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Despite Trump’s claims, the Dept. of Defense doesn’t plan to lead vaccine distribution

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President Donald Trump doubled down on his optimism that a COVID-19 vaccine for the masses is just around the corner during Thursday night’s final presidential debate with former Vice President Joe Biden. That flies in the face of what most experts, including senior Trump administration officials, have said, as debate moderator Kristen Welker noted.

But Trump insisted that he believes in a more accelerated timeline that can be boosted by the U.S. military, which would ostensibly help deploy tens of millions of doses to the general population once a vaccine clears regulatory hurdles.

“You have said a vaccine is coming soon within weeks now. Your own officials say, ‘It could take well into 2021 at the earliest for enough Americans to get vaccinated,’” said Welker.

“No, I think my timeline is going to be more accurate. I don’t know that they’re counting on the military the way I do, but we have our generals lined up, one in particular that’s the head of logistics, and this is a very easy distribution for him. He’s ready to go,” Trump responded. “As soon as we have the vaccine—and we expect to have a 100 million vials—as soon as we have the vaccine, he’s ready to go.”

While it’s true that the military may be involved in transportation of some vaccine doses, practical logistics suggest it won’t be at nearly the scale that Trump suggested in the debate and has repeated multiple times in the past.

For one thing, distribution of any COVID vaccine will likely be dictated by need through a tiered prioritization strategy. The U.S. Centers for Disease Control (CDC) and National Institutes of Health (NIH) commissioned a framework for equitable distribution of the COVID vaccine by the National Academies of Sciences, Engineering, and Medicine.

That initial framework recommends, in its delivery and allocation section, that the Department of Health and Human Services (HHS) build “the capacity and systems to collect and integrate the necessary data (digital and other) from public health and private providers of care to facilitate the identification and monitoring of people with pre-existing conditions and other high-risk characteristics” for the first tranche of people to receive a vaccine.

Theoretically, a military jet could help in this transport system. But there are myriad complexities involved given the nature of a coronavirus vaccine. Many vaccines currently under development, including from drug giants like Pfizer and smaller biotechs like Moderna, would need to be refrigerated at temperatures as low as negative 112 degrees Fahrenheit. Others, such as one under development by Johnson & Johnson, could eventually be stored at conventional fridge temperatures for up to three months.

While Air Force cargo jets could be equipped with the proper refrigeration units to transport ultracooled vaccines (in collaboration with the companies developing them), there’s another logistics dilemma: transferring these highly sensitive materials from a manufacturing site or truck to units on a military plane.

That process could possibly taint the product, which is why experts note that a more realistic option is likely relying on supercooled cargo trucks that can transport a COVID vaccine directly to a medical center that has its own specialized infrastructure.

The Defense Department itself said as recently as late September that it doesn’t expect the military to be involved in vaccine distribution in any large-scale fashion. In a statement to the trade publication American Shipper, a Pentagon spokesperson said that “DOD-required support would be by exception,” noting that “military air assets may be called upon to deliver vaccines to a remote location only if no other means of transportation is feasible.”

On a broader level, Trump’s suggestion that a vaccine will be instantly available once granted FDA authorization or approval defies practicality and the nature of rolling out a vaccine in less than a year. Much like coronavirus testing, high-risk patients and frontline workers will be prioritized before the broader populace will be able to get their shots, likely sometime next year.

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