The Daily - When and How You’ll Get a Vaccine

Episode Date: November 30, 2020

For Americans, months of collective isolation and fear could soon be winding down. A coronavirus vaccine may be just weeks away.According to Dr. Moncef Slaoui, head of Operation Warp Speed, the federal effort to accelerate vaccine development, the first Americans could receive the vaccine in mid-December.With the vaccine within reach, we turn to more logistical questions: Who will receive the shots first? Who will distribute them? And what could go wrong?Guest: Katie Thomas, who covers the drug industry for The New York Times.We want to hear from you. Fill out our survey about The Daily and other shows at: nytimes.com/thedailysurveyFor more information on today’s episode, visit nytimes.com/thedaily Background reading: Promising clinical trials have buoyed hope that the end of the pandemic is in sight. But even if the vaccines are authorized, only a sliver of the American public will be able to get one by the end of the year.In mid-December, 6.4 million doses of Pfizer’s vaccine are expected to be shipped across the United States in an initial push.

From The New York Times, I'm Michael Barbaro. This is The Daily. Today. Now that multiple vaccines are making their way toward approval, what do we know about the plan and timetable for distributing them? I spoke to my colleague, science reporter Katie Thomas. It's Monday, November 30th. Katie, tell me about this interview with the head of Operation Warp Speed. Joining us now is the chief scientific advisor for Operation Warp Speed, Dr. Mansef Slaoui.

So last Sunday, Dr. Mansef Slaoui, who's the head of the big federal effort to develop a vaccine, went on CNN and was asked about where things stand. When do you expect the first person will be vaccinated? Well, our plan is to be able to ship vaccines to the immunization sites within 24 hours from the approval. So I would expect on the 11th or on the 12th of December, hopefully, the first people will be immunized. And in the interview, he laid out a timeline that I think would be pretty surprising to many Americans. that I think would be pretty surprising to many Americans. 70% or so of the population being immunized would allow for true herd immunity to take place.

He said that, you know, based on his understanding of how the vaccines will be rolled out and when the vaccines might be ready... That is likely to happen somewhere in the month of May or something like that, based on our plans. ...some form of normal life might be able to return by May of next year. Right. And I read about that, Katie, the next morning. I think I saw it in a tweet. And I actually thought to myself, that can't be right. Someone got that wrong. And then I

went to the CNN website and I looked at the transcript and I was like, oh, he actually said that. May. That felt really early. Yeah, it is pretty remarkable that we could have a vaccine by then. But a lot of things will have to go right and many, many steps will have to fall into place. But it's entirely possible this could end up being correct. Well, what exactly gives him the confidence to make this very public declaration? Well, it's based on how far along we are in the development process. We've already had really good results from some of the companies, Pfizer, Moderna, and AstraZeneca. And Pfizer in particular has already submitted its application for emergency authorization with the

FDA. And so now FDA scientists are pouring over that data and evaluating whether they're going to okay it. And there's even been a date set on December 10th for an outside panel of independent vaccine experts who are going to weigh in on it. And then the belief is that pretty shortly after that, it could be authorized by the FDA. And from what Dr. Slaoui and the other Warp Speed officials have said, you know, the vaccines could start rolling within 24 hours of an authorization. And when you say rolling, what exactly does that mean? I think everyone is extremely interested in the question of when and how the vaccines actually start to reach all of us. Yeah.

So for the past several months, even as these vaccines have been, you know, going through clinical trials, these officials at Operation Warp Speed have kind of been gaming out how this is going to work and planning out with the states exactly how it's going to be distributed and how they're going to get these vaccines and these vials from the factories to your local clinic. So what distribution plan have they come up with? So just take Pfizer for a second because they're the furthest along. have they come up with? So just take Pfizer for a second because they're the furthest along. Their vaccine needs to be kept extremely cold. It's got to be kept at minus 94 degrees Fahrenheit.

So they've designed these special shipping boxes that they say will be able to keep their vaccines at this ultra-cold temperature. And they hold 975 vials of vaccine. And they have GPS-enabled thermal sensors that track the location and the temperature of each of these vaccine boxes as they're shipped across the country. When the boxes arrive, then the clinic or the hospital, they're going to have a couple of options. They could just put it into an ultra-cold freezer, and a lot of hospitals are actually buying these freezers especially for this right now. And if they put it in this freezer, then they can store it there for up to six months.

