# How does vaccine distribution work?

**URL:** <https://boards.straightdope.com/t/how-does-vaccine-distribution-work/926275>\
**Category:** The Quarantine Zone\
**Tags:** covid-quarantine\
**Created:** [November 23, 2020, 4:31pm UTC](https://boards.straightdope.com/t/how-does-vaccine-distribution-work/926275 "2020-11-23T16:31:49Z")\
**Posts on this page:** 20\
**Page:** 8

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**Author:** ![digs](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/digs/32/14889_2.png) [@digs](https://boards.straightdope.com/u/digs)\
**Post date:** [December 3, 2020, 4:11am UTC](https://boards.straightdope.com/t/how-does-vaccine-distribution-work/926275/141 "2020-12-03T04:11:42Z")

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I’m assuming IM shots aren’t as difficult as other shots.

Am I correct that it’s easier than trying to find a vein?.. (and infinitely easier than finding an artery?)

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**Author:** ![squeegee](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/squeegee/32/14537_2.png) [@squeegee](https://boards.straightdope.com/u/squeegee)\
**Post date:** [December 3, 2020, 4:42am UTC](https://boards.straightdope.com/t/how-does-vaccine-distribution-work/926275/142 "2020-12-03T04:42:06Z")

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IM is “intramuscular”. Find a muscle.

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**Author:** ![BippityBoppityBoo](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bippityboppityboo/32/5745_2.png) [@BippityBoppityBoo](https://boards.straightdope.com/u/BippityBoppityBoo)\
**Post date:** [December 3, 2020, 4:45am UTC](https://boards.straightdope.com/t/how-does-vaccine-distribution-work/926275/143 "2020-12-03T04:45:54Z")

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> [@digs](#):
>
> I’m assuming IM shots aren’t as difficult as other shots.

They are considered **more** difficult than intradermal or subcutaneous. More can go wrong. It is not as easy as it looks.

> [@digs](#):
>
> Am I correct that it’s easier than trying to find a vein?.. (and infinitely easier than finding an artery?)

They really aren’t comparable, except they both involve a needle and a syringe. Veins and arteries are superficial. IMs are the deepest form of injection (barring cardiac or intrathecal [into the spinal column], both of which are done with a physician present)

Arteries are usually slightly more difficult than veins because physiologically they lie deeper than veins.

The most important difference is that with blood draws something is being taken out of the body, not something being put in. It’s all the intangibles that matter there. Not much serious can go wrong with a botched blood draw-lots can go wrong with a badly done injection. That’s why nurse and pharmacists go to school for years. Self injections are a whole different beast-there is no liability issues with self-injection, you aren’t going to sue yourself for malpractice. Just like someone who gives a family member an injection, you aren’t likely to sue your spouse or kid for trying to help you.

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**Author:** ![FigNorton](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/fignorton/32/5619_2.png) [@FigNorton](https://boards.straightdope.com/u/FigNorton)\
**Post date:** [December 3, 2020, 4:48am UTC](https://boards.straightdope.com/t/how-does-vaccine-distribution-work/926275/144 "2020-12-03T04:48:37Z")

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So would optometrists be at the top of your list to sub in on vaccinations?

Eta: I’d go Physiotherapists personally. Lots of clinic space and already handy with bodies and (non-injection) needles.

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**Author:** ![BippityBoppityBoo](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bippityboppityboo/32/5745_2.png) [@BippityBoppityBoo](https://boards.straightdope.com/u/BippityBoppityBoo)\
**Post date:** [December 3, 2020, 5:00am UTC](https://boards.straightdope.com/t/how-does-vaccine-distribution-work/926275/145 "2020-12-03T05:00:11Z")

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> [@FigNorton](#):
>
> So would optometrists be at the top of your list to sub in ?

Military medics or corpsmen, EMTs or paramedics (if all of them aren’t busy doing ambulance runs or being shift as firefighters)-we really don’t have any to spare if those other things are going to be staffed.

Nursing students would work, if the recipients consented. The caveat there is that students have to be closely supervised by an RN when doing clinical things and any spare RNs are already busy taking care of people in hospitals, many of whom couldn’t be bothered to stay home or wear masks. I never hesitate to have a nursing or medical student do a procedure on me, FWIW.

