With the distribution of the COVID-19 vaccine fully underway, there are more than a few moving parts related to the logistics and distribution components in this major, groundbreaking initiative. The United States Government’s Operation Warp Speed (OWS) is front and center for these efforts, with a goal to “produce and deliver 300 million doses of safe and effective vaccines with the initial doses available by January 2021, as part of a broader strategy to accelerate the development, manufacturing, and distribution of COVID-19 vaccines, therapeutics, and diagnostics (collectively known as countermeasures),” according to the U.S. Department of Health and Human Services. Logistics Management Group News Editor Jeff Berman recently spoke with Marion Whicker, deputy chief, supply, production and distribution for Operation Warp Speed, about how OWS is approaching the COVID 19 vaccine logistics and distribution efforts. Whicker holds a business degree from Ohio Wesleyan University and has been a career U.S. Army civilan for the last 36 years. She was assigned to Operation Warp Speed in May 2020, and upon completion of her Operation Warp Speed duties she will transition back to her position as executive director for the U.S. Army’s Integrated Logistics Support Center, in which she manages 65% of the Army’s equipment for its brigade combat team.
Logistics Management (LM): In regards to OWS, how was the organization able to procure and secure dry ice that is needed for the Pfizer vaccine?
Whicker: The initial packing of the product in dry ice is done at Pfizer, and Pfizer not only has the ability to produce dry ice but they also can get supplemental dry ice. That first packing of the vaccine into the special soft boxes is all done by Pfizer. The procurement challenge was not an issue, because Pfizer takes care of that. Now what happens is as that box gets transferred to an administration site, one of two things is going to happen. If that administration site has an -80C capable freezer, they are going to take it out of the box and put it into the freezer and, thus, there is no need for dry ice replenishment. But in a scenario in which someone is going to use that box to administer the vaccine, which is what it is intended for, within 24 hours of a box being received at an administration point, the U.S. Government has contracted with McKesson, our central distributor, and they sub it out to UPS. UPS will come in and refresh the dry ice in the box within 24 hours. Upon doing that, it will also provide a supplemental kit that we call a dry ice support kit, and in that kit are goggles or a face shield, gloves, and an ice scoop. So, for the refresh and for those sites that are going to be living out of that dry ice box, they will have that. That gets you five days of being able to administer out of that box with that initial refresh by the U.S. Government. That is a vaccination site going in there no more than twice a day in about less than three minutes…if you are pulling the vaccine out and thawing it, you don’t need much more time than that. After five days a site can do one of two things: if they are done with the vaccine, then they ship the box back, but if a site wants to [refresh] the dry ice, then they can do that. We have actively been searching the market, there is not a shortage of dry ice. And if there is a jurisdiction that does not have that capability, the U.S. Government will certainly do that. We can help make arrangements with UPS if a site cannot get dry ice. Dry ice does not appear to be a challenge for us.
LM: UPS and FedEx are playing a major role in vaccine distribution processes. How do you work with them to address the challenges related to transporting dry ice and coordinate with them?
Whicker: Vaccine distribution comes in a few different ways. When you think about the Pfizer product, Pfizer directly contracted with UPS and FedEx for the distribution of its vaccine. What happens with that is UPS or FedEx, depending on where the package is going, will go to a Pfizer site and pick up the vaccine. The vaccine then is distributed based on where it is allocated to go. So, the dry ice is already taken care of, and the box is already prepped and packed at Pfizer, and it then goes on a UPS or FedEx truck. With the Moderna vaccine and others that may be approved, those will go through a little bit of a different distribution process.
LM: What does that process entail?
Whicker: McKesson Medical was awarded the central distribution contract…all distribution of [Moderna’s] product will be coordinated with McKesson. McKesson has elected to use UPS and FedEx to be its distributors of the product, and it will be from a UPS and FedEx perspective. Their coverage scenarios will be a little bit different from what Pfizer has them doing versus what McKesson has them doing. UPS and FedEx are extremely large and capable global shipping companies, and they looked at what we planned to ship and are shipping, and they ship it through their medical areas…and they do that for regular vaccines. They have assured us—and we are completely supportive of it—that they can meet all of the requirements. They have been exceptional partners in this process with us.
LM: What are some of the other logistical challenges that can arise with vaccine distribution along the lines of weather issues, service challenges, or other things?
Whicker: The [December] storms in the Northeast are a great example. Deliveries the first day after the storm all went off, with UPS and FedEx making all of their deliveries, even with a slight delay for weather. UPS and FedEx have a lot of backup plans. They back backup planes in case they need to do that, and they have backup trucks. FedEx has talked about having primary and secondary and tertiary [backup] plans as one of its company mantras. We recently visited them, and they walked us through the second and third order planning that it does in terms of ensuring that the vaccine gets from the delivery site to the point of administration. And before that, General Perna visited UPS. It is pretty amazing to see what those two companies are doing to ship the vaccines throughout the country.
