The role of the military in vaccinations to be strictly behind the scenes

WASHINGTON – When President Trump talks about getting the coronavirus vaccine delivered to millions of Americans in their normal lives, he often says he “expects the military” to do so.

Mr Trump gave the impression that the troops were packing bottles, transporting them from factories to pharmacies, and perhaps even delivering shots. And at times, military officers working on an extensive agency program who moved vaccine doses from drug factories to the doctor’s office indicated the same.

In reality, the role of the military was less public and more comprehensive than this characterization suggests.

When companies did not have the physical space to conduct their drug tests, the Department of Defense received trailers and permits to create pop-up medical spaces in parking lots. When there was a shortage of a necessary plastic or glass, the military applied a law passed during the Korean War to force manufacturers to take them to the beginning of the line. If a hurricane hits somewhere, shutting down the trucks, the military is ready for transport.

But the distribution of vaccines remains largely to manufacturers and commercial delivery companies. Black Hawk helicopters will not land next to the pharmacy next door to deliver the doses. No team shoots.

“It is extremely unlikely that anyone in the government will touch a vaccine, be it loading a truck, unloading a truck, moving dry ice or giving the vaccine before the Americans receive it,” said Paul Mango, deputy chief of cabinet at the Department of Health and Human Services and The main spokesman for Operation Warp Speed ​​is a multi-agency federal consortium that allows vaccines to be tracked quickly.

However, he added, “every logistical detail you can think of, needles, syringes, tampons, bandages, dry ice,” can be obtained through the government contracting process, and often faster than through the private sector.

The Department of Defense staff is linked through government agencies involved in the effort and makes up a significant portion of the federal staff dedicated to the effort. This figure prompted some current and former officials at the Center for Disease Prevention and Control to privately grumble that the Army’s role in Operation Warp Speed ​​was too large for a task that was essentially a public health campaign.

“Honestly, it was breathtaking to watch,” said Paul Ostrowski, director of transportation, manufacturing and distribution for Warp Speed ​​Operation. He is a retired Army lieutenant general selected by General Gustave F. Perna, chief operating officer of Operation Warp Speed, to manage the logistics of the program.

Evading volunteers from four accelerated vaccine trials — difficult in all circumstances — was an even greater challenge during an epidemic, when it was often not possible to ask hundreds of thousands of subjects to sit in hospital waiting rooms and other health centers. The Pentagon has helped three companies – AstraZeneca, Moderna and Janssen – set up pop-up sites to test at 63 locations across the country.

Required for all sites: double wide trailers equipped with wheelchair ramps and septic systems. Some need to be hurricane-proof.

These are the kinds of things that the military can quickly obtain through its contract system, as well as all the permits needed to set them up. “We are able to create a world-wide range of housing opportunities a moment in advance,” said General Ostrowski.

Military officials can call companies, he said, “And they say,‘ I need Trailer No. X, and I need them right away. “Certificates and that all codes are addressed,” he said.

The pharmaceutical companies currently running the two vaccinations, Pfizer and Moderna, estimate they will have 45 million doses by the beginning of next year, or enough to vaccinate 22.5 million Americans. Since they have begun manufacturing vaccines awaiting federal approval, they must be ready to begin shipping them within days of insurance.

However, some companies have been hampered by a lack of overcapacity in the United States and a lack of goods needed to manufacture and package vaccines. In terms of raw materials, the military was able to take advantage of its contracted muscles, as well as the Defense Production Act, a Korean War era law that allows the federal government to introduce some control over the private sector.

“Everyone sticks to this material or this product,” General Ostrowski said. “We do this, we understand the grasp of supply chains.”

Operation Warp Speed ​​has issued six defense production laws to companies to put themselves in large containers at the top of the line for certain shipments, such as vaccines. In October, the government awarded $ 31 million to Cytiva to expand bathtub production.

“There are only a certain number of producers in the world,” said General Ostrowski. “We could make sure they knew where the priority was.”

Military officials have also come up with the clever idea, if it works, to coordinate the delivery of vaccines to pharmacies, medical centers and other immunization sites by sending kits full of needles, syringes and alcohol wipes. Vaccine manufacturers will be alerted when kits arrive at an immunization site to know if they are delivering doses. After giving the first dose, you will notify the manufacturer so that you can send the second dose with the patient’s name seven weeks later.

But as far as the Herculean task of vaccine distribution is concerned, it will be largely up to the manufacturers to deliver the vaccines from the loaders to the pharmacies and the doctor’s office.

While governors can use their National Guard units in their vaccination programs, the military has the least role to play in moving vaccine doses – and teams are certainly not expected to help deliver the shots, despite what Mr Trump suggested.

“I was surprised when Trump talked about the Department of Defense distributing any vaccine,” said Dr. Marcus Plescia, chief physician of the Association of State and Regional Health Officials, who was deeply involved in vaccine planning. “There’s no role for the military there. And if they were, we would be in arms because of that, because we are advocates for states. “

Concerns about conspiracy theories surrounding vaccinations further justify keeping the military away, Dr. Plescia said. “There was a lot of concern about the hesitation about vaccinations, and if there were a lot of teams around, it wouldn’t be very helpful,” he said. “Even the participation of the National Guard can be detrimental.”

As one of the country’s largest suppliers of liquid injectable drugs, Pfizer already has a large network of commercial carriers that facilitate the relocation of drugs from its Michigan plant to the entire country. This will be all the more important with the company’s coronavirus vaccine, which must be kept below freezing.

The military spent hours doing table exercises to think about how the program might go bad and how to take action for help.

“The government has offered all the support and is ready to remove the barriers,” said Amy Rose, a spokeswoman for Pfizer. Of the six companies developing the vaccine, the pharmaceutical giant was the only one to reject federal funding.

Pentagon designers have examined a number of risks of vaccine distribution, ranging from large-scale protests disrupting traffic to bad weather. According to the military, you can use your planes and helicopters to transport vaccines to remote locations, but only if no other means of transportation is feasible.

The military also monitors the distribution of vaccines through an operations center. “They will know where all the doses of the vaccine are,” Mr. Mango said in a call to reporters. “If there is a danger of the dose of the vaccine, its movement will be directed elsewhere.”

According to General Ostrowski, this particular assignment is worth delaying his retirement. “This is very important for our nation and our world,” he said. “I couldn’t imagine a better challenge and something nobler than to do that.

Abby Goodnough contributed to Washington.