Pharmacists and dentists and dental students would be good candidates. With perhaps the dental ones given a brush up on IM anatomy and protocols. I don’t know enough about optometrists to know if they deal with injections outside of locals around the eyes (and I’m not sure if many of them do those).

The problem is that virtually of these are already more than busy doing their current jobs. With the exception of students, there aren’t enough pharmacists or medics available that don’t already have more to be done than they can do as it is.

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**Author:** ![BippityBoppityBoo](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bippityboppityboo/32/5745_2.png) [@BippityBoppityBoo](https://boards.straightdope.com/u/BippityBoppityBoo)\
**Post date:** [December 3, 2020, 5:06am UTC](https://boards.straightdope.com/t/how-does-vaccine-distribution-work/926275/146 "2020-12-03T05:06:46Z")

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> [@FigNorton](#):
>
> I’d go Physiotherapists personally. Lots of clinic space and already handy with bodies and (non-injection) needles.

Physiotherapists would be a good consideration. Hadn’t thought of them. They’d understand anatomy, and if they did dry needling, they would stand sterility concepts. IMs are different though in that an active substance is being injected into tissue and that is different than a super super thin dry-needling needle. If they were willing though, it’s worth trying. How many of them though are not already busy doing essential healthcare. Supply, supply, supply.

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**Author:** ![FigNorton](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/fignorton/32/5619_2.png) [@FigNorton](https://boards.straightdope.com/u/FigNorton)\
**Post date:** [December 3, 2020, 5:10am UTC](https://boards.straightdope.com/t/how-does-vaccine-distribution-work/926275/147 "2020-12-03T05:10:47Z")

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Physios I know are working again, and fairly busy, but they’ve been included in previous shutdowns excepting post op physio patients.

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**Author:** ![BippityBoppityBoo](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bippityboppityboo/32/5745_2.png) [@BippityBoppityBoo](https://boards.straightdope.com/u/BippityBoppityBoo)\
**Post date:** [December 3, 2020, 5:16am UTC](https://boards.straightdope.com/t/how-does-vaccine-distribution-work/926275/148 "2020-12-03T05:16:58Z")

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> [@FigNorton](#):
>
> Physios I know are working again but they’ve been included in previous shutdowns excepting post op physio patients.

Around my region they stayed open throughout (at least after the initial week or two). PTs do a lot more than just post op patients-those other patients still need them, accident, injuries, pediatric and developmental, convalescent rehab patients.

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**Author:** ![FigNorton](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/fignorton/32/5619_2.png) [@FigNorton](https://boards.straightdope.com/u/FigNorton)\
**Post date:** [December 3, 2020, 5:19am UTC](https://boards.straightdope.com/t/how-does-vaccine-distribution-work/926275/149 "2020-12-03T05:19:44Z")

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I know, they just didn’t consider anything other than post-op “essential” hereabouts. Frankly, if you do your damn exercises you can miss a month or two of physio. Nobody does that though. Lol .

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**Author:** ![LivingGhost371](https://avatars.discourse-cdn.com/v4/letter/l/b9e5f3/32.png) [@LivingGhost371](https://boards.straightdope.com/u/LivingGhost371)\
**Post date:** [December 3, 2020, 5:21am UTC](https://boards.straightdope.com/t/how-does-vaccine-distribution-work/926275/150 "2020-12-03T05:21:32Z")

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Back to the idea of using car washes: I’ve never been to a car wash that wasn’t heated. In a climate like Maine or where I live, half the year the outside temperature is below the freezing point of water…

The newer indoor style mini-storage units also have a heated bay where you can pull your car in to unload your stuff.

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**Author:** ![eschrodinger](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/eschrodinger/32/122_2.png) [@eschrodinger](https://boards.straightdope.com/u/eschrodinger)\
**Post date:** [December 3, 2020, 7:11am UTC](https://boards.straightdope.com/t/how-does-vaccine-distribution-work/926275/151 "2020-12-03T07:11:28Z")

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I think I mentioned it in this thread before – I am sure there are complicating factors that can make it more difficult, but it seems to me that you could have a group of volunteers working with a nurse there, so they can hand off anything challenging, and call for help if something unusual happens.

