Simple access to COVID-19 vaccines creates unprecedented logistical complexity

Cooperation and partnership will open the door for success

The fact that we’re on the brink of having three authorized COVID-19 vaccines developed and deployed in under a year is a miracle. It is an unprecedented achievement in our history and stands as a testament to the human spirit and societal imperatives that demand dedicated resources and expertise to address our most difficult and devastating collective challenges. The development of these remarkable medicines hopefully places light at the end of a dark and difficult tunnel. It’s now the moral imperative of all capable parties to put forward potential solutions that will allow us to reach the other side of the tunnel as fast as possible. To that end, today I too want to offer a solution to the unprecedented logistical challenges facing those in the public and private sector who are working tirelessly to create access to the COVID-19 vaccines – leverage the established U.S. pharmaceutical distribution industry when the time is right. 

Before going any further though, it is necessary to acknowledge where we are: the lag in getting shots in arms combined with state-level issues like inadequate funding to raise vaccination sites, prioritization confusion, data-sharing and communication hurdles, have contributed to the slow start. The distribution - meaning the physical logistics of getting COVID-19 vaccines from manufacturers to states - has been a success.

As the company I lead, AmerisourceBergen, has worked around the clock with the government, pharmaceutical manufacturers and health care providers to create access to novel COVID-19 therapies, I have been watching and respecting the work of McKesson, FedEx and UPS – the companies leading the current logistics efforts for vaccines in partnership with the U.S. Centers for Disease Control & Prevention (CDC). Nearly 60 million vaccines have been successfully delivered to states and sites of care. In just two months since the first vaccine authorization was granted, nearly 8 percent of Americans have received at least one shot – a remarkable feat made even more impressive by the challenging handling requirements presented by current vaccines.

With that in mind, it is also important to acknowledge that vaccine access in the United States is at a critical inflection point. We’re on the precipice of having another breakthrough COVID-19 vaccine from J&J. And last week, the Federal Government announced the early launch of the Federal Retail Pharmacy Program, which will give 21 pharmacy chains and independent community pharmacy networks access to COVID-19 vaccines to support inoculation efforts to prioritized populations across the states. While supply of COVID-19 vaccines is still limited, the addition of retail pharmacy in the vaccine effort is game changing. Vaccination points have increased to now include 6,500 pharmacies overnight and tens of thousands of additional pharmacies and physician practices are eager to play their role in administration as supply increases with growing production and newly approved products. With more sites of care and more available vaccine supply on the way, we are at a logistical turning point.

Should we reinvent the wheel? 

While our situation today is undeniably unprecedented, we can learn from and lean on the lessons and best practices of the pharmaceutical distribution industry, which grows more efficient each year. Mass vaccination in the United States is not new - just look at historical trends with flu vaccine supply. This year alone more than 170 million doses of flu vaccine were distributed. As many of us have experienced, accessing this product – along with numerous other childhood and adult vaccines – is generally simple, requiring that patients do little more than visit their primary care provider or pharmacy. This effort is made possible by the full breadth of the pharmaceutical distribution industry and with more vaccines becoming available, supply steadily growing, and more pharmacies getting involved, there will come a time when the deployment of the United States full pharmaceutical distribution infrastructure will be well suited to support moving greater quantities of vaccines to greater numbers of providers. 

This pharmaceutical distribution industry – which includes more than 35 national, regional and specialty distributors, delivers millions of medications daily and ships to 180,000+ dispensation points across the country – is the established bridge between manufacturers and providers. We are the reason local pharmacies, hospitals and many varied sites of care are stocked, and why providers can order inventory at 7 p.m. and get medications the next morning. It is the most efficient, safe and sophisticated supply chain and physical infrastructure that exists for timely delivery of medications to providers in the world.  

While acknowledging that centralized control and data are necessary – particularly when specific populations need priority vaccine access based on risk - other pharmaceutical distributors could easily become force multipliers to the current vaccine distribution operations. In other words, the CDC could use more of our industry’s distribution centers – which are already set-up to store delicate pharmaceutical products - to house more vaccine inventory. 

By going in this direction, the vaccine distribution effort will acquire more localized partners with institutional knowledge and the same know-how to manage and facilitate distribution of unique pharmaceuticals; organizations that are trusted partners to manufacturers and who have existing relationships and knowledge of health care providers who will ultimately administer vaccines in their communities. This deep industry knowledge of how individual pharmacies, physicians and health systems need to receive inventory, will allow simpler redirection of vaccines across care networks and can bring forward pharmaceutical allocation expertise. 

It would be disingenuous to not acknowledge that this model has its own hurdles. One is that the technology platform connecting the parties supporting COVID-19 vaccines logistics is currently a closed-loop system. Only limited parties have line of sight into where vaccines are and the ability to place and process states' orders.

For this “force multiplier model” to work, this platform would need to integrate additional pharmaceutical distributors into the system to support states' order management processes and the tracking and delivery of vaccines. While full technology integration and interim process solutions would involve work from both the public and private entities involved, the benefits of increased capacity and efficiency greatly outweigh any additional burden. 

Regardless of the on-boarding hurdles that may be required, the core competencies of companies in the pharmaceutical distribution industry are built to manage the complexity that lies ahead — if they are given the chance to assist. Government leaders have been exceptional with a strong desire to learn about industry capabilities and a clear goal of doing what’s best for the American public. Our goal is to do whatever we can to contribute to the entire country’s critical need to take control of the pandemic and create the pivotal opportunity to return to the normalcy that so many of us crave.