The Centers for Disease Control and Prevention (CDC) in coordination with the U.S. Department of Health and Human Services (HHS) and Department of Defense (DoD) have released documents to health officials in all 50 states outlining the strategy for the distribution of a possible coronavirus vaccine. 

This strategy is a result of the efforts made by Operation Warp Speed. Operation Warp Speed is a partnership between the HHS and DoD, as well as other federal agencies and private firms that coordinate to help accelerate the development, manufacturing and distribution of COVID-19 vaccines, therapeutics and diagnostics.

The “COVID-19 Vaccination Program Interim Playbook for Jurisdiction Operations” outlines a three-phased approach to the vaccination process. The first phase is set to begin as soon as a coronavirus vaccine is approved by the U.S. Food and Drug Administration (FDA). The Trump administration announced that they are hoping for that approval to come as soon as early November. 

With the limited supply of doses expected to be available in the first few months, Phase one distribution concentrates on what they have deemed critical populations that include healthcare professionals, higher risk individuals and essential workers. 

Phase two will begin as soon as a large number of vaccine doses become available for the general public, which is estimated to not be until January 2021 at the earliest. 

The final phase will begin as the demand for coronavirus vaccinations begins to decrease, resulting in a shift to open access to the vaccination and routine doses. 

Some people have begun questioning how the vaccine will be distributed fairly within the general population while doses are still limited. The CDC has reassured the distribution process will be fair and equitable, including in their plan that minority populations known to be at greater risk will receive priority access to the vaccine.

The looming possibility for widespread distribution of a COVID-19 vaccine is going to be a complex effort that will need the urgent preparation and cooperation of all levels of government in order to be a success. The Trump administration has struggled with the logistical challenges of containing the spread of coronavirus, so this daunting task of proper vaccine handling and allocation spreads concerns of effectiveness. 

Some health experts worry that the Trump administration is compromising scientific integrity by seeking to rush vaccine approval and distribution so that it occurs before Election Day on Nov. 3. This casts doubts on the President’s intentions and the safety of the vaccine.

A poll released by NPR in August found that 60 percent of Americans say they will choose to be vaccinated if a COVID-19 vaccine is made available to them and 35 percent would decline.

The timeline on a possible coronavirus vaccine is unprecedented, taking less than a year to complete a process that usually takes several to yield reliable results. The leaders of Operation Warp Speed are trying to allay public concerns of the safety of the vaccine by publishing an outline of their progress and reiterating how any possible vaccine will be held to high scientific standards. The FDA is also stressing that if they make a decision for an emergency use authorization before testing has concluded, it will be based solely on data rather than politics. 

The coronavirus vaccine will be distributed to states in order based on proportional population. This means that Missouri would be the 18th state to receive the new vaccine. Missouri Department of Health and Senior Services Director, Dr. Randall Williams, assures that the department, in conjunction with the CDC, has begun actively planning for the complicated distribution methods needed to effectively provide vaccinations for people in all areas of the state.

In the Middle East and Africa, many infant girls and young woman experience a cultural ritual that goes by many names. Female genital cutting (FGC), female genital mutilation (FGM) and female circumcision are all terms used to describe the process of removing female’s external genitalia. While the proper terminology is debated, many African governments and Middle Eastern countries are trying to put an end to this cultural idea that genitalia removal is necessary, though they are facing the challenge of overcoming a ritual lineage that predates the common era.

The term “female circumcision” has been rejected by woman and children’s rights advocates due to its inaccurate correlation to male circumcision. These groups argue that this comparison is a mistaken depiction, because unlike male circumcision, FGC has no health benefits, impairs fertility, removes sexual pleasure and inflicts lifelong symptoms of pain and health risks.

FGC is the preferred classification over “female genital mutilation,” because of the insensitivity of labeling the women as “mutilated.” Since FGM is a cultural practice, the parents doing the cutting have the intentions of social acceptance, marital opportunities and spiritual cleanliness, not mutilation.

FGC originated in African tribes and spread to the Middle East. Indonesia, Malaysia and India have significant populations of the practice as well. Through migration, FGC has popped up across the globe in Australia, North America and Europe. It is commonly believe that FGC is correlated with one particular religion; however, the practice has been associated with Christians, Muslims and Jews.

Many people assume that FGC is an ancient practice similar to Chinese women footbinding. However, it is very much alive and is expanding to further countries and generations. In the first half of the 1900’s, some American and European surgeons practiced female circumcision. It was believed to be a cure for psychological disorders, marital problems and other radical medial theories.

Today there are 125 million women living with FGC, and every year an estimated 3 million more girls are at high risk of experiencing the procedure. There are 29 countries known for widely practicing FGC. In Somalia, 97.8 percent of the female population is living with FGC, and in Egypt 91.1 percent of women are experiencing the practice. For countries like Australia who have 100,000 immigrants that were born in countries of highly concentrated FGC practice, there is a high risk for the practice to continue. Advocacy against FGC has become important to many non-practicing countries to prevent the endorsement of this cultural practice.

FGC is classified as a human rights violation by many international organizations due to the non-consensual manner and life-threatening health implications. Typically, FGC is performed using unsanitary knives or razors within tribes and villages that do not have modern medical facilities. Anesthesia is not available in these rural communities, and the girls have to undergo the surgery without medication or numbing. Bleeding caused by the cutting is severe and can be fatal.

In extreme cases, the genitalia is stitched together after external removal, leaving a small opening for bodily fluids and intercourse. This causes lifelong pain for everything from urination to childbirth. FGC has a large impact on pregnancy. Approximately 25-30 percent of all victims are left infertile. If women are able to conceive, the surgery’s scars easily reopen during childbirth, making mothers and infants prone to infection.

Activists such as World Health Organization (WHO) are taking steps to end FGC. Many communities define FGC as empowerment, status and cleansing. Edcational programs and missionaries are making their way through these regions to help woman redefine empowerment and understand then damaging effects of FGC.

[Sources: www.orchidproject.org, www.fpv.org.au, www.womenshealth.gov]