But if they don't have one of these freezers, they can just take the vials out of this ultra-cold shipping box and put it just into a regular refrigerator. Essentially thaw out the vaccine. And then those vaccines would have to be used within five days. And then the last option is that they can keep the vials in these special boxes, and those can be used as temporary storage as long as they keep refilling it with dry ice for up to 15 days. And how much vaccine is going to get shipped in this first few weeks of mid-December? Well, initially, not nearly enough for everybody. The first week of a shipment that they've said will be about 6.4 million doses. And remember, Pfizer is a two-dose shot that's given three weeks apart.

Pfizer is a two-dose shot that's given three weeks apart. So when we hear the number 6.4, we should assume that actually means doses enough for some 3 million people. Correct. And then the government is saying that there should be about 40 million doses of the vaccines by the end of the year. Right, which again, we should cut in half to assume 20 million Americans. That's right. So that's a very small percentage of the American population. So what are government officials telling you will be the kind of hierarchy for who gets it and in what order? These details, they are still being worked out.

And, you know, states and the federal government and local officials are still kind of talking about this stuff. But there is generally a broad consensus that the first group that will get them are doctors, nurses, other health care workers. And then almost simultaneously with that, the other group is residents of long-term care facilities like nursing homes. And how many people is that, Katie? Doctors, healthcare workers, people in long-term health centers? There's about 20 million healthcare workers and about 3 million people who live in long-term care facilities. Huh. So that would pretty much use up this entire first batch. Yes, that's right.

Okay. So let's presume that more and more vaccine keeps getting made. Who is next on the list? So the next big group that's been widely discussed would be this big category that's known as an essential worker. And that's a very big group of people. That's more than 80 million people in the U.S. Wow. And you can broadly think of these people as the people who do work that doesn't allow them

to stay home and social distance. In order for them to do their job and to kind of keep our world running, they have to go into work and therefore expose themselves to COVID-19. You know, meatpacking plant workers, people who work on utilities, firefighters, police officers, even teachers. These are, again, the people that kind of keep our country running.

Mm-hmm. And is that a list that's written down somewhere or decreed by the government? Is it going to be kind of flexible or we don't know yet? I don't think we fully know yet. It's being kind of worked out as we speak. And it may end up being something that is up to local authorities. All right.

So after essential workers, who comes next? The other priority group that's been discussed is people who are over 65 and people who have an underlying health condition that could be diabetes or heart condition. Again, this is a group of people, and this becomes a very, very large group of people. But this is a group of people that are at a much higher risk of dying or become very, very ill if they were to test positive for coronavirus. So at this point, and the math is a little bit hard to keep track of, it sounds like we're talking about probably on the order of 100 million plus people.

Does that feel right? Yep, that's about right. Okay. So now we're pretty well into 2021. Right. And so, you know, if all continues to go well and perhaps new vaccines are approved, the manufacturing plants are really working at top capacity and they're churning out millions not especially vulnerable through underlying conditions, when does that group of Americans start to get the vaccine? outlined, I mean, that's a pretty big chunk of the general public. By this time, you know, a lot of the country will have been able to have gotten a vaccine. But what Dr. Slaoui had said, remember, that May date is what they are saying is their best guess for when people who don't fall into

any of these risk groups, you know, when they will be able to get a vaccine if they want one. And to explain a word that Dr. Munsef-Slaoui used in that interview with CNN, which you'd mentioned, Katie, he said that May is the point around which enough Americans will be immunized that herd immunity or something like it will be achieved. And I wonder if you can just remind us what that means and why it's important. Herd immunity means that enough people have themselves personally, you know, some form of immunity from the coronavirus so that they will not be able to pass it along to somebody else. And if enough people in the community have it, then the virus really

can't spread as readily as it has. Now, I will add one caveat to what Dr. Slaoui said. And in some ways, I'm surprised he was able to make such a confident statement about that because there's still a lot that we don't know about these vaccines and how they work. And the vaccines were actually not testing on the question of whether once you get them, you can actually still pass the virus along to someone else. The only thing that these clinical trials were testing was whether they prevented people from developing COVID-19, which of course is the disease that you develop after having been infected by the coronavirus. So we really don't know yet whether even if a vast section of the American public gets this, if they still won't be able to pass the virus from person to person. So you're saying there's still a possibility, we don't know for sure, that tens of millions of us will get this vaccine, and we ourselves will probably not get sick, because that's

