Planes, dry ice, pharmacies: the vaccine challenges



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The United States could be the first country to launch one of the most ambitious vaccine operations in history – distributing and administering up to 600 million doses of the Pfizer and BioNTech Covid-19 vaccine in just a few months.

Mass vaccination campaigns are nothing new: they have been carried out for decades in the fight against measles and flu, for example.

But eradicating the coronavirus is a clearly new challenge due to three factors: the short term to inoculate a large number of people; the fact that most vaccines will require two doses; and the very low temperature at which some of the vaccines must be stored.

The vaccine developed by the American pharmaceutical giant Pfizer and the German BioNTech, on the way to being the first authorized for use, should be stored at -70 ° C, while the flu vaccine can be stored in a normal refrigerator.

Pfizer vaccines distributed in the United States will come from its largest manufacturing facility located in Kalamazoo, Michigan. Your shipment will include a precise, clock-like dance of containers, trucks, and planes.

The thermal transport containers will each be filled with dry ice and 975 vials of the vaccine, each containing five doses, for a total of 4,875 doses.

Every day, six trucks will take the doses to airlines such as FedEx, UPS or DHL, which will deliver them across the United States in a day or two and around the world in three, Pfizer said.

Plane

The company expects an average of 20 cargo flights a day around the world.

FedEx had to obtain special permission from civil aviation authorities to transport so much dry ice that it could pose a danger to the crew if it accidentally undergoes “sublimation” and goes from a solid to a gas, the company said.

Once the boxes have reached their final destination, they can only be briefly opened twice a day.

“Running a large mass vaccination clinic is fine,” said Julie Swann, a pandemic response expert at North Carolina State University.

But the vaccine would not be suitable for distribution in doctors’ offices or pharmacies, which are too small, he warned.

At least at first, people will have to go to hospitals or maybe even large distribution centers set up in parking lots much like Covid’s testing sites, he said.

The vaccines can stay in their boxes for two weeks, which means that hospitals won’t need a special freezer.

“We are not recommending at this time that hospitals or clinics buy ultra-cold equipment,” said Janell Routh of the Centers for Disease Control and Prevention.

American biotech giant Moderna is also making a vaccine, which can be stored at normal freezer temperatures.

The US government is organizing a free distribution of this vaccine to US states and territories, with each jurisdiction deciding how to distribute the doses to hospitals, pharmacies, doctors or even universities and companies will distribute the doses , in a decentralized system much like what was used for the H1N1 flu pandemic in 2009.

“The federal government does not intend, with very, very few exceptions, to touch a single dose of vaccine before it enters the arm of the Americans,” said Paul Mango, an official with Operation Warp Speed, during a briefing.

The goal is to provide vaccines to the most vulnerable populations by the end of December, to healthcare workers by the end of January, and to all Americans by early April.

Pfizer expects to produce 50 million doses this year and 1.3 billion in 2021. The United States has already ordered 100 million in total, including 20-30 million for delivery before the end of December. The European Union will order 300 million, Japan 120 million, Great Britain 30 million and Canada 20 million.

Moderna, AstraZeneca, Johnson & Johnson, Sanofi and others hope that their own vaccines will also prove safe and effective, and their global implementation will follow suit.

Carrier DHL estimates that 15 million cooling boxes would need to be delivered over the next two years, with approximately 15,000 flights worldwide.

Poorer countries that lack storage capacity for large quantities of vaccines that need super cold storage have little hope of benefiting from the first few doses, said Prashant Yadav, an expert on global health supply chains at the Center for Global Development. .

Ultra-cold freezers that can reach temperatures of -80 ° C cost five times more than standard freezers and are only made to order, he said.



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