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How will the UK distribute the first Covid-19 vaccines?

A person holding a vial of vaccine labeled "Pfizer"
Reuters/Dado Ruvic
A woman holds a small bottle labeled with a “Vaccine COVID-19” sticker and a medical syringe in this illustration taken April 10, 2020.
  • Katherine Ellen Foley
By Katherine Ellen Foley

Health and science reporter

Now that the UK has become the first western country to authorize the widespread use of the Pfizer/BioNTech Covid-19 vaccine, the question remains: How will it get to the first recipients?

Broadly, the UK’s approach to vaccine distribution hinges on the country’s centralized National Health Service (NHS). The first order of business is triaging who gets the vaccine first; NHS has already agreed to adhere to recommendations from the Joint Committee on Vaccination and Immunisation to prioritize older adults who are living in care facilities, followed by those who are 80 and older, and frontline healthcare workers. These individuals will likely get their first of two jabs by Monday, Dec. 7.

The logistics of this plan rely on systems already put in place. The UK pre-ordered 40 million doses of the Pfizer/BioNTech vaccine, which should cover 20 million people. The first shipments will come in from Pfizer’s manufacturing plant in Puurs, Belgium, in specialized freezer crates that keep the vaccines at the required -70°C (-94°F), according to the Guardian. They’ve been equipped with GPS and thermometers to make sure they stay at the required temperatures, so supervisors can replenish them with dry ice if needed as they’re shipped via planes and trucks.

Then, it’s off to the main hubs: At first, vaccines will be administered at roughly 50 hospitals that already have the ultra-cold storage needed to keep the vaccine stable. Hospitals have the added bonus of being easy to access for healthcare workers. But because the vaccine can only be stored in crates of 1,000, the NHS will have to work with nursing homes with small resident populations to get them to and from hospitals. Outside of hospital settings, the NHS has stated that it plans to contact individuals when it’s their turn.

After these first two groups have been served, the NHS plans to set up roughly 1,500 vaccine distribution centers across the country. These centers, which are currently under construction, will be stood up in places like conference centers and race tracks—anywhere with ample space will do. The NHS has plans to recruit extra workers to vaccinate up to 5,000 people a day, hiring people like flight attendants, firefighters, retired doctors, and the unemployed for $15 an hour, according to the Guardian. After those vaccine centers are up and running, many people will also be able to go to their primary care provider or pharmacy to get shots—but these people are likely going to be those who are far down the priority list.

This centralized, top-down approach is comprehensive, but it leaves little room for UK citizens to make their own choices about which vaccine they get and when. There likely won’t be a way for individuals or companies to try to privately buy vaccines because drug companies are working with the NHS (not accounting for the fact that government pre-orders have spoken for all the current production). On the plus side, this means that it should eventually be available for everyone, regardless of their ability to pay.

It’s a different approach from what will likely happen in the US if and when the Food and Drug Administration authorizes a Covid-19 vaccine for use. Like the UK, the US has also preordered Pfizer/BioNTech’s vaccine (100 million of doses), and an advisory group to the US Centers for Disease Control and Prevention has similarly recommended that healthcare workers and nursing home residents are first to get the vaccine.

But the US has historically opted for a decentralized approach to healthcare, relying instead on individual states to decide how they want to serve their residents. Most have already started coming up with plans, the Kaiser Family Foundation reports, but many aren’t yet finalized. States don’t technically have to follow the CDC’s distribution guidelines; they may prioritize certain groups based on local needs.

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