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Who will get the first COVID vaccines? States race to decide

By Noam N. Levey, Los Angeles Times on

Published in News & Features

That contrasts with the opaque process for doling out ventilators and protective equipment from the national stockpile, procedures that the Trump administration refused to disclose until they were obtained by congressional investigators earlier this year.

The distribution formula also should avoid the political favoritism that the president embraced earlier in the pandemic when he suggested medical supplies would be routed to reward his allies.

"My main concern was that vaccine process was going to be politicized," said Pennsylvania health secretary Dr. Rachel Levine, who is the current president of the Association of State and Territorial Health Officials. "But despite political comments that were made during the campaign, the process has stayed professional."

The CDC is overseeing the development of detailed state immunization plans that, among other things, must outline how each state will prioritize the distribution of vaccine.

At the same time, federal officials working on Operation Warp Speed, a Trump administration initiative to speed the development and distribution of a COVID-19 vaccine, said this week they are finalizing preparations for shipping vaccine doses to states.

This is a major logistical challenge, in part because the vaccine developed by Pfizer, which is expected to be the first available, must be kept at a very low temperature. The other current leading vaccine candidate, from drugmaker Moderna, does not have the same extreme cold requirement.


The first round of vaccine shipments is expected to go to medical centers that have the ability to store the vaccine and are best positioned to administer it to front-line health care workers, according to state and federal health officials.

A second delivery track to get the vaccine to nursing homes and other long-term care facilities is being coordinated by major pharmacy chains CVS and Walgreen's in partnership with the federal government.

U.S. Health and Human Services Secretary Alex Azar said Wednesday that the federal government expects to be able to ship 40 million vaccine doses — enough to immunize 20 million people — by the end of December.

The initial distributions require states to identify their health care workers and nursing home residents, a lengthy process that many states are scrambling to complete.


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