bars
0:00/25:57
-25:57

transcript

When and How You’ll Get a Vaccine

Hosted by Michael Barbaro; produced by Daniel Guillemette, Sydney Harper, Rachelle Bonja and Michael Simon Johnson; and edited by Dave Shaw.

Multiple inoculations for the coronavirus are making their way through the approval process. Here’s what we know about the plan for their distribution.

michael barbaro

From The New York Times, I’m Michael Barbaro. This is The Daily.

Today— now that multiple vaccines are making their way toward approval, what we know about the plan and timetable for distributing them. I spoke to my colleague, science reporter Katie Thomas.

It’s Monday, November 30.

Katie, tell me about this interview with the head of Operation Warp Speed.

archived recording

Joining us now is the chief scientific advisor for Operation Warp Speed, Dr. Moncef Slaoui. Doctor, how—

katie thomas

So last Sunday, Dr. Moncef Slaoui, who’s the head of the big federal effort to develop a vaccine, went on CNN and was asked about where things stand.

archived recording

When do you expect the first person will be vaccinated?

archived recording (moncef slaoui)

Well, our plan is to be able to ship vaccines to the immunization sites within 24 hours from the approval. So I would expect on the 11th or on the 12th of December, hopefully, the first people will be immunized.

katie thomas

And in the interview, he laid out a timeline that I think would be pretty surprising to many Americans.

archived recording (moncef slaoui)

70 percent or so of the population being immunized would allow for true herd immunity to take place.

katie thomas

He said that based on his understanding of how the vaccines will be rolled out and when the vaccines might be ready—

archived recording (moncef slaoui)

That is likely to happen somewhere in the month of May or something like that, based on our plans.

katie thomas

—some form of normal life might be able to return by May of next year.

michael barbaro

Right. And I read about that, Katie, the next morning. I think I saw it in a tweet. And I actually thought to myself that can’t be right. Someone got that wrong. And then I went to the CNN website and I looked at the transcript. And I was like oh, he actually said that, May. That felt really early.

katie thomas

Yeah, it is pretty remarkable that we could have a vaccine by then. But a lot of things will have to go right and many, many steps will have to fall into place. But it’s entirely possible this could end up being correct.

michael barbaro

Well, what exactly gives him the confidence to make this very public declaration?

katie thomas

Well, it’s based on how far along we are in the development process. We’ve already had really good results from some of the companies— Pfizer, Moderna, and AstraZeneca. And Pfizer, in particular, has already submitted its application for Emergency Authorization with the F.D.A. And so now F.D.A scientists are poring over that data and evaluating whether they’re going to OK it. And there’s even been a date set on December 10 for an outside panel of independent vaccine experts who are going to weigh in on it. And then the belief is that pretty shortly after that, it could be authorized by the FDA. And from what Dr. Slaoui and the other Warp Speed officials have said, the vaccines could start rolling within 24 hours of an authorization.

michael barbaro

And when you say rolling, what exactly does that mean? I think everyone is extremely interested in the question of when and how the vaccines actually start to reach all of us.

katie thomas

Yeah. So for the past several months, even as these vaccines have been going through clinical trials, these officials at Operation Warp Speed have kind of been gaming out how this is going to work and planning out with the states exactly how it’s going to be distributed and how they’re going to get these vaccines and these vials from the factories to your local clinic.

michael barbaro

So what distribution plan have they come up with?

katie thomas

So just take Pfizer for a second, because they’re the furthest along. Their vaccine needs to be kept extremely cold. It’s got to be kept at minus 94 degrees Fahrenheit. So they’ve designed these special shipping boxes that they say will be able to keep their vaccines at this ultra-cold temperature. And they hold 975 vials of vaccine. And they have GPS-enabled thermal sensors that track the location and the temperature of each of these vaccine boxes as they’re shipped across the country.

