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The first Europeans are expected to be able to get a COVID-19 vaccine by the end of the year after several pharmaceutical companies announced successful trials.
But with a vaccine seemingly found in record time, the focus is now on the challenge of distributing it to the world’s population of 7.5 billion.
We spoke with two experts to learn about the main obstacles that health authorities must overcome in order for the vaccine to reach all corners of the world.
Manufacturing capacity
All three candidate vaccines require two injections, although AstraZeneca / Oxford University has been shown to be most effective when the first short dose is half a dose.
AstraZeneca has announced plans to produce 3 billion doses over the next year, while BioNTech / Pfizer plans to manufacture 1.3 billion.
These goals “appear to be feasible,” said Dr Zoltan Kis, from the department of chemical engineering at Imperial College London. “However, the global demand by assuming 2 doses per person is far from being satisfied by the end of 2021.”
Phanish Puranam, professor of strategy at INSEAD business school, told Euronews that “it could take up to 2.5 years to manufacture the more than 10 billion doses needed for global coverage.”
Storage temperature
“Routine vaccines are stored and distributed between 2 ° C and 8 ° C. There is enough infrastructure for cold storage and distribution in that temperature range in high-income countries, and thanks to the efforts of GAVI (the Vaccine Alliance), the Gates Foundation and UNICEF, enough capacity has also been built in Africa, South Asia and other less developed regions of the world to store and distribute vaccines between 2 and 8 ° C, “said Puranam.
The problem is that of the three candidate vaccines so far, only one is in that temperature range: AstraZeneca’s.
The Pfizer / BioNTech and Moderna vaccines have cooling requirements of -70 ° C and -20 ° C respectively.
“Pfizer-BioNTech vaccines require an ultra-cold chain [infrastructure] it doesn’t even exist in the EU and the US, with the exception of some academic medical centers and some specialized distribution centers, “he added.
Pfizer has developed a special freezer box that can keep the vaccine safely for up to 10 days, but still, its distribution to “low and middle income countries or rural areas of other countries is a challenge due to the lack of of suitable freezing temperatures. ” “Dr. Kis said.
As for the Moderna vaccine, according to Puranam, although it “holds between 2 and 8 ° C for a few weeks”, the manufacturing capacity “is not that much”.
“So their supplies would not be available outside the United States, Canada, the EU,” he added.
Overall, Dr. Kis concluded, “Europe and North America are considered to have the greatest capacity to distribute and store vaccines at low temperatures, such as -70 ° C, relative to their population.”
“On the other hand, sub-Saharan Africa is considered to be in the worst position when it comes to the distribution of vaccines at low and ultra-low temperatures,” while “the other continents are somewhere in between,” he added.
Urban vs rural
Due to cooling requirements that will also affect transportation, access to the vaccine in rural and remote areas will be more difficult than in large cities.
In addition, the Pfizer vaccine package is in 1,000-dose containers, according to Puranam.
“Some rural clinics do not have the capacity to absorb as many doses in a short time span of 2 to 3 days. In rural areas there is a lack of staff who can act as vaccine administrators.
“Vaccine administration also requires PPE [personal protective equipment] for the personnel who will administer the vaccine and the supply chain to deliver PPE to rural areas is a challenge ”, he also pointed out.
‘Highly challenging’ immunization campaigns
“Administering vaccines to patients is another very challenging process,” said Dr. Kis.
This is due to the time it takes to immunize people, including a 10-15 minute recovery period after the vaccine is given, and to record each procedure correctly.
The requirement for social distancing and the “limited number of doctors / vaccinators available per capita”, which is even lower in low- and middle-income countries, compound the problem.
“In addition, the administration of the vaccine requires the greatest amount of human involvement, so additional challenges / problems may occur at this stage, especially considering that two doses of vaccines should be administered per person, usually with an interval of 3 to 4 weeks, “he added.
