U.S. military leaders and logistics specialists are working on multiple fronts to ensure rapid distribution of COVID-19 vaccines. Efforts include reducing red tape for imports and exports of clinical trial materials and coordinating logistics plans with public health jurisdictions across the country.
The Department of Defense is essentially serving as a lead logistics provider, applying its vast logistical capabilities to coordinate with private sector manufacturing and freight transportation companies the on-time delivery and availability of critical materials.
“We have the best logisticians in the world at the Department of Defense, working in conjunction with the Centers for Disease Control, to guide … every logistical detail you could possibly think of,” said Paul Mango, the deputy chief of staff for policy at the Department of Health and Human Services, during a Friday teleconference.
The endeavor, he said, involves everything from swabs, adhesive bandages and needles to dry ice and trucks. “We will have an operation center that will tell us at any given time exactly where every dose of vaccine is … . If a vaccine dose is at risk of expiring, they will guide the movement of that to someplace else.”
Representatives from Operation Warp Speed (OWS), a multiagency task force led by the Department of Defense, recently convened to rehearse vaccine distribution plans unveiled last month by the Trump administration, according to a weekly update posted on the DOD website. The “battle rhythm” event allowed government and industry partners to define roles and responsibilities, synchronize movements, identify gaps and plan for potential challenges at every stage of the distribution process.
Whether military assets will actually be used to supplement commercial logistics capabilities remains an open question. Pentagon officials claim there is no need for wide-scale deployment of transportation equipment, although industry sources and analysts indicate scenarios being studied include the use of U.S. Air Force cargo planes to ferry vaccines that need to be deep frozen.
“The federal military will not be involved in moving any doses or injecting any vaccines,” Mango said.
The military is simply providing planning and program management to help enable other parties in the fight against COVID, explained Army Gen. Gustave F. Perna, the program’s chief operating officer, Tuesday to the Heritage Foundation in Washington. “There will not be this vision that some have that there will be Army trucks driving through the streets delivering vaccines. The commercial industry knows how to do it.”
In a commentary on Fox Business, HHS Secretary Alex Azar explained how the DOD might assist with the physical distribution of vaccines. “If a shipment from overseas might normally take six weeks on a ship but is needed much faster, we ensure it’s put on a plane instead,” he wrote.
The involvement appears to resemble the Federal Emergency Management Agency’s Project Airbridge that chartered freighters from Asia for urgently needed personal protective equipment early in the pandemic.
One way OWS is accelerating the vaccine timeline is by investing in large-scale manufacturing of vaccine candidates while clinical trials are still underway, something pharmaceutical companies would likely never do on their own because of the risk. Officials insist they are not bypassing any safety or validation steps.
Manufacturing has begun for all six vaccines supported by OWS. More than 23 manufacturing facilities across the U.S. have already scaled up capabilities under the public-private partnership, with the DoD actually building some production facilities, according to officials. The government is also supporting manufacturers of needles, syringes and vials.
On Wednesday, the Trump administration announced a $375 million agreement with Eli Lilly & Co. to purchase the first doses of the company’s COVID-19 investigational antibody therapeutic bamlanivimab if the FDA authorizes its use. Earlier this week, Eli Lilly ended the trial in hospitalized COVID patients after federal researchers determined the therapy provided little recovery benefit. The company is pursuing other trials in the hope of preventing disease progression for those in earlier stages.
Meanwhile, U.S. Army logistics officers supporting OWS are working with U.S. Customs and Border Protection, the State Department and the Food and Drug Administration to streamline and expedite approvals of shipments to and from the U.S. of clinical trial materials, including for machinery, vaccine doses, lab kits and personal protective equipment.
“Operation Warp Speed logistics professionals embedded with pharmaceutical manufacturers provide visibility of production lines and priorities, supporting a larger effort to prioritize and schedule shipping and delivery on products that boost the capacity to produce vaccine at the required volume,” DOD spokesman Peter Hughes said in a statement to FreightWaves. “Those items include raw materials and consumables — from tubing and large sterilized plastic bags to bioreactors. Most materials are coming from European countries.”
OWS also is supporting clinical trials in Central America, South Africa and other countries by making sure trial doses and equipment receive quick government clearance, he said.
The Defense Department said OWS is also working with the U.S. Marshals Service to ensure the security of the vaccine supply chain, including delivery to administration points. Marshals Service liaisons are embedded with the OWS team to ensure consistent communication and coordination.
The CDC has tasked McKesson, a large medical supply wholesaler, to manage the commercial distribution. Express carriers FedEx and UPS are supporting the effort in North America and when it expands worldwide.
OWS leaders on Monday visited a new McKesson warehouse in Memphis, Tennessee, that has freezers capable of storing medicines at minus 80-degrees Celsius.
HHS and private companies are also setting up a specially designed IT system to track vaccine orders and track which vaccine dose someone has received so health officials in all jurisdictions can make sure people get a correct second dose.
Five of the six U.S.-supported vaccines in development require two doses.
“We need to know where every vial was, whether it was in the factory, or it was on a truck, or it had been distributed down to an administration site; we must have 100% accountability of all vaccines every day,” Perna said.
Determining how many people are actually taking the vaccines will be important, he said, because the amount of vaccine being distributed will dramatically increase shortly after the first doses become available.
“Initially, there will be tens of millions of doses available,” he said, but beginning in January, the number of doses will quickly ramp up to hundreds of millions. “It’ll be essential that we maintain the right flow of vaccine to the American people.”
Perna also said COVID-19 vaccine distribution will differ from other types of vaccine distribution efforts in that a COVID-19 vaccine will be “pushed” out to the public, rather than “pulled.” For influenza vaccines, distribution happens when hospitals and pharmacies order it from manufacturers. With the COVID-19 vaccine, the U.S. government has already paid for the vaccine, so it will be sent out where it’s needed without individual administration sites needing to ask for it.
“We are going to allocate equitably vaccine doses to all of America simultaneously,” Perna said. “As doses become available, we’re pushing down and out to the United States of America.”