When the boxes arrive, then the clinic or the hospital, they’re going to have a couple of options. They could just put it into an ultra-cold freezer. And a lot of hospitals are actually buying these freezers especially for this right now. And if they put it in this freezer, then they can store it there for up to six months. But if they don’t have one of these freezers, they can just take the vials out of this ultra-cold shipping box and put it just into a regular refrigerator, essentially thaw out the vaccine. And then those vaccines would have to be used within five days. And then the last option is that they can keep the vials in these special boxes. And those can be used as temporary storage as long as they keep refilling it with dry ice for up to 15 days.

michael barbaro

And how much vaccine is going to get shipped in this first few weeks of mid-December?

katie thomas

Well, initially, not nearly enough for everybody. The first week of a shipment that they’ve said will be about 6.4 million doses. And remember, Pfizer is a two-dose shot and that’s given three weeks apart.

michael barbaro

So when we hear the number 6.4, we should assume that actually means doses enough for some 3 million people.

katie thomas

Correct. And then the government is saying that there should be about 40 million doses of the vaccines by the end of the year.

michael barbaro

Right, which, again, we should cut in half to assume 20 million Americans.

katie thomas

That’s right.

michael barbaro

So that’s a very small percentage of the American population. So what are government officials telling you will be the kind of hierarchy for who gets it and in what order?

katie thomas

These details, they are still being worked out. And states and the federal government and local officials are still kind of talking about this stuff. But there is generally a broad consensus that the first group that will get them are doctors, nurses, other healthcare workers. And then almost simultaneously with that, the other group is residents of long-term care facilities, like nursing homes.

michael barbaro

And how many people is that, Katie? Doctors, healthcare workers, people in long-term health centers?

katie thomas

There’s about 20 million healthcare workers and about 3 million people who live in long-term care facilities.

michael barbaro

Huh. So that would pretty much use up this entire first batch.

katie thomas

Yes, that’s right.

michael barbaro

OK. So let’s presume that more and more vaccine keeps getting made. Who is next on the list?

katie thomas

So the next big group that’s been widely discussed would be this big category that’s known as an essential worker. And that’s a very big group of people. That’s more than 80 million people in the US.

michael barbaro

Wow.

katie thomas

And you can broadly think of these people as the people who do work that doesn’t allow them to stay home and social distance. In order for them to do their job and to kind of keep our world running, they have to go into work, and therefore expose themselves to Covid-19— meatpacking plant workers, people who work on utilities, firefighters, police officers, even teachers. These are, again, the people that kind of keep our country running.

michael barbaro

Mm-hmm. And is that a list that’s written down somewhere or decreed by the government? Is it going to be kind of flexible or we don’t know yet?

katie thomas

I don’t think we fully know yet. It’s being kind of worked out as we speak. And it may end up being something that is up to local authorities.

michael barbaro

All right, so after essential workers, who comes next?

katie thomas

The other priority group that’s been discussed is people who are over 65 and people who have an underlying health condition. That could be diabetes or a heart condition. Again, this is a group of people— and this becomes a very, very large group of people— but this is a group of people that are a much higher risk of dying or become very, very ill if they were to test positive for coronavirus.

michael barbaro

So at this point, and the math is a little bit hard to keep track of, it sounds like we’re talking about probably on the order of 100 million plus people. Does that feel right?

katie thomas

Yep, that’s about right.

michael barbaro

OK. So now we’re pretty well into 2021.

katie thomas

Right. And so if all continues to go well, and perhaps new vaccines are approved, the manufacturing plants are really working at top capacity and they’re churning out millions and millions of doses, we could start really vaccinating much bigger groups of the population.

michael barbaro

So, Katie, when are those of us who are under 65, not essential workers, not especially vulnerable through underlying conditions, when does that group of Americans start to get the vaccine?

katie thomas

Well, remember, the Americans that fall into all of those groups that you just outlined, I mean, that’s a pretty big chunk of the general public. By this time, a lot of the country will have been able to have gotten a vaccine. But what Dr. Slaoui had said, remember, that May date is what they are saying is their best guess for when people who don’t fall into any of these risk groups, when they will be able to get a vaccine if they want one.

michael barbaro

And to explain a word that Dr. Moncef Slaoui used in that interview with CNN which you’d mentioned, Katie, he said that May is the point around which enough Americans will be immunized that herd immunity or something like it will be achieved. And I wonder if you could just remind us what that means and why it’s important.

katie thomas

Herd immunity means that enough people have themselves personally some form of immunity from the coronavirus so that they will not be able to pass it along to somebody else. And if enough people in the community have it, then the virus really can’t spread as readily as it has. Now, I will add one caveat to what Dr. Slaoui said. And in some ways, I’m surprised he was able to make such a confidence statement about that, because there’s still a lot that we don’t know about these vaccines and how they work. And the vaccines we’re actually not testing on the question of whether once you get them, you can actually still pass the virus along to someone else.

