Reports say there are now three coronavirus vaccines, with effectiveness from 90 to 95%.  What the reports do not say, however, is: How will they be distributed? How do we get them? Or what they’ll cost? Or how soon they will end the pandemic?

So, correspondent David Pogue decided to ask the experts: Now that you have the vaccine, what next?

“I’ve spent a career of over 35 years in vaccine development, and I can’t recall ever seeing a respiratory virus for which a vaccine provided this high a level of efficacy,” said Bill Gruber, the head of vaccine development at Pfizer. He oversaw the tests of the Pfizer-BionTech vaccine on 44,000 volunteers.

His team learned the good news – that it was 95% effective – on a Zoom call. “They got tears in their eyes,” Gruber said. “This was an extraordinary, extraordinary moment.”

The new, so-called RNA vaccines use a new approach. Instead of giving you a dead or weakened version of the virus itself (like the measles and chicken pox vaccines), these contain only a tiny fragment of the virus.

“It trains your immune system to basically fight off the virus when it encounters it in the future,” said Gruber. “This is a watershed moment in two respects: because obviously it’s safe and effective for coronavirus, but it also could really be a pivotal moment in the ability to develop better vaccines.”

Pfizer tested several different formulas for the vaccine (or constructs, as they call them).

“We didn’t know which one would work best,” Gruber said. “We moved very methodically, but expeditiously.”

But developing the vaccine is only the first hurdle. Now you’ve got to ship it out to people.

Thomas Tighe, the CEO of Direct Relief, a nonprofit that distributes medicine to community health centers and free clinics, explained: “It goes from the manufacturers to the distributors to the CVSes and Walgreens and RiteAids of the world, to doctors’ offices directly.”

And you have to keep it cold.  Some of the vaccines are getting down to -70 degrees Celsius [-94 Fahrenheit]. Ultra-cold!

Tighe introduced Pogue to the concept of the cold chain for medicine distribution.

“If you buy ice cream, you’re receiving food through a cold chain. It’s manufactured, it’s kept cold ’til it gets to the distribution center of your grocery store, where you are the picker and packer. You are your own last mile.”

If the FDA gives approval to the new coronavirus vaccines, some of them will soon be crossing the country in special containers surrounded by super-frozen slabs. They assemble the slabs around the box, enveloping it in cold.  The temperatures of each box can be monitored throughout its journey via GPS.

And for use on planes and trucks, there’s a self-contained, battery-powered shipping freezer. “On a forklift, you could bring this,” Tighe said. “It’s rated for -20 Celsius, -4 Fahrenheit.”

“It does seem like there’s a big difference between the Pfizer vaccine with its -94 requirements, and the Moderna, which could survive in a lot of these existing cold technologies,” said Pogue.  

“The temperature difference is significant,” Tighe said.

The next challenge is making enough of the vaccine. Pfizer, Moderna, and the other pharmaceutical companies are already making their vaccines in huge tanks, 24 hours a day. In fact, they started months ago, even before the trials were complete.  

“They gotta come up with 330 million doses?” asked Pogue.

“Oh, no, no, it’s much more than that,” said Harvard Business School professor Willy Shih, an economist and an expert on manufacturing.  “We should be thinking ten times that much, at least, as a starting point. We should be thinking three-and-a-half billion doses.”

And shipping companies are already preparing: “A lot of the carriers, like FedEx, like UPS, like DHL, they’ve been building these freezer farms in anticipation of having to ship larger quantities of COVID-19 vaccines at very cold temperatures,” Shih said.

The bigger problem, Shih said, will be managing our expectations. The pandemic won’t end once you get your shot: “I really worry about this, people not understanding – ‘I got that shot, I should be good, right? I can go back out to dinner. I can get my hair cut. You know, I can go to the gym.’ Not so fast. Certainly until we get broader immunization, people are still gonna have to wear masks. And they’re still gonna have to practice social distancing.

“I don’t think the American public is ready for that yet,” he said.

“I was probably, with a lot of the country, thinking, ‘This is the beginning of the end of the pandemic,'” Pogue asked.

“No,” Shih replied. “Only when the contagion rate goes down will we get back to some semblance of normal. And that’s gonna take a long time.”  

The government plans to allot the vaccines to the states according to their populations. The vaccine will be free to all. The CDC will recommend giving it first to health care workers and older Americans. If all goes well, by the spring of 2021, the vaccine will be available to anyone who wants it.

But the question is: Will enough people want it?

“Convincing people to get vaccinated is going to be our biggest challenge of all,” said Céline Gounder, an epidemiologist at the NYU Grossman School of Medicine and Bellevue Hospital.  “In the United States, we have a history of vaccine skepticism.

You have people who don’t want to be told by the government what to do. You have people who don’t trust pharmaceutical companies. You also have communities of color that have a long distrust of the health-care system.”

Pogue asked, “This might seem like a really dumb question, but what are people worried about?”

“People are afraid about side effects,” Gounder replied. “They’re afraid that they might get sick. I’ve even heard theories that people think this is a vaccine for mind control.  A lot of this is all over the map. We have a real tough road ahead in terms of convincing people that is not the case.”

“So you’re a member of President-Elect Biden’s advisory committee on the coronavirus; is there a plan in place for addressing some of the skepticism?”

“We’re gonna have to think outside the box here and be a bit creative,” Gounder replied. “This is something that we haven’t had to do here before.”

“Do you envision public-service announcements and celebrity endorsements?” Pogue asked.  

“That’s not really thinking that far outside the box,” she said. “I think you’re gonna have to see a lot of more grassroots community outreach, partnering with local leaders, people who are trusted by the community.”

Pogue said, “Well, let me ask you this, Dr. Celine Gounder, on national television: would you take the Pfizer or Moderna vaccine for you and your family right now?”

“I will likely be among the first who are lining up to get it,’ she replied. “I am a frontline health care worker. So, I would really love to get vaccinated before I have to put myself at risk in that way again.”

“You’re not worried about mind control?”

“I am not worried about mind control!” Gounder laughed.

The reputation of the AstraZeneca vaccine has suffered because of reporting of testing irregularities. But as for the Pfizer and Moderna vaccines, the whole story seems improbable; the stakes were high, society was shut down, and somehow in the clutch researchers and scientists came up with a new kind of vaccine that they say is 95% effective – in a matter of months.

Pogue asked Pfizer’s Bill Gruber how that was even possible.

“We live in a remarkable age,” he said. “Science has really progressed to a point where we have the tools to do this type of thing. And we have the dedicated people to do it, people who dedicated their lives. You know, everybody’s rowing together, and it’s a really extraordinary thing. It would not have happened without that.”

       
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Story produced by Gabriel Falcon. Editor: Ed Givnish.