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A&M epidemiologist on COVID-19 vaccine delays: “We just haven’t had that time and experience yet”

Published: Jan. 14, 2021 at 8:35 PM CST
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BRYAN, Texas (KBTX) - Yesterday, the Brazos County Health District announced a more streamlined system to administer COVID-19 vaccinations almost a month after the first doses arrived in the Brazos Valley.

So, why did it take so long for officials to announce a mass COVID-19 vaccine distribution plan?

First News at Four sat down with Texas A&M epidemiologist and biostatistician, Rebecca Fischer, to find out.

“Those in the vaccine world have been doing this sort of work across the globe for many decades,” Fischer explains, “this sort of vaccine rollout is what helped us stamp out Polio and what has eradicated Small Pox from the globe.

“But,” she says, “this is bigger. We have more people, everybody needs this, the disease is so widespread that so many of us are at risk, and we need the vaccine. So this is really an unprecedented scope of vaccine delivery.”

She says there are a number of factors that are slowing down the distribution process including, but not limited to, the difficulty of evaluating who is most vulnerable. Fischer says with a limited quantity of the COVID-19 vaccine currently available, it’s extremely important to get the vaccine first to those who incur the highest risk of dying from the virus. She says the state is following expert guidance in ensuring all healthcare workers who want the vaccine have first priority.

“But what it means is that the vaccine isn’t available to everybody at the same time,” Fischer explains.

She says that can even be true within these prioritized groups. For example, the U.S. has distributed roughly 30 million doses according to data from the Centers for Disease Control and Prevention as of Jan. 14. However, there are about 18 million prioritized healthcare workers across the nation. If every healthcare worker were to receive the vaccine, that would leave just 12 million left over. So while Texas is leading the nation in COVID-19 vaccinations, that still means a large portion of group 1B won’t be able to get vaccinated right away because there just aren’t enough doses yet.

But even when there are enough doses of the COVID-19 vaccine to meet widespread demand, Fischer says safely transporting mass quantities of it presents issues.

A worker transports a container carrying boxes of the Pfizer-BioNTech COVID-19 vaccine to be...
A worker transports a container carrying boxes of the Pfizer-BioNTech COVID-19 vaccine to be shipped at the Pfizer Global Supply Kalamazoo manufacturing plant in Portage, Mich., Sunday, Dec. 13, 2020. (AP Photo/Morry Gash, Pool)(Morry Gash | AP)

“It’s the trucks, and it’s refrigeration, and it’s freezing, and it’s temperature.” Fischer explains, “Really rolling it out, think of all the refrigerated and frozen trucks and dry ice and carriers and how they have to stop and replenish the dry ice at times. So, this is a massive undertaking... and that’s just delivery.”

It’s not that vaccine producers weren’t anticipating these challenges, she says. But instead, it’s the difficulty in ramping up all of the production of technology involved in transporting and housing the vaccine, like refrigeration and deep freezing, that’s causing problems. Fischer says we’re using the technology necessary to transport the COVID-19 vaccines at unprecedented levels.

Another factor, Fischer says, is the challenge of anticipating how quickly both Pfizer and Moderna will be able to ramp up production of the vaccine.

COVID-19 vaccine doses being produced on the Modern production line.
COVID-19 vaccine doses being produced on the Modern production line.(KBTX)

“Vaccine manufacturers are used to producing a lot of vaccine,” Fischer says, before going on to add, “again, this is something that is different. This is a scope that’s new.”

On Tuesday, the federal government released all reserves of the COVID-19 vaccine being held for second doses, adding more than a third of all doses already distributed to the accessible supply. Initially, the U.S. Department of Health and Human Services had been holding back second doses as a safety precaution against potential shortfalls in production. Now, officials say they’re confident the supply will be there when needed.

Fischer agreed with their initial decision, saying, “one dose is not gonna cut it,” but also agrees with the recent change, explaining, “more of us are receiving that first dose with the understanding that the second dose will come and we still need that second dose.”

Yet another issue, Fischer explains, is the problem of housing the vaccine.

Baylor Scott & White officials safely storing the first shipment of COVID-19 vaccine doses in...
Baylor Scott & White officials safely storing the first shipment of COVID-19 vaccine doses in their facility's deep freezer last month.(KBTX)

“We’re not just talking about having freezers. We’re talking having deep freezers” Fischer says, “so these are at -70° F or -80° F. These are $15,000 units.”

For more populous areas with larger healthcare systems and facilities, safely storing the vaccine is more readily achievable. But for rural areas that don’t already have the necessary infrastructure to store the vaccine, these kinds of storage units can be a challenge to quickly manufacture, install, and test. Fischer says most deep freezers are stationed in laboratories or major hospitals with electrical systems already in place.

“There’s a whole lot that goes into [safely transporting and storing the COVID-19 vaccine],” Fischer explains, “so those rural areas can be particularly hard to reach.”

She says it’s vitally important for academic institutions, like Texas A&M University, to be partnering with hospitals and local officials to make resources, like deep freezers, available. Fischer says the relationship between Brazos County and Texas A&M has played an important part in ramping up local deep freezer storage capacity.

But even when the vaccine is widely available and into the arms of a majority of Americans sometime down the road, Fischer says we may still have to utilize preventative practices like mask usage, social distancing, and frequent hand washing and sanitizing.

“Even when we can get [the pandemic] at bay and most people are vaccinated,” Fischer explains, “it’s highly likely that we will continue to see outbreaks.”

She says the only way that outbreaks can be prevented is by completely eradicating COVID-19, something researchers and scientists across the globe aren’t presently capable of doing. When outbreaks do arise, Fischer says, we’ll need to rely on those preventative measures in order to contain the outbreaks.

“Until we can get enough people vaccinated,” Fischer says, “and the estimate of this is 70-80% of individuals vaccinated, we are going to want to continue to use the respiratory barriers, so using our facemasks, washing hands, being careful about our distance around other folks, and limiting our group sizes because those are prevention methods and those work.”

“Again,” Fischer says, “a vaccine cannot prevent exposure, and it cannot prevent infection. We just don’t know enough science to understand yet how well the vaccine can prevent some of those transmission events.

“With the vaccine for Coronavirus,” Fischer concludes, “we just haven’t had that time and experience to learn those things yet through observation.”

Watch the full interview in the player above.

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