Originally published in ToolBox Tech. 

The COVID-19 vaccines are here, but getting them to 331 million Americans will be a monumental challenge. Luckily, the technology exists to ensure healthcare professionals maintain a steady pace of inoculations while keeping people safe, says Kevin Grauman, CEO of QLess.

In March 2020, the world as we knew it ground to a halt. The COVID-19 virus reached North America and prompted governments worldwide to take unprecedented action to blunt the surge in infections and deaths. In the wake of these moves, the economy took its most severe blow since the Great Depression, pushing millions out of work. Despite this, more than 300,000 Americans have died due to the virus, and millions more have been infected.

Thankfully, there is light at the end of the tunnel. Drug regulators have approved vaccines from Pfizer-BioNTech and Moderna. Both vaccines use new mRNA technology, both have been proven to be around 95 percent effective against COVID-19, and both require two doses roughly a month apart. Rival vaccines from Johnson & Johnson and AstraZeneca are getting close to entering the approval process. It’s a miracle of modern science that a vaccine against this deadly virus was developed in under ten months. 

However, developing the vaccine was just the first major challenge of ending the pandemic. Manufacturing and distributing the vaccine to nearly eight billion people around the world will require a herculean effort. To make matters more difficult, the Pfizer vaccine needs to be transported at temperatures of -94F (-70C), while Moderna‘s is a more manageable -4F (-20C). Pfizer is shipping the vaccine in dry ice, which will keep it at the required temperature for 15 days. Once the Pfizer vaccine is defrosted, it will last up to five days in a conventional refrigerator with a temperature between 2-8C (35-46F). This will require the vaccine to reach its destination swiftly, and it must be used quickly to avoid wasting precious doses.

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A robust technological infrastructure is needed to help governments quickly, efficiently, and smoothly inoculate their citizens. Let’s take a look at what this entails. 

One of the first things any jurisdiction will need to do is notify and convince people the vaccine is here and safe. Unfortunately, there has been a surge in misinformation surrounding vaccines and the pandemic that has blunted many COVID-19 responses. 

Some polls show as many as one-third of Americans may choose not to take the vaccine. A fairly low-tech solution can help overcome this. Governments will need to engage the media — TV, radio, newspapers — and social media to explain how the vaccine works. It must be highlighted that while it’s new, it is safe with minimal risk of side effects. 

It would help to see famous and respected celebrities or politicians get the vaccine. In 1956, Elvis Presley famously got his polio vaccination on the Ed Sullivan Show, which led to hundreds of thousands of adults being inoculated. The media will need to constantly remind people that the vaccine is only effective if they receive both doses about a month apart. 

The logistics of shipping the vaccine will require the ability to track the shipments in real-time and securely. Currently, the Pfizer vaccine is being produced in Belgium, and as mentioned earlier, shipped in containers packed with dry ice to maintain the extreme cold. Each container can hold between 1,000 and 5,000 doses. The packaging also holds a GPS tracker and thermal sensors to ensure the shipment arrives safely and remains viable. 

The vaccine will be shipped from Europe via aircraft. The Federal Aviation Agency (FAA) is working with airports across the U.S. to ensure they can handle large cargo aircraft, have adequate parking for the jets, prioritize aircraft carrying the vaccine, and give cargo handlers quick access to unload the medicine. U.S. Customs and Border Protection (CBP) is working with shippers, airlines, and freight-forwarders to speed up the customs clearance process.

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In the U.S., the vaccine will be distributed by state-run agencies. This means 50 different governments handling the vaccination process in 50 different ways. While each state will decide who gets priority to the vaccine, the first round of vaccinations would be healthcare workers — doctors, nurses, lab techs, paramedics — and long-term care home residents. The next could be essential workers — which refers to a broad group whose jobs help keep society running, ranging from meatpacking plant workers to electrical line workers — older adults aged over 65, and those with underlying health conditions that make COVID-19 particularly dangerous.

Due to the vaccine’s extreme temperature requirements, a database is required to categorize which facilities can store the medicine and handle the crush of people seeking a dose. This list could include hospitals, pharmacies, clinics, and doctors’ offices. 

The most challenging aspects of the vaccine rollout will likely be tracking those who want to be inoculated and scheduling them for both shots. Despite those with qualms about taking the vaccine, there will still be high demand for it. This cannot be a “first come, first served” situation. It would be detrimental to have large crowds of people queuing for a vaccine while the pandemic is still raging around them. 

To streamline the process, a website will need to be set up to help people register, schedule their appointments for each dose of the vaccine and take all their pertinent information. The software also exists to create virtual lines, so people will not be stuck waiting in long queues. This can help speed the process up, keep people informed of when they need to be at the facility, and reduce stress on both the medical staff and patients. This will help ensure the facility where the vaccinations occur has enough doses, minimize wastage due to spoilage, and operate at peak efficiency every day. 

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There is a vital need to keep track of who has been vaccinated and confirm who got both shots, what vaccine was used, and who experienced any adverse reactions, which is especially important due to the quick development of the vaccines. This information could be used to re-open the economy sooner and allow those who are inoculated to travel internationally. The development of this type of database is important since many states do not track vaccinations, though this does raise some difficult questions regarding privacy. 

Finally, ensuring people get both doses could be a serious challenge. Experts worry that as many as 30 percent of people may neglect to get their second shot, which would undermine the vaccination process. Digital reminders will need to be sent via email or SMS text messages, and follow-up phone calls may be necessary.

The rapid development of the COVID-19 vaccine is a major scientific achievement. It promises to end the pandemic, re-open the economy, and help return things to normal. While distributing doses to more than 331 million people in the United States will be a monumental challenge, the technology does exist to maximize efficiency, avoid waste, and help ensure people get inoculated quickly. Once that’s accomplished, life as we knew it could begin to return.