what the clinical trials have shown this vaccine prevents, but it's possible we still might give the virus to somebody who is not vaccinated. That's right. It's just, it's a scientific question that hasn't been answered yet. We'll be right back. So, Katie, I want to turn to a few logistical questions now that we understand the order of vaccination. How much will this vaccine cost people who get it? In this first phase, it should be free of charge.

For everyone? For everyone, for all Americans. Okay, so basically the government is subsidizing this to the point where you would get the vaccine and it would cost you nothing. That's right. They've essentially bought these vaccines on behalf of the American people. They have paid billions of dollars to these companies to buy hundreds of millions of vaccines.

Okay, and where will your average American obtain the vaccine? I think we all have visions from too many movies that we have watched of camouflaged military trucks and these vast, tense cities

staffed by soldiers, and kind of that's where you maybe get your vaccine? Or are we just going to be going into our local Walgreens and Walmart pharmacies? Yeah, I mean, it's a really good question, and it's one that people have been curious about. But what's interesting is what the Warp Speed officials have said is they really want this to look as much as possible

like your regular experience of getting a shot, like getting your flu shot. You know, we're all familiar. We walk into a CVS in Walgreens and we see signs everywhere that say, get your flu shot here. You know, what they're aiming to do is to be in those same places that Americans feel comfortable getting their immunizations. And why is that important to them? their immunizations. And why is that important to them? That's important to them because they want people to feel as comfortable as possible getting this vaccination. Remember, this is, first of all, a really scary pandemic. And then second of all, these are brand new vaccines that are really just fresh out of the clinical trials. So there's a lot of hesitancy and a lot of skepticism about these vaccines, and they're trying to do everything they can to kind of make people feel

as comfortable as possible about taking them. Right. So one solution to a vaccine-hesitant society is to ask people to take it at a familiar place, a Walgreens, not a scary military tent. That's right. There aren't going to be soldiers, you know, walking up to your door and knocking on your door and giving grandma a shot. Right.

Hey, now you're making it even scarier than I was willing to make it. Katie, you mentioned the flu vaccine, how much the government wants this all to look and feel like getting that, But that's a single dose. And we know that the COVID-19 vaccine in almost all cases is two doses. And that feels inherently messier. So how does the government planning account for that? Yes, this is going to be a very complex challenge. And we're going to really have to see if all of our systems are up for it.

But what the federal Warp Speed officials have said that they're doing is they're planning a centralized database that will keep track of which vaccine everyone received, what date they received it on, and then when they need to get their second dose. And kind of the idea behind this is that no matter where you go, they can kind of keep track of what you need. You know, one example that's been thrown out is take a snowbird in New York who gets their first dose at a CVS on Long Island of the Pfizer vaccine. Then they go down to their winter home in Florida, they go into a different pharmacy, and the pharmacy there is able to look them up and know exactly what they are due for and which vaccine they should get. But, you know, as we've

seen before with government health systems and databases, these things don't always go as planned. And already state and local officials have been warning that they don't have enough money, you know, to support this. And so we're really going to have to see how this actually rolls out. And with two shots, it feels like there is a real danger that a meaningful number of people kind of forget to go get the second shot, right? And my sense is that means that they are not fully immunized. That's right. I mean, it's going to be a really big challenge. States have all kind of put in their plans for how they're going to do this. And some of the

states have also put in details about this. You know, they're going to send people postcard reminders or text message alerts. And so, you know, public health officials are really trying to plan for how to prompt people to go back for that second dose. But we all know that this is a challenge. Right. Okay, this is a bit more of a curveball question for you. What if Americans decide to get kind of picky and they say, I know that there are three or four or five vaccines out there,

but I've read about vaccine X and I want that one. I don't want that other vaccine. Is that something people can do or are we going to be in a situation where you kind of get what you get? I think it's going to be, you know, you get what you get and you don't get upset as I tell my kids. You know, it's going to be an extremely scarce supply in the beginning. Katie, is there any talk of mandating that people in any of the categories that we have been talking about must take the vaccine? I suspect that doctors have to take the vaccine to go to work. Perhaps that's going to also be true of some essential workers. But when it comes to regular

