With the approval of the Food and Drug Administration for the coronavirus vaccine on Friday, the United States became the third highly developed Western country – after Britain and Canada – to approve such a bullet, and people are expected to start vaccinating in a few days.
But the three countries have very different health care systems. And they face different challenges in the race to get the vaccine for millions of people.
Here are a few similarities and contrasts.
Is it the same vaccine?
For now, yes.
The first vaccine approved by US regulators, and the first approved by their British and Canadian counterparts, is that developed by pharmaceutical giant Pfizer and small company BioNTech. It could get European Union approval in a few weeks.
But several others are behind them, especially a vaccine developed by the Modern and National Institutes of Health, and another from AstraZeneca and the University of Oxford. It could be that half a dozen or more vaccines will be approved in the coming months.
So as it develops in 2021, which injections (most inoculations require two injections at intervals of a few weeks) may vary by country, depending on the speed of regulatory approvals, which governments have made to buy stocks, and how much they cost vaccines. Even within a state, there may be differences based on how easy it is to distribute and use a particular vaccine.
The Pfizer-BioNTech and Moderna-NIH vaccines are a new type that has never been used before; they require ultra-cold storage and are more expensive than likely competitors. Pfizer’s image must be especially cold, at minus 94 degrees Fahrenheit, which most health care institutions are not equipped with.
How centralized is representation?
In Britain, very. Not in the United States. In Canada, somewhere in between.
With a strong central government and the National Health Service covering all its people, Britain, which started giving the vaccine this week, is directing the procedure from London. The national government selected 50 hospitals to initially receive the vaccine and made sure they were prepared; decided how much each would get; and drafted rules that determine the order in which people are entitled to receive it.
The Trump administration has shifted much of the decision-making to states. The federal government will distribute the vaccine in each state based on population, and it shouldn’t, but some states have complained that they don’t know enough about the arrangements.
It is up to the states to decide how they will divide the doses between hospitals, clinics and ultimately, pharmacies and doctor’s offices, but initially at least the vaccine will go to hospitals with ultra-cold storage.
The committee that advises the Centers for Disease Control and Prevention compiles a list of priorities, starting with the medical staff. But that work is still ongoing, and the guidelines are not binding. States are expected to differ somewhat in their approach.
Like Britain, Canada has a universal health care system, but like the United States, it has a federal government. The Canadian health care system is decentralized, governed by provinces and territories.
For the distribution of vaccines, the central government plans to work through these regional governments. Ottawa will play a big role in guiding the process.
How many people will get it in the beginning?
That stays a bit murky.
Canada has ordered enough Pfizer-BioNTech vaccines for all its people, 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 hit problems with increasing production. In addition, all three countries bought in advance from other companies, so the pace of vaccine approval could significantly affect the speed of introduction.
This speed will also be affected by the need for vaccination sites to be equipped with real freezers, injection staff and sufficient syringes and protective equipment.
The initial delivery is a small part of the pre-sales – 800,000 doses to Britain and the expected 249,000 this month to Canada.
U.S. officials have said they hope to receive 40 million doses of the vaccine by the end of the month, which may be optimistic. That would be enough to vaccinate 20 million people.
Rural areas where hospitals are not equipped to maintain vaccines at appropriate temperatures or do not have staff to prepare them for injections will not receive Pfizer footage. This is a bigger hurdle in the United States and Canada, huge countries with vast, sparsely populated regions, than in the UK, which is much more compact.
In Canada, where the military plays a central role in the distribution of vaccines, the government sends shipments to all 10 provinces. The three northern territories will have to wait.
In the United States, FedEx and UPS will deliver vaccines from distribution centers to every part of the country. But the holiday season is the busiest time of the year for delivery services, which could slow things down.
How soon will most people get vaccinated?
It’s even more murky.
Britain, Canada, the United States and the European Union have followed similar strategies, pre-ordering a huge number of doses – more than enough to vaccinate everyone – from multiple manufacturers, protecting their bets in the event that some vaccines are not approved or some manufacturers have interruptions. production.
In relation to their population, the United States ordered much smaller doses than Canada or Britain, and last summer Pfizer made an offer to increase its order in advance. Administration officials say the numbers are misleading because the government has signed options to buy many more vaccines if it sees the need.
But faced with high global demand, it is not clear how quickly pharmaceutical companies will be able to fulfill the orders they have, much less any additional orders.
And again, the speed of development, approval and production will affect how quickly stocks reach people. A country that bets more on one vaccine could be much better than one that relies more on another.
Megan Twohey and Ian Austen contributed to the reporting.