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How the Trump administration could distribute a free COVID-19 vaccine after FDA approval

Most vaccines will require two doses and should be free to the public, but the plan to distribute millions of doses across the U.S. is complex.

TAMPA, Fla. — Operation Warp Speed promises to have COVID-19 vaccines moving to states across the U.S. within 24 hours of the Federal Food and Drug Administration’s approval.

The Trump Administration's new plan says most vaccines will require two doses and should be free to the public.

“What you heard was that there's an effort to try to be prepared when a vaccine is ready and we still don't know for sure exactly when that will be," said Dr. Marissa Levine with USF Public Health. She says the puzzle to get a coronavirus vaccine supplied and distributed is complex.

“We learned a lot actually during the H1N1 Pandemic about preparing for vaccination. I was involved in that and some really critical things came out that this plan is attempting to incorporate. So you really do need to be prepared, and it works better if the vaccine is more readily available to people in places they're used to getting vaccinated; at their physicians' offices and pharmacies which have become vaccination sites.”

So states should be working with their own local governments to prepare for the intake of the vaccine now. 

The Department of Health and Human Services (HHS) says the plan will make sure enough doses are available for everyone who wants to be vaccinated, but in case there isn't enough, the vaccine "playbook" breaks down a phased approach.

Jurisdictions should be planning in terms of three phases:

Phase 1: Potentially limited supply of COVID-19 vaccine doses available

  • Focus initial efforts on reaching the critical populations listed above. Ensure vaccination locations selected can reach populations, manage cold chain requirements, and meet reporting requirements for vaccine supply and uptake.

Phase 2: Large number of vaccine doses available

  • Focus on ensuring access to vaccine for members of Phase 1 critical populations who were not yet vaccinated as well as for the general population; expand provider network.

Phase 3: Sufficient supply of vaccine doses for entire population (surplus of doses)

  • Focus on ensuring equitable vaccination access across the entire population. Monitor vaccine uptake and coverage; reassess strategy to increase uptake in populations or communities with low coverage. The following graph illustrates the three phases of the COVID-19 Vaccine Program and populations of focus in each phase.

“The challenge is that we can't over promise and under deliver. Quite frankly, that's exactly what happened during H1N1. We overpromised that we'd have a vaccine and when people really wanted it, we didn't have it," Levine said. "There was a delay. So I think we have to be really careful. We all want COVID to end. 

"It's not going to end anytime soon and even if we have a vaccine, it's going to take quite some time, if the vaccine works the way everybody wants it to, for the community to be immunized to a level where we can have a more normal existence."