Supply Chain Matters reflects on reports of nationwide distribution challenges of updated Covid-19 booster vaccines across the U.S.


The fall season is quickly approaching in the U.S.  and with that. health officials and medical agencies expect a likely surge of new strains of Covid-19 infections as people return to more indoor activities over the next several months. Thus people, especially those with inherent risk conditions, are being asked to receive an updated booster dose of the vaccine as soon as they can.

This week’s headlines include reports that after the U.S. federal government urged citizens to make their appointments for vaccine shots, the availability of vaccine supply across various pharmacies and healthcare providers is described as sporadic, and on a day-to-day availability basis, as if there were a demand and supply imbalance. The appearance is that individual vaccine administration sites have little visibility as to what level of supply that they would have on any given day. Recall that when the overall sheer volume of vaccine administration need peaked at the heights of the pandemic, there were similar challenges. But back then, volumes and designated shot delivery sites were far higher.

What is different in this latest wave of vaccination need is that the U.S. federal government is not taking responsibility for overall acquisition, supply management and distribution. Instead, individual pharmacy chains and healthcare providers are coordinating and administering the vaccine. Unlike the previous phases when the federal government paid vaccine makers directly for vaccines, health insurance carriers pay for the vaccine as a part of health insurance benefits. They, in turn, are ordering adequate supplies and coordinating payment benefit for individuals. This is, of course, how the system is supposed to operate.

A Wall Street Journal published report on this situation (Paid subscription) indicates that in previous Covid vaccine rollouts, vaccine makers such as Pfizer and Moderna shipped and took responsibility for needed doses being shipped directly to designated vaccination centers. U.S. health regulators actually turned over coordination and oversight of volume vaccine distribution to experienced military logistics professionals who coordinated with vaccine makers and specialty logistics providers.

Regarding the current ongoing supply and distribution challenges, the WSJ report cites Pfizer’s Vice President of Global Supply Chain, William Falstich as indicating that most doses are now being shipped to pharmaceutical and drug wholesalers, who in turn, ship to vaccine administration sites. He further indicates that these downstream distribution challenges are not about Pfizer’s vaccine supply: “To the extent that there’s downstream issues, I’d be speculating as to why that might be, but what I can say definitively is it’s not because Pfizer doesn’t have doses.Moderna reportedly has shipped millions of doses to support vaccine administration needs as well.


Supply Chain Matters Perspectives

Judging from past challenges that continue to exist across U.S. health drug and medicines related procurement and supply networks, there should be little surprise to the current situation.

The report indicates that one national pharmacy chain and 3rd party payment benefits provider CVS Pharmacy has its individual pharmacists so overworked and swamped that corporate staff workers are being encouraged to work 4-5 hour shifts at local retail outlets to assist in managing appointments, administration and supply needs over the next six weeks.

Vaccine administration has shifted from being delivered in physician offices and hospital clinics to national drug retail chains that not only provide medicines, but owned healthcare services clinics.

The three U.S. pharmaceutical and drug wholesalers are constantly being challenged with continual incidences of critical drug shortages from drug makers. Data from the University of Utah Drug Information Services indicated that there were more than 300 drugs listed as being in active nationwide short supply as of August. Now, the need to simultaneously support the needed supply and administration of the three prescribed vaccines, Covid, seasonal flu and RSV, nationally over the next six weeks, to a changing healthcare delivery landscape is the latest challenge.

Thus, if readers have not surmised at this point, these are the same healthcare drug supply and delivery networks that continue to struggle with overall procurement, inventory movement, patient support and timely delivery needs. From our perspective, production sourcing and distribution is predicated on the needs of drug companies and insurance providers vs. patient need. Occurring simultaneously are geopolitical events impacting the economics of global sourcing, a U.S. healthcare system that is constantly shifting for cost reasons and consequently fraught with stakeholder conflicts related to a holistic and mutually beneficial system.

It is at times of maximum need when the industry’s supply chain networks invariably succumb.

Thus, there should be no surprises as to what is occurring with this year’s vaccine surge, and patients are forced to bear the results.

Readers are encouraged to add their observations and perspectives.


Bob Ferrari

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