Americans, some of whom, as you just said, are going to be pretty skeptical. They may not take it. Is there talk of any requirement that they get the vaccine? No, there's really no talk of a mandatory vaccine. There may be, as we move forward, isolated cases of employers or even businesses that might require that you have a vaccination, you know, for example, an airline. But really, no one's talking about some sort of national vaccine mandate. Katie, what in your mind could still go terribly wrong here? I think there's a lot that could go wrong.

The vaccines could not get approved. Some of the vaccines that are still in development could fail to work. The distribution could break down. These shipping boxes might fail. The database that we talked about could crash. There could be long lines for vaccination or just a lot of confusion. This is an extremely complex process and a huge project. And, you know, as we've seen, sadly, so many times before,

there's any number of things that really could go wrong. Katie, you have been immersed in this world of Operation Warp Speed, the question of vaccines and vaccine distribution for, I think, around six months now. I recall the first time we talked to you about this, the operation had just been created. And now here we are at this point where vaccines are theoretically on the verge of approval. This distribution system has been thought out and people are quite possibly going to be getting these doses in weeks. And so I wonder how you're feeling about all these developments. You know, I'm feeling pretty optimistic, which is a funny place, I admit, for a reporter to be,

because we tend to look for, you know, all the things that might go wrong. You know, I've spent this year writing about really dark stuff, really terrible stories. But I'm starting to kind of picture scenes that make me feel just a little bit better. You know, I'm thinking, for example, of nursing homes, the site of so much terrible suffering and death. And, you know, if all goes well, within the next couple of weeks, we could start seeing people who live in these nursing homes getting vaccinated. And, you know, maybe even by January, what if every single nursing home and every single resident who wanted one got a vaccine? That would be amazing. I mean, that would be amazing.

And that's really just around the corner. really just around the corner. And, you know, even in my own life, I think all of us, this has continued on for so long, and it's been so tough that we've all kind of stopped allowing ourselves to really think about the future. And I have been kind of allowing myself to think about what would we do after the pandemic? You know, when could my kids see their grandparents? When would that be safe? And, you know, honestly, those are things that I really haven't even almost allowed myself to plan for. And I'm starting to think about that a little bit. I'm guessing you haven't bought plane tickets, but you're maybe looking at prices. I'm not even that far along. I'm just picturing in my head, my kids seeing their grandparents.

And just being able to have those thoughts is itself a comfort to me. This is a weirdly hopeful moment. And I think all of us have our fingers crossed. So thank you very much, Katie. We appreciate it. Yeah, thanks. Yeah, thanks. Later today, Moderna will seek emergency authorization from the Food and Drug Administration to begin distributing its vaccine for the coronavirus, making it the second company after Pfizer to reach that milestone. We'll be right back.

Here's what else you need to know today. The Times reports that the assassination of a top Iranian scientist threatens to derail President-elect Joe Biden's plan to revive the Iran nuclear deal. The scientist, Mohsen Fakhrizadeh, who has overseen Iran's pursuit of a nuclear weapon for decades, was gunned down in his car on Friday

in an operation attributed to Israel. It is widely believed that the Trump administration was either aware of or blessed the operation. Biden has said that a new agreement between the U.S. and Iran designed to prevent Iran from developing nuclear weapons is a major priority, but both Trump and Israeli Prime Minister Benjamin Netanyahu want to block such an agreement, and the assassination of Fakhrizade may be designed to make such a deal as difficult for Biden as possible. And,

Beginning the week of Monday, December 7th, New York City public schools will begin to reopen. New York Mayor Bill de Blasio said he would reopen the city's public elementary schools and abandon the controversial threshold for shutting them down, which was triggered two weeks ago. The announcement was an acknowledgment that linking in-class learning to a citywide infection rate of 3% was impractical since the infection rates inside schools had remained far lower. We now believe we know what we didn't know back in the summer.

We know what works through actual experience. That's it for The Daily. I'm Michael Barbaro. See you tomorrow.