As a COVID-19 vaccine nears, states are working to prepare themselves for storage and delivery of the vaccine.

As Pfizer and BioNTech work to get what could be the first COVID-19 vaccine approved for an emergency use authorization, states are working to prepare themselves for storage and delivery of the vaccine.

The Pfizer vaccine requires special storage conditions that many hospitals are currently unprepared to meet. The vaccine must be stored at around minus 70 degrees Celsius (about minus 100 degrees Fahrenheit), which typical freezers are incapable of reaching. Ultra-cold freezers, which cost between $10,000 and $15,000, would be required to store the vaccine if a hospital plans on keeping many doses available.

The vaccine, which is administered in two doses 28 days apart, is shipped in dry ice-packed boxes which can store the doses for up to 10 days. The dry ice can be replenished up to three times every five days (up to 15 days) and the package cannot be opened more than twice a day. On day 15, the vaccines must then be transferred to a refrigerator where they can survive for five days and cannot be refrozen.

Katie Johnson, vice president of marketing and communications for Lake Region Healthcare, said, “We are partnering with the county and (West Central Minnesota Healthcare Preparedness Coalition) members to provide the vaccine and together we are looking to secure storage with a both/and approach, getting access to the type of dry ice needed and a freezer that can accommodate storage.”

Minnesota’s eight regional health care coalitions were established in 2002 and consist of hospitals, emergency medical services and public health agencies, among other partners, who are responsible for maintaining health care services during emergencies. The West Central Healthcare Preparedness Coalition serves Clay, Douglas, Grant, Otter Tail, Pope, Stevens, Traverse and Wilkin counties.

While the federal government’s vaccine program, Operation Warp Speed, will be delivering the vaccine to states, it’s up to states to plan distribution. The CDC asked states to turn their plans in on Nov. 2, Minnesota, Hawaii and Pennsylvania said they are still working on theirs according to a Nov. 10 report from ProPublica.

The primary concern with distribution is related to the unique circumstances required for storing the vaccine. The packages in which they are shipped contain 1,000 to 5,000 doses. A larger hospital may be able to handle that volume, but smaller rural hospitals may struggle to get through so many doses before they go bad.

Another concern is prioritizing communities: With a limited number of vaccines available at the outset, who should get them first? Should the state risk losing vaccines (to lack of storage or low population) by sending them to rural areas?

The CDC has told state health departments not to invest in ultra-cold freezers yet, as the Pfizer vaccine has not been approved and a different vaccine with easier storage requirements may become available not long after. As of Nov. 11, there are about 11 vaccines globally that are undergoing Phase 3 trials, including the Pfizer vaccine.

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