The only thing that these clinical trials were testing was whether they prevented people from developing Covid-19, which, of course, is the disease that you develop after having been infected by the coronavirus. So we really don’t know yet whether even if a vast section of the American public gets this, if they still won’t be able to pass the virus from person to person.

michael barbaro

So you’re saying there’s still a possibility, we don’t know for sure, that tens of millions of us will get this vaccine and we, ourselves, will probably not get sick, because that’s what the clinical trials have shown this vaccine prevents, but it’s possible we still might give the virus to somebody who is not vaccinated?

katie thomas

That’s right. It’s just— it’s a scientific question that hasn’t been answered yet.

[music]

michael barbaro

We’ll be right back.

So, Katie, I want to turn to a few logistical questions now that we understand the order of vaccination. How much will this vaccine cost people who get it?

katie thomas

In this first phase, it should be free of charge.

michael barbaro

Hmm. For everyone?

katie thomas

For everyone, for all Americans.

michael barbaro

OK, so basically, the government is subsidizing this to the point where you would get the vaccine and it would cost you nothing.

katie thomas

That’s right. They’ve essentially bought these vaccines on behalf of the American people. They have paid billions of dollars to these companies to buy hundreds of millions of vaccines.

michael barbaro

OK. And where will your average American obtain the vaccine? I think we all have visions from too many movies that we have watched of camouflaged military trucks and these vast tent cities staffed by soldiers and kind of that’s where you maybe get your vaccine. Or are we just going to be going into our local Walgreens and Walmart pharmacies?

katie thomas

Yeah, I mean, it’s a really good question. And it’s one that people have been curious about. But what’s interesting is what the Warp Speed officials have said, is they really want this to look as much as possible like your regular experience of getting a shot, like getting your flu shot. We’re all familiar. We walk into a C.V.S. and Walgreens and we see signs everywhere that say get your flu here. What they’re aiming to do is to be in those same places so that Americans feel comfortable getting their immunizations.

michael barbaro

And why is that important to them?

katie thomas

That’s important to them because they want people to feel as comfortable as possible getting this vaccination. Remember, this is, first of all, a really scary pandemic. And then second of all, these are brand-new vaccines that are really just fresh out of the clinical trials. So there’s a lot of hesitancy and a lot of skepticism about these vaccines. And they’re trying to do everything they can to kind of make people feel as comfortable as possible about taking them.

michael barbaro

Right. So one solution to a vaccine-hesitant society is to ask people to take it at a familiar place, a Walgreens, not a scary military town.

katie thomas

That’s right. There aren’t going to be soldiers you know walking up to your door, knocking on your door, and giving Grandma a shot.

michael barbaro

Right. Hey, now you’re making it even scarier than I was willing to make it. Katie, you mentioned the flu vaccine, how much the government wants this all to look and feel like getting that. But that’s a single dose. And we know that the COVID-19 vaccine, in almost all cases, is two doses. And that feels inherently messier. So how does the government planning account for that?

katie thomas

Yes, this is going to be a very complex challenge. And we’re going to really have to see if all of our systems are up for it. But what the federal Warp Speed officials have said that they’re doing is they’re planning a centralized database that will keep track of which vaccine everyone received, what date they received it on, and then when they need to get their second dose. And kind of the idea behind this is that no matter where you go, they can kind of keep track of what you need.

