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Before Americans get their Covid-19 vaccines, some pharmacies need major improvements

Despite the special storage requirements for Pfizer vaccine, pharmacy grocery stores may be one step ahead of traditional pharmacies and independent pharmacies, as they already have vaccine storage space that requires only standard cooling.
Pfizer's manufacturing facility in Kalamazoo, Michigan.

“Grocery stores will help speed up the spread of a national vaccination program,” David Bishop, a partner and analyst at retail and grocery consulting firm Brick Meets Click, told CNN Business. It’s just a function of capacity in grocery stores, Bishop said. Many grocers who already work with pharmacies have “much larger and existing storage areas, whether we’re talking in the back or on the sales floor,” he said.

But the Pfizer vaccine will be sent to pharmacies in the United States, and grocery stores and pharmacies are “absolutely starting from scratch” when it comes to buying and using ultra-cold freezers, said Gary Bisig, vice president of LabRepCo, a research firm. devices for the pharmaceutical industry.

Pfizer's manufacturing facility in Kalamazoo, Michigan.

The Pfizer vaccine will arrive in thermal forwarders, which can be used as temporary storage units when filled with dry ice. The vials withstand these conditions for 15 days, according to a statement from Pfizer, which makes it a good option for a quick turnaround, but not for long-term storage of vaccines, which is likely to be common. According to Pfizer’s instructions, the boxes can only be opened twice a day and each time for no more than a minute.

The vaccine can also be stored at 2 ° C to 8 ° C in refrigerators, which are usually offered in hospitals, the company said, but the vials can only last five days under these conditions.

Ultra-low freezers extend the shelf life of the vaccine to six months and could be useful in places where clinicians feel they may not get through the vaccine quickly.

Pharmacies have been using flu and pneumococcal vaccines for many years, but about 99% of US pharmacies they do not have access to a freezer -80 ° C, Bisig said.

Bisig added that ultra-cold storage facilities have traditionally been bought by “large hospitals” and “huge medical colleges” that use freezers for research. “The use of this freezer is traditional for drug detection,” he stressed. “It’s not about drug distribution.”

LabRepCo began building small -80 ° C devices for small pharmacies and clinics as soon as it heard about the storage requirements for the Pfizer vaccine.

“Ultra – cold freezers will be an essential part of [Walgreens’] plan, “a Walgreens spokesman told CNN.” We are exploring the use of a combination of these ultra-cold freezers and dry ice storage solutions to support these drugs. “

However, CVS plans to use Pfizer’s shipping containers instead of buying its own ultra-cold storage devices. “We would refill the dry ice every five days for a total of 15 days,” a CVS spokesman told CNN Business. The vials can then be cooled for another five. “Each dose will be used within this window,” the spokesman said.

“We started doing them as quickly as possible, but it wasn’t enough,” Bisig said. “These factories can’t grow up to twice their normal size. All they can do is add more people and try to get more raw materials and do everything they can.”

“The whole global demand for these products has swelled to an unsustainable level at the moment,” he said.

Grocery store pharmacies are also preparing, but many grocery plans to buy ultra-cold storage depend on obtaining permission for specific vaccines. If the Pfizer vaccine is approved first, stores will focus on acquiring and using ultra-cold storage.

“Supermarket pharmacies are in a good position to administer Covid-19 vaccines in a safe and convenient place when they are available,” Heather Garlich, vice president of FMI, a food marketing group, retailer and wholesaler, told CNN Business. . The group currently liaises with major refrigeration service providers in case there is a need for refrigeration above existing capacity.

Long lines

An inscription at the entrance to the pharmacy reads

Storage is not the only problem. Managing potentially long queues in stores is another hurdle that pharmacies will likely have to overcome.

Some clinics are already testing vaccines influenza vaccine strategies while the pharmaceutical industry awaits approval from the US Food and Drug Administration. Brian Tankillut, a health fund analyst at Jeffries, highlighted a pilot program at a clinic in Shreveport, Louisiana. He said the clinic was testing flu vaccines to prepare for the introduction of a driving strategy for state-owned Covid-19 vaccines.

Similar to CVS’s Covid-19 testing operation, vaccines will only be available to CVS customers upon prior request and can be booked through the CVS website or application.

“Think of it as a return ticket – you’ll book both doses at once, with a healthy number of reminders (texts, calls, etc.) before the first and second shots,” a CVS spokesman told CNN Business. There will also be a special 800 number for customers who do not have online access.

The Albertsons food chain is also preparing for the vaccine. The company said that once the Covid-19 vaccine is available, recipients will be able to fill out vaccine consent forms at Albertsons pharmacy applications, reducing time spent at the pharmacy.

Which pharmacies will have the vaccine?

The US Department of Health and Human Services has published a list of pharmacies that have agreed to provide the vaccine when it becomes available to the public. The list includes Albertsons, Costco, CVS, Publix, Rite Aid, Kroger, Walgreens, Walmart and Winn-Dixie, among others.

The government has essentially “entered into agreements with these retailers to make sure they can get vaccines through them,” Tankilut said. It is now up to these companies to find out – in consultation with the government – which specific sites will administer the Covid-19 vaccine.

Even with high demand, some places for Walgreens and CVS will not administer the vaccine, Tanquilut said. He stressed that not all CVS and Walgreens sites do Covid tests, and vaccination proposals are likely to reflect this.

“Larger places will be chosen that will have these opportunities,” he added.

As for delivery, “the government needs to determine delivery because it is a highly distributed product,” Tankilut said.

In its current form, it may soon be the goal of vaccinations for the general public. But this could happen in June or later, depending on how the Advisory Committee on Immunization Practices decides, what the supply of vaccines looks like and how smooth the distribution is. Healthcare workers, nursing home residents, high-risk adults and key workers are expected to have access to the vaccine from December.

CVS and Walgreens are preparing to be among the first to administer Covid-19 shots in the United States if the FDA authorizes emergency use. But these vaccinations will be given in long-term care facilities, not retail stores, according to CVS and Walgreens. CVS pharmacists will travel to the establishments, similar to the way they operate seasonal flu clinics on site, the company said in an email to CNN Business.

Speakers at Kroger, Publix, Albertsons, Wegmans and Gristedes were unable to share details about the purchase of ultra-cold storage devices.

– Naomi Thomas and Maggie Fox of CNN contributed to this report

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