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With the Food and Drug Administration clearance of a coronavirus vaccine on Friday, the United States became the third highly developed Western country, after Britain and Canada, to approve such a vaccine, and is expected to begin inoculating. to people in a few days.
But the three countries have very different health systems. And they face different challenges in the race to bring the vaccine to millions of people.
Below are some similarities and contrasts.
Is it the same vaccine?
For now yes.
The first vaccine licensed by US regulators, and the first approved by their British and Canadian counterparts, is the one developed by the pharmaceutical giant Pfizer and a small company, BioNTech. It could get approval from the European Union in a few weeks.
But several others are very close, notably a vaccine developed by Moderna and the National Institutes of Health, and another by AstraZeneca and the University of Oxford. It could well be that half a dozen or more vaccines will be approved in the coming months.
So as 2021 progresses, which vaccines (most vaccines would require two injections, weeks apart) someone receives could vary widely by country, depending on the speed of regulatory approvals, what agreements the governments to buy supplies and how much vaccines cost. . Even within a country, there could be differences based on the ease with which a particular vaccine is distributed and used.
The Pfizer-BioNTech and Moderna-NIH vaccines are of a new type never used before; they require ultra-cold storage and are more expensive than potential competitors. The Pfizer injection must be kept especially cold, minus 94 degrees Fahrenheit, which most healthcare facilities are not equipped to handle.
How centralized is the launch?
In Britain, very. In the United States, no. In Canada, somewhere in between.
With a strong central government and a National Health Service covering all its people, Britain, which began administering the vaccine this week, is leading the process from London. The national government chose the 50 hospitals that would initially receive the vaccine and made sure they were prepared; decided how much each would receive; and wrote the rules that determine in what order people would be eligible to get it.
The Trump administration has delegated much of the decision-making to the states. The federal government will have the vaccine distributed to each state based on population, not need, but some states have complained that they don’t know enough about the arrangements.
It will be up to states to decide how to spread doses across hospitals, clinics, and ultimately pharmacies and doctors’ offices, but initially, at least, the vaccine will go to hospitals with ultra-cold storage.
A committee that advises the Centers for Disease Control and Prevention is drawing up a priority list, starting with medical workers. But that work is still in progress and the guidelines are not binding. The states are expected to differ somewhat in their approach.
Like Great Britain, Canada has a universal healthcare system, but like the United States, it has a federal government. The Canadian health system is decentralized, administered by the provinces and territories.
For the distribution of vaccines, the central government plans to work through those regional governments. Ottawa will play an important role in directing the process.
How many people will get it at first?
That is still a bit murky.
Canada had ordered enough Pfizer-BioNTech vaccine for its entire population, Britain enough for 30 percent, and the United States for 15 percent.
But those numbers reflect deliveries that are expected to take months to complete, and Pfizer, like other companies, has struggled to increase production. In addition, the three countries have also made advance purchases from other companies, so the pace of vaccine approval could significantly affect the speed of implementation.
That speed will also be affected by the need for vaccination sites to be equipped with adequate freezers, staff to prepare vaccines, and sufficient syringes and protective equipment.
Initial shipments are a small fraction of previous purchases: 800,000 doses to Britain and 249,000 this month to Canada.
US officials have said they expect to have 40 million doses of the vaccine by the end of the month, which may be optimistic. That would be enough to inoculate 20 million people.
Rural areas where hospitals are not equipped to keep vaccines at the proper temperatures, or do not have the staff to prepare them for injection, will not receive injections from Pfizer. That’s more of an obstacle in the United States and Canada, huge countries with vast and sparsely populated regions, than in Britain, which is much more compact.
In Canada, where the military plays a critical role in vaccine distribution, the government ships shipments to all 10 provinces. The three northern territories will have to wait.
In the United States, FedEx and UPS will ship vaccines from distribution centers to all parts of the country. But the holiday season is the busiest time of year for delivery services, which could slow things down.
How quickly will most people get vaccinated?
That’s even more murky.
Britain, Canada, the United States and the European Union have followed similar strategies, ordering a large number of doses in advance, more than enough to inoculate everyone, from multiple manufacturers, hedging their bets in case some of the vaccines are not. approved or some manufacturers have breakdowns in production.
Relative to its stocks, the United States ordered far fewer doses than Canada or Britain, and last summer it turned down an offer to increase its pre-order from Pfizer. Administration officials say the figures are misleading, because the government has signed options to buy much more vaccine if it sees the need.
But in the face of intense global demand, it is not clear how quickly pharmaceutical companies will be able to fulfill the orders they have, much less the additional orders.
And again, the speed of development, approval, and production will affect how quickly supplies get to people. A country that bets more on one vaccine could be much better off than one that depends more on another.
Megan Twohey and Ian Austen contributed reporting.