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**Author:** ![digs](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/digs/32/14889_2.png) [@digs](https://boards.straightdope.com/u/digs)\
**Post date:** [December 3, 2020, 4:33pm UTC](https://boards.straightdope.com/t/how-does-vaccine-distribution-work/926275/152 "2020-12-03T16:33:15Z")

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I’m just amazed that, instead of hearing about dozens of failed vaccines through 2022 (like I pessimistically thought), we’re discussing the many working vaccines, and who best to stab us with it.

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**Author:** ![elfkin477](https://avatars.discourse-cdn.com/v4/letter/e/a9a28c/32.png) [@elfkin477](https://boards.straightdope.com/u/elfkin477)\
**Post date:** [December 4, 2020, 4:33am UTC](https://boards.straightdope.com/t/how-does-vaccine-distribution-work/926275/153 "2020-12-04T04:33:52Z")

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> [@FigNorton](#):
>
> I know, they just didn’t consider anything other than post-op “essential” hereabouts. Frankly, if you do your damn exercises you can miss a month or two of physio. Nobody does that though. Lol .

Hey, I did! I fell off a ladder the Saturday before MLK day and landed on my knee. I got my brother to bring me to urgent care when I couldn’t walk more than 3 steps without it buckling, and after a bunch of x-rays showed nothing was broken they decided I did ligament or tendon damage, so I had my knee immobilized for 2 weeks, then got a brace from the ortho and started PT on Valentine’s day. I only went about a month before PT got shut down until the stay-at-home order was lifted at the end of May.

I did all my exercises, every single day (other than the 2 heaviest days of my cycle) and by early June I felt fine 98% of the time so I never went back.

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**Author:** ![FigNorton](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/fignorton/32/5619_2.png) [@FigNorton](https://boards.straightdope.com/u/FigNorton)\
**Post date:** [December 4, 2020, 4:42am UTC](https://boards.straightdope.com/t/how-does-vaccine-distribution-work/926275/154 "2020-12-04T04:42:20Z")

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That’s awesome! Bonus tip: do the exercises to some degree even when you feel good. They’re preventive as well as for getting better 🙂

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**Author:** ![LilahBlue](https://avatars.discourse-cdn.com/v4/letter/l/b4bc9f/32.png) [@LilahBlue](https://boards.straightdope.com/u/LilahBlue)\
**Post date:** [December 5, 2020, 9:07am UTC](https://boards.straightdope.com/t/how-does-vaccine-distribution-work/926275/155 "2020-12-05T09:07:55Z")

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Oh my fucking god. So, to be clear, a child of yours braided fringe on a blanket and it moved you to incredible levels of rage, right? But now you are fine with sacrificing lives that you deem “too old”? No wonder your kids hate you.

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**Author:** ![Colibri](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/colibri/32/1841_2.png) [@Colibri](https://boards.straightdope.com/u/Colibri)\
**Post date:** [December 5, 2020, 5:11pm UTC](https://boards.straightdope.com/t/how-does-vaccine-distribution-work/926275/156 "2020-12-05T17:11:51Z")

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> [@LilahBlue](#):
>
> Oh my fucking god. So, to be clear, a child of yours braided fringe on a blanket and it moved you to incredible levels of rage, right? But now you are fine with sacrificing lives that you deem “too old”? No wonder your kids hate you…

**Moderator Warning**

This is an official warning for insults and being a jerk. In addition, the post that you responded to already received a warning. THERE IS NO NEED TO RESPOND TO POSTS THAT HAVE BEEN MODERATED.

Colibri  
Quarantine Zone Moderator

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**Author:** ![Treppenwitz](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/treppenwitz/32/3445_2.png) [@Treppenwitz](https://boards.straightdope.com/u/Treppenwitz)\
**Post date:** [December 5, 2020, 8:42pm UTC](https://boards.straightdope.com/t/how-does-vaccine-distribution-work/926275/157 "2020-12-05T20:42:20Z")

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Here’s something from the MHRA website, which I think is extremely poorly expressed but, having heard a description of how shipping works on BBC news, I _think_ I now understand it.

> - Distribution as part of the deployment can be controlled at either ULT [Ultra Low Temperature] (-70 +/- 10 degrees Centigrade) within four transitions below -15 degrees Centigrade, or in 2-8 degrees Centigrade within 120 hours of leaving ULT.
> - Further packing down of lots to aid deployment can occur at 2-8 degrees Centigrade within the 120 hours shelf life of leaving ULT.
> - Transit of the undiluted product at 2-8 degree Centigrade can occur either in two journeys each up to 6 hours or, where there are real deployment needs, for a maximum of 12 hours in one sitting. These times are to be taken within the 120 hour shelf life.