One example that’s been thrown out is take a snowbird in New York who gets their first dose at a C.V.S. on Long Island of the Pfizer vaccine. Then they go down to their winter home in Florida. They go into a different pharmacy. And the pharmacy there is able to look them up and know exactly what they are due for and which vaccine they should get. But, as we’ve seen before with government health systems and databases, these things don’t always go as planned. And already, state and local officials have been warning that they don’t have enough money to support this. And so we’re really going to have to see how this actually rolls out.

michael barbaro

Mm-hmm. And with two shots, it feels like there is a real danger that a meaningful number of people kind of forget to go get the second shot, right? And my sense is that means that they are not fully immunized.

katie thomas

That’s right. I mean, it’s going to be a really big challenge. States have all kind of put in their plans for how they’re going to do this. And some of the states have also put in details about this. They’re going to send people postcard reminders or text message alerts. And so public health officials are really trying to plan for how to prompt people to go back for that second dose. But we all know that this is a challenge.

michael barbaro

Right. OK, this is a bit more of a curveball question for you. What if Americans decide to get kind of picky and they say I know that there are three or four or five vaccines out there, but I’ve read about vaccine x and I want that one. I don’t want that other vaccine. Is that something people can do or are we going to be in a situation where you kind of get what you get?

katie thomas

I think it’s going to be you get what you get and you don’t upset, as I tell my kids. It’s going to be an extremely scarce supply in the beginning.

michael barbaro

Katie, is there any talk of mandating that people in any of the categories that we’ve been talking about must take the vaccine? I suspect that doctors have to take the vaccine to go to work. Perhaps that’s going to also be true of some essential workers. But when it comes to regular Americans, some of them, as you just said, are going to be pretty skeptical. They may not take it. Is there talk of any requirement that they get the vaccine?

katie thomas

No, there’s really no talk of a mandatory vaccine. There may be, as we move forward, isolated cases of employers or even businesses that might require that you have a vaccination, for example, an airline. But really, no one’s talking about some sort of national vaccine mandate.

michael barbaro

Katie, what in your mind could still go terribly wrong here?

katie thomas

I think there’s a lot that could go wrong. The vaccines could not get approved. Some of the vaccines that are still in development could fail to work. The distribution could break down. These shipping boxes might fail. The database that we talked about could crash. There could be long lines for vaccination or just a lot of confusion. This is an extremely complex process and a huge project. And, as we’ve seen, sadly, so many times before, there’s any number of things that really could go wrong.

michael barbaro

Katie, you have been immersed in this world of Operation Warp Speed, the question of vaccines and vaccine distribution for, I think, around six months now. I recall the first time we talked to you about this, the operation had just been created. And now here we are, at this point where vaccines are theoretically on the verge of approval. This distribution system has been thought out and people are quite possibly going to be getting these doses in weeks. And so I wonder how you’re feeling about all these developments.

katie thomas

You know, I’m feeling pretty optimistic, which is a funny place, I admit, for a reporter to be, because we tend to look for all the things that might go wrong. I’ve spent this year writing about really dark stuff, really terrible stories. But I’m starting to kind of picture scenes that make me feel just a little bit better. I’m thinking, for example, of nursing homes, the site of so much terrible suffering and death. And if all goes well, within the next couple of weeks, we could start seeing people who live in these nursing homes getting vaccinated. And maybe even by January, what if every single nursing home and every single resident who wanted one got a vaccine?

michael barbaro

That would be amazing.

katie thomas

I mean, that would be amazing. And that’s really just around the corner. And even in my own life, I think all of us, this has continued on for so long. And it’s been so tough that we’ve all kind of stopped allowing ourselves to really think about the future. And I have been kind of allowing myself to think about what would we do after the pandemic? When could my kids see their grandparents? When would that be safe? And honestly, those are things that I really haven’t even almost allowed myself to plan for. And I’m starting to think about that a little bit.

michael barbaro

I’m guessing you haven’t bought plane tickets, but you’re maybe looking at prices.

katie thomas

I’m not even that far along. I’m just picturing in my head my kids seeing their grandparents. And just being able to have those thoughts is, itself, a comfort to me.

michael barbaro

This is a weirdly hopeful moment. And I think all of us have our fingers crossed. So thank you very much, Katie. We appreciate it.

katie thomas

Yeah, thanks.

michael barbaro

Later today, Moderna will seek Emergency Authorization from the Food and Drug Administration to begin distributing its vaccine for the coronavirus, making it the second company after Pfizer to reach that milestone.

