When will I be able to get the vaccine?
If you’re like me, you’ve been asking that question a lot lately. I’m a relatively healthy 29-year-old with no rationale to get the vaccine before anyone else, so I’m going to be lumped in with the general public. Utah currently estimates the public will be able to get the coronavirus vaccine somewhere in the March through July time frame.
Good golly, that’s a big window. If you called your cable company asking for a repair and it said a worker would be over sometime between March and July, you’d probably want a new cable company.
Unsatisfied, and living up to my reputation as a huge nerd, I dug into what it takes to make and distribute the vaccine. Then I built some models to help us narrow down that general vaccine availability window. Let’s get started.
The vaccine landscape
Here are the vaccines we have:
• Pfizer’s mRNA vaccine was the first approved in the U.S. Right now, the company is releasing 4.4 million doses per week.
• Moderna’s mRNA vaccine was second. Right now, Moderna is releasing 5.8 million doses per week.
And here are the vaccines that might be coming in the next few months.
• Johnson & Johnson’s viral vector one-dose vaccine finished its Phase 3 trial Jan. 29, showing the vaccine is 72% effective — not bad. Dr. Anthony Fauci said Johnson & Johnson would likely receive Food Drug Administration approval by “mid- to end February”.
• Oxford/AstraZeneca’s viral vector vaccine was approved in the United Kingdom way back in December and in the European Union this week, but the company doesn’t expect to get FDA approval until April at least. That’s because the company hasn’t finished its Phase 3 trial here, and America doesn’t totally trust the company’s international data due to dosing and transparency issues.
• Novavax’s recombinant protein vaccine just finished its Phase 3 trial in the U.K. and found that it was 90% effective. Like AstraZeneca’s vaccine, Novavax also has a Phase 3 trial ongoing here, but executives hope they can persuade the FDA to accept a mix of the U.K. results and early U.S. results to gain approval.
They have a shot, because their vaccine is using a more traditional technology, and because they’ve been more transparent throughout than AstraZeneca. That early approval could mean March, but if the FDA ignores the U.K. data, think Juneish.
There are other manufacturers that have passed Phase 3 testing in Russia and China, but the U.S. just isn’t going to use a Russian or Chinese vaccine. No other vaccines look close to launching in the next six months.
Contracts for millions of doses
“Andy, how much vaccine are those companies going to be able to deliver?” you ask. Of course, the various companies have different manufacturing capabilities, and estimating those is the hardest part of solving this problem.
To try to figure this out, I looked at reporting on the contracts the federal government has with vaccine makers and comments from Utah Gov. Spencer Cox, who announced vaccine targets in his Thursday news conference.
Cox said the numbers were from federal projections given to the states — Utah gets about 0.8% of the nation’s total doses. That also happens to be the approximate percentage of the number of American adults who live in Utah.
• Pfizer is releasing 4.4 million doses per week now, but company officials said they will release 100 million doses in all by the end of March and 200 million total doses by the end of May. To reach 100 million doses by end of March, Pfizer would need to ship an average of 8.4 million doses per week. To reach 200 million by end of May, it would need to release 9.9 million doses per week.
But there’s a weird quirk to the Pfizer numbers: the extra dose. Pfizer vials usually contain six usable doses rather than the five indicated on the label. Politico reported that the weekly dose totals reported so far do not include the extra dose, but Pfizer said that the extra dose would count toward its 100/200 million goals.
To use the extra dose, you have to get a high-quality syringe that doesn’t waste the vaccine. Those will now be shipped along with the vials.
• Moderna is currently releasing 5.8 million doses per week; the company has contracted to give 100 million doses to the federal government by the end of March, and 200 million doses in total by the end of June. That’d be an average of 7.8 million doses per week.
Cox turned heads when he said that Utah could receive 195,000 doses in total of the Pfizer and Moderna vaccines per week, beginning in March. That would represent a large increase in the combined manufacturing capability of the two companies: nationally, 24 million vaccines per week would need to be manufactured.
• Johnson & Johnson has had delays in its manufacturing process. A New York Times report said the company may only have 3 million to 4 million doses total ready by the end of February, rather than the 12 million originally envisioned. Last week, a company board member said officials felt “comfortable” with their contract to give the U.S. 100 million doses by the end of June.
Cox’s projections estimated 33,000 doses per week in Utah, beginning in the first half of March. That would mean 4 million doses manufactured weekly at the national level. That’s an impressively quick ramp-up, if it comes true.
• Oxford/AstraZeneca and the U.S. reached a deal way back in May 2020 for 300 million doses. No timeframe has been reported on that contract.
Here, again, Cox surprised some folks on Thursday. He said Utah believes it could receive 84,000 doses per week beginning in April. That would mean 10 million doses nationwide per week. There had been some thought that the European Union may get these vaccines first, given the lack of other vaccines there, but Cox’s comments indicate the U.S. still considers the Oxford/AstraZeneca vaccine as part of the American solution.
• Novavax’s contract with the U.S. government provides for 100 million doses, without a reported time frame for American delivery — but the Maryland-based company’s CEO says it hopes to be able to make 150 million doses per month globally by May or June. Cox didn’t mention Novavax.
How many of those doses are headed to Utah?
“Andy, that’s great. What I really want to know is: How many of doses of total vaccine are coming to Utah, and when?” Fair enough.