LM: With the tight schedule of vaccine distribution, as a second shot is needed about three weeks after the first one, this will be a frequent process over the next several months. What do you anticipate will be some of the lessons learned along the way?
Whicker: We recently did the first rollout of the Pfizer product so 21 days later is that second dose. After the rollout, states are in the planning for the second dose, and we will subsequentially allocate that second dose to them. We have wonderful planners, and our computer system—Tiberius—helps manages all of that, but you have a first dose, a second dose, a 21-day apart vaccine [for Pfizer] and a 28-day apart vaccine [for Moderna], and all of those things are just part of the logistical process that, based on the vaccine, will work. It is a great problem to have, in terms of being able to vaccinate the nation. That is why the logistical people and the planners are here, and it is our job to just continue to work and figure things out. As we get into more vaccines towards the end of January and into February, that great problem we have will just continue to multiply, and that is OK.
LM: Prior to the vaccines getting approval, what was the planning process for vaccine distribution?
Whicker: We did not start from a blank slate. What we did was take the extremely successful CDC Vaccine for Children’s Program, which uses the same vaccine tracking system, called VTrckS, and that part is the same. McKesson was one of CDC’s contractors that was already part of that process so it was really building on the great processes CDC already had in place. There is a perception that we had to start from scratch, in terms of the planning for an ultracold vaccine, but I want to highlight it is the great systems that the CDC already had. We just kind of out it on steroids, if you will.
LM: Looking at where things are and where things will be, when this is all done, what do you think some of the biggest logistics “lessons learned” may be coming out of this?
Whicker: That is a good question. I recently did a seminar with the University of Iowa for about 350 supply chain students, and we talked about that. The question is “how did they do it?” A lot of things ran in parallel rather than sequentially is number one. When you think about the manufacturing capability and other things, a lot of it was not in existence when we first started this. In a normal vaccine, when it rolls out, everything is done sequentially, because it is a huge investment risk to the pharmaceutical manufacturer developing that vaccine. The U.S. government took the financial risk, so while we were doing the trials, we were building up manufacturing at the same time rather than waiting for a vaccine, getting it approved, and then manufacturing it. The more you can do things in parallel rather than sequentially help the supply chain. One of the other things we did was with defense prioritization…we are able to prioritize the manufacturing requirements for people like the consumables and even helping to get some of the workforce done, for things like Customs and imports and all of those things. It really is a case study in how to manage the entire supply chain to ensure that end state. What General Perna did and what we did was take the end state of delivering the vaccines and what all of those steps were, and working our way back for what we had to do. While the clinical trials were going on in Phase Three, we were manufacturing the vaccine, and the vaccine was able to roll out timely, with the completion of the emergency use authorization. It was making sure all of those things—like the manufacturing, making sure that bioreactors or air handlers are available, as well as the bags and the vials—are set up. It is really the same thing we do at the Department of Defense for building a tank, in making sure the manufacturing lines are set up and the raw materials are ordered, and have a training plan developed and be able to field it. It is really a lot of the same thing as is done in my Army logistical training, which has enabled me here with this from an analytical perspective, while the product is different.
LM: What do you think the timeline looks like, in terms of the homestretch for COVID-19 vaccine distribution?
Whicker: It depends on when the American public will choose to take it. And, in terms of vaccine availability, what we believe is it will be late into the second quarter. Part of that timeframe depends on the vaccine producers. People like to think vaccines are an exact science. It comes out in a weekly production, and it is not like filling up a keg of beer, where you fill it up with X amount of gallons in it. A vaccine comes in a batch, it gets reviewed and has to be released, approved by the proper levels and then sent out. It is not an exact science. That is one of the areas people look for, with everyone wondering “how much am I going to get in week in and week out?” We simply don’t know, because it is not an exact science. And there are two vaccines now with the same thing; that is one of the challenges. It is kind of like a production line, in which you would like to produce 50 alternators a week, but if some parts don’t come through you may only produce 40 and if you work overtime, you could maybe produce 60.
About the Author
Jeff Berman, Group News Editor
Jeff Berman is Group News Editor for Logistics Management, Modern Materials Handling, and Supply Chain Management Review. Jeff works and lives in Cape Elizabeth, Maine, where he covers all aspects of the supply chain, logistics, freight transportation, and materials handling sectors on a daily basis. Contact Jeff Berman