Wisconsin, distributors prepare for COVID-19 vaccine

Matthew DiLoreto, Healthcare Distribution Alliance

Pharmaceutical wholesale distributors are preparing to meet the unique needs of each state in distributing a COVID-19 vaccine.

Wisconsin and other states are playing a unique role in determining vaccine administration, according to Matt DiLoreto, vice president of government affairs for the Healthcare Distribution Alliance (pictured above).

HDA is a national trade organization that represents about 35 pharmaceutical wholesale distributors including McKesson Corporation, which the federal government has contracted with to distribute the early stages of the vaccine. 

Department of Health Services Secretary Andrea Palm said in a recent health briefing the federal government will also distribute syringes and other equipment to administer the vaccine. The feds will bear the front-end cost, she added.

“The federal government is not controlling all aspects of how these vaccines are distributed. They are actually giving a lot of authority to individual states,” DiLoreto said in an interview. “Most state plans have a lot in common, but the granular details of how a vaccine will be administered and where it will be administered in Wisconsin will be unique to Wisconsin.”

Wisconsin’s priority populations include health care workers and vulnerable populations, such as those living in nursing homes, said Palm. Phase two of DHS’ plan to expand to other critical populations is “to be determined.” A federal advisory panel and state advisory committee are deliberating over that guidance, she added.

“As a scarce resource, we will need to prioritize its use in our populations here in Wisconsin,” she said. 

Dr. Ryan Westergaard, the state’s chief medical officer, predicted the state’s work on population prioritization will wrap up in the next few weeks, “plenty of time” before a vaccine is ready to be delivered.

Both the HDA and Palm cited the unknowns of the vaccine as a challenge to distribution.

When Wisconsin will begin vaccinating depends on the time between approval and when the first vials start coming off of the manufacturing line, Palm said. 

“And then, do they distribute by state alphabetically? I mean, there’s lots of variables about from the point of approval to the point it lands in the state of Wisconsin,” she added.

The National Governors Association wrote a letter to President Trump earlier this month asking a series of questions about the vaccine’s funding, supply chain and other information. While HDA didn’t have a role in crafting those questions, DiLoreto said the questions are what a lot of people are asking right now. 

Palm said that despite unknown factors such as how many candidates will ultimately receive FDA approval, how quickly vaccines will come off of the manufacturing line and how soon after they will arrive in Wisconsin, “we’ll be ready.”

As the logistics experts of health care, distributors’ will need to be ready, too, as their role in delivering medicines and health care products is more critical now than ever. 

HDA members connect 180,000 healthcare providers and pharmacies with 1,300 drug manufacturers across the country. Up to 95 percent of prescription and over-the-counter drugs arrive at the dispensing location from a wholesale distributor, DiLoreto said.

Distributors streamline the supply chain to reduce time and knock off billions of dollars in costs related to ordering, real-time delivery and storage of medicines for both major urban centers and rural centers.

And the industry faced unique changes just like every other industry during the pandemic, DiLoreto explained.  

Throughout the spring and summer, HDA encountered changes to supply and demand that its members had to work out. An increase in the need for specific medications related to COVID-19 treatment and personal protective equipment put a strain on manufacturers. Pop-up treatment clinics and alternate care facilities were new locations for the critical medications to go to.  

“Now, what we are really seeing is a shift to vaccine distribution efforts,” DiLoreto said. 

HDA acts as a resource to provide supply chain and distribution education to federal government entities. HDA has also weighed in with all the state governors, including in a letter to Gov. Tony Evers.  

In addition, the association is preparing its distributors for when the vaccine becomes more widespread and available. For example, the sheer volume of need in a short time frame is a challenge. 

“In the most safe manner possible, the government and manufacturers are trying to get these products online, but the second that that is greenlighted, okayed, the supply chain needs to kick into gear and get these products to hundreds of millions of Americans,” DiLoreto said.

He added that while there’s no date as to when the vaccine will be approved and ready to go out, everything is pointing to the winter months — a challenging time for travel and delivery in Wisconsin.  

John Parker, HDA’s senior vice president of communications, assured that distributors have worked through national emergencies before, such as blizzards, tornados and hurricanes. 

“From the standpoint of getting those vaccines to where they need to go, especially in the middle of winter, just that alone is something that they have experience with many times over,” he said. “That will present unique challenges, but our companies are well-suited to handle those environmental challenges as well.” 

The COVID-19 vaccines will also have unique storage and handling requirements. Two temperature thresholds exist for immunizations: cold chain and ultracold chain. These require special storage and transportation.

DiLoreto admitted that the “ultracold chain” is somewhat unprecedented for a typical supply chain, but distributors have experience storing and transporting temperature tentative products.

“Should there be a safe and effective vaccine or more than one candidate makes it across the finish line and is deemed as safe and effective, we certainly will be encouraging all Wisconsinites to get vaccinated,” Palm said. “It will be a really important new tool in our toolbox to help reduce this virus in the state of Wisconsin and allow us to get back to something that looks like more normal life, more normal course of business here.”

-By Stephanie Hoff