Here’s the truth: Some of those above commitments will be met, while others likely won’t be. Knowing that, we’ll want to create three scenarios: a pessimistic one, an average one, and an optimistic one.
• The pessimistic scenario represents no vaccine growth at all — we get only the same amount of Moderna and Pfizer vaccine that we received this week, over and over again.
• The average scenario represents Moderna and Pfizer meeting its commitments 100%, but somewhat below the rapid pace of Cox’s projections. It also adds Johnson & Johnson vaccine that assumes their manufacturing delays will linger a bit, delivering 50% of their original commitment through June.
• The optimistic scenario is essentially the one laid out by Cox in his weekly news conference: all of the commitments are met 100%, and manufacturers even accelerate manufacturing beyond those commitments to get more vaccine out sooner. This scenario also includes Cox’s projections for the Oxford/AstraZeneca vaccine, and a small but reasonable amount of the Novavax vaccine.
In creating these models, I did my best to account for real-world conditions. There’s been a predictable lag in the number of allocated doses actually being received by each state, so I account for that. That extra Pfizer dose in each vial? I account for that.
Once the state receives the vaccine, I’m modeling that it will take about a week to move it, use it, and record that it was used. Right now, the Centers for Disease Control and Prevention reports that Utah has injected 76% of the vaccine it has received, which ranks fifth in the nation.
Enough setup. Let’s get to the models!
You can see the differences: It takes until the middle of June for Utah to receive 2 million doses in the pessimistic model, but it happens by early May in the average model, and mid-April in the optimistic model.
But of course, we don’t really care about the total number of doses. We really care about the number of people vaccinated — and remember, Johnson & Johnson’s vaccine requires only one dose.
This model doesn’t take vaccine reluctance into account, instead assuming the conditions that will fit our world best for the next few months: that every vaccine dose available will be wanted.
As expected, here there are even bigger differences between the vaccination timelines. The optimistic model is so optimistic, in fact, that we have to cut off the number of vaccinated off early, because it starts to exceed Utah’s population. Still, it shows just how widely available the vaccine could be by May, if Cox’s targets are correct.
When do we hit herd immunity? Let’s say 75% is our benchmark. (Herd immunity isn’t this binary in real life — it really helps prevent spread if 50% of people are vaccinated! — but that’s a discussion for another day.) There are approximately 2.17 million adults in Utah, so 75% of them is 1.62 million.
Pessimistically, we wouldn’t reach that number until September. But under the middle scenario, we’d get there in early June, and the optimistic scenario sees us get there in early May. This analysis also doesn’t account for the large percentage of Utahns who have already been infected with COVID-19.
Under your models, when would I get vaccinated?
“Andy! Just tell me when I, a person waiting in the back of the line, can get vaccinated!” the Veruca Salt part of your brain screams.
So here’s the deal. Right now, Utah is vaccinating health care providers, long-term care facility staff and residents, first responders, teachers, and adults older than 70. The state estimates it will vaccinate roughly 412,000 Utahns in these groups, and set a goal to do so by the end of February. My models say it would take until about March 3, but, hey, that’s pretty close.
After that, the next prioritized group is eligible to begin being vaccinated on March 1. That group is those 65 or older, along with younger adults in high-risk situations: organ transplant recipients; certain cancers; people who are immunocompromised from blood, marrow or bone transplant, HIV or use of other immune weakening medicines; severe kidney disease and people on dialysis; people with uncontrolled diabetes, chronic liver disease, chronic heart disease, people with severe chronic respiratory diseases other than asthma; and those who have had a stroke or have dementia.
The state estimates that there are about 400,000 Utahns in these combined groups. In Cox’s optimistic scenario, the state will be able to immunize these Utahns in 3-4 weeks.
It’s not clear if there would be another prioritized group after that or if we’d move to the general public. The state could choose to prioritize the next age bracket down; if they chose 55+, that would be another 300,000. They’ve also stated a desire to vaccinate those in congregate settings, like prisoners and the homeless.
Some will choose not to be vaccinated, too — about 15% of Utahns over 55 said they probably or definitely weren’t going to get the vaccine in a January poll. Let’s assume it is the same percentage for the high-risk.
If all of those groups end up getting priority — and I hope they do — you get (really roughly) about a million Utahns who will be vaccinated early in total.
So now it’s time to get back to our vaccine distribution models! Under the pessimistic vaccine scenario, it takes until mid-June to see 1 million Utahns receive the first dose of the coronavirus vaccine. But under the average model, we’d get to 1 million by early May. In the optimistic model, we’d get there by early April.
As vaccine demand from those priority groups begins to subside, us general public folk could begin to schedule our first vaccination appointments. And under the optimistic scenario, the absolute biggest difference is that the general public is vaccinated more quickly — nearly at the million people per month level.
So instead of March to July, expect it to be more realistically early April to mid-June. Remember, that’s only for the first dose; it’ll still be a few more weeks until you get to immunity.
I understand that it still feels like a long wait. But ultimately, a tiered prioritization system is the right moral move, because it protects those who are most at risk from serious illness first. It would absolutely prevent death in our state.
Hopefully, this gives you a better understanding of what’s going on with our vaccination process. And through the power of research and modeling, we were able to close that vaccination window down quite a bit.
Andy Larsen is a data columnist. He is also one of The Salt Lake Tribune’s Utah Jazz beat writers. You can reach him at firstname.lastname@example.org.