How to Get Your Non-Acute Facility Ready for COVID-19 Vaccines

December 8, 2020
factory line of vials

In November, Pfizer announced that its vaccine for COVID-19 was 90% effective in preventing the coronavirus. This made the company the first  pharmaceutical manufacturer to cross the finish line with a vaccine solution to the pandemic. About a week later, Moderna said its vaccine showed 94.5% effectiveness against COVID-19 and expected to have about 20 million doses ready to ship in the U.S. by the end of the year.

By April of 2021, Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases (NIAID), expects that people will be able to walk into their local healthcare provider to get a vaccination

The challenge of eradicating COVID-19 isn’t over with a drug on the market. Instead, the challenge now shifts to distribution and education. The medical supply chain has to meet the high demand, while patients and their families have many questions about the vaccine, including if it’s safe, side effects and who should receive it first.

Non-acute healthcare facilities must take a proactive approach to receive, store and provide the vaccine. They must also have a strategy for identifying and notifying patients who should receive the vaccine first.

Shipping vaccines sometimes requires doses to be transported and stored at extremely low temperatures. Cold storage will likely create challenges for the distribution of the Pfizer vaccine and any other vaccine that becomes available. Vaccines like Pfizer’s that use the synthetic messenger RNA (mRNA) to activate the immune system against the virus must be stored at an ultracold temperature between -76 and -112 degrees F (-60 to -80 degrees C) to maintain optimal efficacy, according to USA Today.
The vaccine from Moderna also uses mRNA technology. That vaccine will need to be stored at -4 degrees F (-20 degrees C), according to reports.
Storage, distribution and handling requirements for these vaccines will make it difficult for community clinics, healthcare providers and local pharmacies to store and administer them. State and local providers are responsible for storing and administering the vaccines once they’re delivered.
Pfizer has been working with the U.S. government and state officials on the best way to ship the vaccine. The comprehensive plan involves using dry ice to transport frozen vaccine vials by air and by land at their recommended temperatures. The company developed a special thermal shipping container that can be kept cold with dry ice and store vaccine doses for up to 15 days, notes Forbes.
Non-acute medical providers like clinics are expected to be major vaccination sites, but they are not all equipped with the specialized cold storage appliances needed for the vaccines. As a result of the cold storage supply chain and shipping requirements, transporting the vaccines to rural areas may be extremely difficult because of the challenges of keeping the temperature of the doses stable.
Solving the problem isn’t as simple as buying the ultra-cold deep freezers. They cost $5,000 to $15,000, which puts them out of reach for many rural providers. Even if facilities have the money, the freezers may not be available. Many large hospitals and providers have already purchased them, creating a shortage. The upside is that the Centers for Disease Control and Prevention (CDC) says other vaccines may be available soon that do not have the same storage requirements.
One of those could be from Mynvax. Its “warm” COVID-19 vaccine is ready for safety tests and human clinical trials. One unique benefit of the vaccine is its ability to be stored at 98 degrees F (37 degrees C) for more than a month, which eliminates the need for a cold supply chain.

Government healthcare officials are determining who should receive the vaccine first. A task force organized by the National Academies of Sciences, Engineering, and Medicine has broken down priority into four phases, giving preference to those at the greatest risk:

  • Phase 1. Those at risk of acquiring COVID-19, including healthcare workers in high-risk settings like nursing homes, frontline workers, those with high-risk medical conditions, seniors in nursing homes and people with two or more serious underlying conditions.
  • Phase 2. Essential workers including teachers, all seniors and people living in group settings.
  • Phase 3. Kids, young adults and remaining essential workers.
  • Phase 4. The general population.

The U.S. government is planning to distribute 6.4 million doses of a COVID-19 vaccine by mid-December and a total of 40 million doses by the end of 2020. 

Facilities need a plan for communicating details with patients. It should include sending information to patients, updating the facility’s website with current details and reaching out to at-risk patients in the higher priority groups when the vaccine is ready.

Communication to patients is critical. Even if some facilities won’t have access to the coronavirus vaccine until 2021, their patients will have questions now. For example, there is some concern about giving the vaccine to residents of long-term care (LTC) facilities because it has not been tested on elderly patients in poor health. “This population is not a population that’s been studied in the vaccine trials,” according to a doctorLTC facilities should be prepared to answer questions about this from residents and their families.

“The challenge of eradicating COVID-19 isn’t over with a drug on the market. Instead, the challenge now shifts to distribution and education.”


Healthcare professionals administering the vaccine will need personal protective equipment to safeguard against infection. They will also need needles, syringes, alcohol, pads, bandages, masks and other items used for administering vaccines.

Facilities should plan now to procure and add the needed items to their inventory. They should also determine staffing levels and make any adjustments that may be required not only for clinical needs, but also administrative needs for patient scheduling.

Staying in touch with facilities’ GPO is also advantageous. Once a vaccine is ready for distribution, healthcare providers will need to be agile to respond quickly to its availability and any best practices for storage and allocation. For example, some vaccines may require two doses. In that case, facilities will need to book follow up appointments with patients within the specified time frame.

Providers that need to purchase an ultra-cold vaccine freezer should reach out to their GPO to find out about prices and availability. Communication with a GPO, patients and industry and government organizations will be essential to successfully vaccinate against the pandemic.

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