We’ll be right back.

Here’s what else you need to know today— The Times reports that the assassination of a top Iranian scientist threatens to derail President-elect Joe Biden’s plan to revive the Iran Nuclear Deal. The scientist, Mohsen Fakhrizadeh, who has overseen Iran’s pursuit of a nuclear weapon for decades, was gunned down in his car on Friday in an operation attributed to Israel. It is widely believed that the Trump administration was either aware of or blessed the operation. Biden has said that a new agreement between the US and Iran, designed to prevent Iran from developing nuclear weapons, is a major priority. But both Trump and Israeli Prime Minister Benjamin Netanyahu want to block such an agreement. And the assassination of Fakhrizadeh may be designed to make such a deal as difficult for Biden as possible. And—

archived recording (bill de blasio)

Beginning the week of Monday, December 7, New York City Public Schools will begin to reopen.

michael barbaro

—New York Mayor Bill de Blasio said he would reopen the city’s public elementary schools and abandon the controversial threshold for shutting them down, which was triggered two weeks ago. The announcement was an acknowledgment that linking in class learning to a citywide infection rate of 3 percent was impractical, since the infection rates inside schools had remained far lower.

archived recording (bill de blasio)

We now believe we know what we didn’t know back in the summer. We know what works through actual experience.

michael barbaro

That’s it for The Daily. I’m Michael Barbaro. See you tomorrow.


For Americans, months of collective isolation and fear could soon be winding down. A viable coronavirus vaccine may be just weeks away.

According to a timeline described by Dr. Moncef Slaoui, head of Operation Warp Speed, the federal effort to accelerate vaccine development, the first Americans could receive a shot as early as mid-December, with herd immunity potentially reached by May 2021.

That timeline, while feasible on paper, requires a lot of things to go right.

With vaccines within reach, we turn to more logistical questions: Who will receive the shots first, and in what order will others follow? Who will distribute it? And what could go wrong?



  • Katie Thomas, who covers the drug industry for The New York Times.

Image
Two companies, Pfizer and Moderna, have estimated they will have 45 million doses of the coronavirus vaccine, or enough to vaccinate 22.5 million Americans, by January.Credit...Bebeto Matthews/Associated Press

INSIDE THE DAILY For an exclusive look at how the biggest stories on our show come together, subscribe to our newsletter. Read the latest edition here.

There are a lot of ways to listen to The Daily. Here’s how.

We want to hear from you. Tune in, and tell us what you think. Email us at thedaily@nytimes.com. Follow Michael Barbaro on Twitter: @mikiebarb. And if you’re interested in advertising with “The Daily,” write to us at thedaily-ads@nytimes.com.


Katie Thomas contributed reporting.

The Daily is made by Theo Balcomb, Andy Mills, Lisa Tobin, Rachel Quester, Lynsea Garrison, Annie Brown, Clare Toeniskoetter, Paige Cowett, Michael Simon Johnson, Brad Fisher, Larissa Anderson, Wendy Dorr, Chris Wood, Jessica Cheung, Stella Tan, Alexandra Leigh Young, Lisa Chow, Eric Krupke, Marc Georges, Luke Vander Ploeg, Kelly Prime, Sindhu Gnanasambandan, M.J. Davis Lin, Austin Mitchell, Neena Pathak, Dan Powell, Dave Shaw, Sydney Harper, Daniel Guillemette, Hans Buetow, Robert Jimison, Mike Benoist, Bianca Giaever, Liz O. Baylen, Asthaa Chaturvedi, Rachelle Bonja, Alix Spiegel, Diana Nguyen, Marion Lozano and Soraya Shockley. Our theme music is by Jim Brunberg and Ben Landsverk of Wonderly. Special thanks to Sam Dolnick, Mikayla Bouchard, Lauren Jackson, Julia Simon, Mahima Chablani, Nora Keller, Sofia Milan and Desiree Ibekwe.

Advertisement

SKIP ADVERTISEMENT