([Source](https://www.gov.uk/government/publications/regulatory-approval-of-pfizer-biontech-vaccine-for-covid-19/conditions-of-authorisation-for-pfizerbiontech-covid-19-vaccine) - see the section on deployment)

OK, so you need to know (from the [Summary of Product Characteristics](https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/941452/Information_for_healthcare_professionals.pdf) that I posted upthread) that:

> After thawing, the vaccine should be diluted and used immediately. However, in-use stability data  
> have demonstrated that once thawed, the undiluted vaccine can be stored for up to 5 days at 2 °C to 8 °C

OK, so taking into account that I think it highly unlikely that you can thaw and refreeze the vaccine repeatedly (I may be wrong about that, but it seems very improbable - plus the SPC states _Once thawed, the vaccine cannot be re-frozen_) my interpretation of what they re trying to say is this.

Ship at ULT if you can. If you cannot, then for shipping the frozen vaccine, you may use non-ULT temperatures lower than -15° C. However shipping at non-ULT temperatures lower than -15° C can only occur a maximum of four times and (I think) _the shipping times should be deducted from the 5 day (120 hour) refrigerated shelflfe_ (I can’t make sense of the rules unless this is the case because, obviously, there must be some time restriction on shipping at non-ULT temperatures lower than -15° C, and I cannot find any other stated time restriction).

And, separately, once you have thawed the product with the intention of using it (but prior to dilution), you may ship it out to clinics etc either in two journeys each up to 6 hours or, where absolutely necessary, for a maximum of 12 hours in a single journey. Subtract this shipping time from the 5 day (120 hour) refrigerated shelflfe.

So this is my best guess. If I find any further clarification, I’ll post it.

On a separate subject, vaccination starts in the UK on Tuesday and my best estimate is that I’m something like number 8 million in the queue.

([UK priority list](https://www.bbc.co.uk/news/health-55045639) - scroll down)

j

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**Author:** ![Treppenwitz](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/treppenwitz/32/3445_2.png) [@Treppenwitz](https://boards.straightdope.com/u/Treppenwitz)\
**Post date:** [December 5, 2020, 8:54pm UTC](https://boards.straightdope.com/t/how-does-vaccine-distribution-work/926275/158 "2020-12-05T20:54:58Z")

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Damn - missed the edit. That should read

And, separately, once you have thawed the product with the intention of using it (but prior to dilution), you may ship it **(refrigerated at 2 - 8° C)** out to clinics etc either in two journeys each up to 6 hours or, where absolutely necessary, for a maximum of 12 hours in a single journey. Subtract this shipping time from the 5 day (120 hour) refrigerated shelflfe.

Sorry.

j

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**Author:** ![squeegee](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/squeegee/32/14537_2.png) [@squeegee](https://boards.straightdope.com/u/squeegee)\
**Post date:** [December 8, 2020, 4:45am UTC](https://boards.straightdope.com/t/how-does-vaccine-distribution-work/926275/159 "2020-12-08T04:45:05Z")

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I posted in this in the Breaking News thread, but it’s relevant here.

> **[Pfizer tells U.S. officials it cannot supply substantial additional vaccine...](https://www.washingtonpost.com/health/2020/12/07/pfizer-vaccine-doses-trump/)**
>
> Trump administration officials deny there will be availability issues, but others say problems are possible in the second quarter.

Apparently the US passed on pre buying more of Pfizer’s vaccine last summer, so we’re out of luck until summer 2021.

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**Author:** ![Tfletch1](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/tfletch1/32/5340_2.png) [@Tfletch1](https://boards.straightdope.com/u/Tfletch1)\
**Post date:** [December 8, 2020, 8:25pm UTC](https://boards.straightdope.com/t/how-does-vaccine-distribution-work/926275/160 "2020-12-08T20:25:49Z")

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> [@squeegee](#):
>
> Apparently the US passed on pre buying more of Pfizer’s vaccine last summer, so we’re out of luck until summer 2021.

I wonder why the US passed on Pfizer? Was it that they didn’t take government money for development?

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