases, old and new.

Virtual VDC
October 7, 2020

Policy, Politics, Logistics

SARS-CoV-2 Vaccines Part II:
Distribution Challenges


William Foege, MD, MPH

Past Director (retired)
Centers for Disease Control and Prevention

Gates Fellow
The Bill and Melinda Gates Foundation

Emeritus Presidential Distinguished Professor of International Health
Rollins School of Public Health, Emory University


Capt. Janell Routh MD MHS

Co-Deputy, Implementation Planning Unit
SARS-CoV-2 Vaccine Task Force
Centers for Disease Control and Prevention

AFM and Domestic Polio Team Lead
Division of Viral Diseases / NCIRD
Centers for Disease Control and Prevention

Clubhouse Location:
A Zoom screen near you
Agenda: (all times Eastern time zone)
5:20pm — Grab a beer or a glass of wine from the fridge and get online
5:30pm — Meeting called to order in the usual way (ear muffs optional)
5:40pm — This is the part where some really excellent science is presented
6:30pm — Q & A
6:45pm — Optional: Move to break out rooms for BYOF* small group discussions
7:15pm — Adjourn, already dreaming of next month's program

*BYOF=Bring Your Own Food. This is the year in which YOU will put the Dinner in the Vaccine Dinner Club because it turns out to be logistically complicated and cost-prohibitive for us to have dinner individually delivered to everyone's house. Which is not to say that you can't make an occasion out of the evening and arrange to have GrubHub or DoorDash deliver ….

Dear Vacciners,
Think ahead for a minute to a halcyon future in which one or more pharma companies have reached the finish line in developing their SARS-CoV-2 vaccine. Their Phase III human trials are complete, their data have been parsed, their regulatory approvals have been secured, and enough glass vials and syringe needles to fill Shea Stadium (to REBUILD Shea Stadium) are in the process of being churned out.

So NOW what? Given that there is no way in the world that there will be enough vaccine to go around right at first:

Inquiring minds want to know!

Are you an enquiring mind? I hope so because the October 7th VDC will feature two speakers who are uniquely prepared to address questions like these.

First at bat will be Dr. William (Bill) Foege, the public health legend who spent the 1970's devising the global strategy that led to the successful eradication of smallpox, spent June 2020 writing about how badly politicians have bungled the COVID-19 pandemic [see essay #5], and has spent all the minutes since then working on a SARS-CoV-2 vaccine distribution report for the National Academy of Medicine -- that is being un-embargoed by congress JUST in time for him to be allowed to discuss it for the first time (with us!) at this month's VDC.

Up next will be Capt. Janell Routh, the public health rock star who is co-leading the CDC's efforts to get the vaccine(s), when and if one or more are licensed for distribution, from vat to van to a vaccination team near you.

Sound too cool for school? Hell yeah! So Register Now and we'll see you at the Club on October 7th.

-Kimbi Hagen, EdD
Your friendly neighborhood VDC Director/Goddess

*I have to admit that it is the last question – about how we will keep the vaccines viable on their trip to remote corners of the globe -- that has been waking ME up at night lately (because every now and then I like to take a break from worrying about things that are happening to worry about things that haven't yet happened).

Those of you who are VDC old timers may remember when Dr. Stan Foster gave a September 2013 VDC talk titled "Hindsight is 20/20: Lessons Learned and Visions for the Future: 50 Years of Immunization." In it he described the time young CDC EIS (Epidemic Intelligence Service) officer Larry Altman (who grew up to become a science writer for the New York Times) was sent to Mali to address failures in their measles program.

Upon his arrival in Mali, Dr. Altman promptly identified one obvious problem – to be effective, measles vaccines have to be kept cold every step of the way from the moment they are manufactured until the moment they end up in someone's arm and, in Mali, the "cold chain" was broken.

So there ensued a back and forth trail of cables (this being in the dark ages before email) between Dr. Altman and staff in Washington DC:

"Jeeps don't keep the vaccines cold. Send trucks."
"No trucks available. Park under trees."
"Send trees."

"But that was decades and decades ago!" you are no doubt thinking. "Surely things are better managed by now!" Nope. Globally, keeping a cold chain intact is still a complex and costly process that can account for upwards of 80% of the price of vaccinations. Not to mention that it fails often enough to lead to the loss of nearly half of all vaccine doses globally. And that is NOT taking into account the specialized needs of front runner Pfizer's proposed SARS-CoV-2 vaccine that, according to this ABC news article, will need to be stored at 94 DEGREES BELOW ZERO every step of the wayfrom manufacturer to Mali.

That's gonna take some very specialized trees….