As the prospect of a coronavirus vaccine approaches there has been a lot of discussion about how it should be distributed. On the one hand you have many countries privately contracting with leading vaccine developers to buy large numbers of vaccine doses.
On the other hand, there are calls for a worldwide effort to ensure that there is a fair and equitable distribution of the vaccine so that poorer countries get a fair share. The World Health Organisation (WHO) and several other agencies have established guidelines to fairly allocate Covid-19 vaccines that many countries have agreed to. Canada and the EU have signed the agreement, the U.S. has not.
https://www.epmmagazine.com/news/landmark-deal-signed-for-fair-distribution-of-covid-19-vacci
https://www.who.int/news/item/21-09-2020-boost-for-global-response-to-covid-19-as-economies-worldwide-formally-sign-up-to-covax-facility
So Canada has agreed that fair distribution vaccine is an important goal, but let’s look at some actual facts on the ground.
I called my doctor at the beginning of October 2020 to get an appointment for the seasonal flu vaccine, something I’ve done for many years. I was informed that they did not have any flu vaccine and would not be getting any for a few weeks because all the vaccine was being delivered to pharmacies. Somebody may have thought this this was an effective way to deliver the vaccine quickly but I don’t see any reason a proportionate amount could have been delivered to doctors based on the number of their patients. This does not bode well for a future equitable distribution of a vaccine.
Because I was really not sure when or if my doctor would get the high-dose vaccine which is very beneficial for seniors, I signed up for vaccine email alerts from my pharmacy. A week later I got a notice that the vaccine was at my local drug store. I went in the next day only to discover that people had been standing in line outside for up to two hours but that all time slots for the day were filled. I asked if I could reserve a time so I could avoid this. “No we don’t do that. It’s strictly first come first served. Come back tomorrow.”
When I arrived the next day I thought I was in luck because there was no line outside the store. But there was no line because the pharmacy had run out of the vaccine.
There was another drug store in my area that was listed in the email as having the vaccine. I called them to see if they had the high-dose vaccine (since the email didn’t make that clear) but nobody answered the phone after several attempts. So I went in person and discovered “Nope we are out of all the vaccine”. I asked the manager why an email noticed was sent saying they had a vaccine when in fact they didn’t. She replied that she didn’t know anything about messages from the central office, she just knew what was going on in her store. She said they expected another shipment in a few days. I asked again about making a reservation and yes at this store I was able to do so.
The pharmacist explained that they had been running out of the vaccine quickly, and in particular the seniors vaccine, because there was a larger demand than anticipated. Now I’m not a medical or health practitioner but I had been seeing forecasts for quite some time that there would be a very high demand for flu vaccine this year because people wanted to avoid a double whammy of having both the flu and Covid-19. I don’t think it was rocket science to have been better prepared to have enough vaccine doses to meet the demand.
Our health system has been distributing the seasonal flu vaccine for many years. If it is not able to distribute this vaccine equitably and timely, how in the world is it going to be able to distribute a new vaccine for a pandemic that they have never dealt with before? This was incompetence all the way down the line, from the Canada Public Health Agency at the top grossly underestimating the number of doses that would be required, inequitable distribution policies that bypassed family doctors and at the bottom pharmacies who were incapable of providing timely information and reservations for people to receive the shot. The pharmacy in my case was not some little local store but Shoppers Drug Mart, a national chain of one of the largest pharmacies in Canada with over 1300 stores. They can’t argue that they don’t have the resources to develop a simple online reservation system so that people can easily reserve a time in advance.
In the U.S. there has not been a lot of news about how plans are progressing to distribute the vaccine. There are a lot of critical unanswered questions and public health is scrambling. Who has the responsibility to order supplies, sign up vaccine providers, train staff and run mass vaccination clinics? And there is no funding for these programs yet, estimated at $6 billion.
https://www.npr.org/sections/health-shots/2020/10/16/924247360/facing-many-unknowns-states-rush-to-plan-distribution-of-covid-19-vaccines
And there probably will be different strategies, standards and problems in each state.
https://www.wired.com/story/in-the-us-50-states-could-mean-50-vaccine-rollout-strategies/
So the next time you hear a date about the availability of the Covid-19 vaccine, first add three months for regulatory approval and then add up to a year before you may actually get your shot. Unless you are a frontline medical worker or in a retirement home. Hopefully for these critical cases, the system will not be so badly broken and these priorities will be met.
