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The COVID-19 vaccine developed by BioNTech of Germany (with the help of the American company Pfizer) may well herald the beginning of the end of the pandemic.
The race to develop a vaccine has required an unprecedented global mobilization of scientific knowledge and pharmaceutical resources. But that was only the first part of the battle. Bringing the vaccine to the world will require a massive lockdown of transportation and logistics resources.
Get approval, increase production
Regulators have not yet approved the vaccine. However, given the extremely promising results of the trial, it is not expected to take much longer.
Many analysts believe the United States will approve it urgently by the end of the year. The European Medicines Agency will likely follow a similar time frame.
BioNTech has contributed vaccine technology, but requires Pfizer’s vast resources to scale manufacturing. By October, Pfizer had already manufactured several hundred thousand doses at a manufacturing plant in Puurs, Belgium.
Several countries have already made large distribution agreements. This week, the EU closed a deal to buy around 300 million doses of the two-dose vaccine, enough for around 150 million people.
Pending approval, Pfizer says it expects to begin deliveries before the end of 2020. It expects to have around 100 million doses available by the end of the year, with more than 1 billion doses in 2021.
Waiting in very very cold storage
The vaccine must be stored at temperatures of minus 70 degrees Celsius and, once thawed, it can only survive for about five days at temperatures of 2 to 8 degrees Celsius. No other existing vaccine requires this type of deep-frozen storage, as this vaccine has a novel scientific basis.
Consider the complexity of not only transporting billions of doses of the vaccine around the world, but of doing so with such extreme storage requirements.
Existing “cold chains” – supply chains that specialize in low temperatures from production to consumption – are not capable of sustaining such extreme temperatures.
As a result, Pfizer has come up with its own short-term solution. It has developed its own “thermal chargers”, each the size of a suitcase and capable of storing up to 5,000 doses of the vaccine. Packed with dry ice, they will be able to keep the vaccines at the proper temperature for about 10 days, if they are not opened. The boxes themselves can be stored at temperatures of 15-25 degrees Celsius.
The vaccine cold chain hurdle is just the latest pandemic disparity weighted against the poor
Even with thermal transporters, the vaccine will take only 10 days to reach a vaccination center, such as a hospital or doctor’s office, and then it must be used within five days unless its final location is capable of storing it at minus 70 degrees . In that case, it could last for an additional six months before being thawed and used in a few days.
Give me your tired, rich and crowded masses
Ultra-low freezing technology is not common in hospitals and surgeries, and not at all in low-income countries.
“Nowhere on the planet is there the logistical capacity to deliver vaccines at this temperature and volume without massive investment,” Toby Peters, Professor of Cold Economics at the University of Birmingham, said in a statement.
“The problem is particularly acute in the Global South, where many rural villages don’t even have a working vaccine refrigerator.”
In the case of richer countries, it seems that the problem can be overcome, even if it is a logistical challenge. Puurs and another Pfizer facility in Kalamazoo, Michigan, have massive freezer storage capacity, which will be complemented by the use of so-called freezer farms, such as one in Karlsruhe, Germany.
Pfizer’s specialty boxes are equipped with GPS and the company expects to be able to move about 7.5 million daily doses from its centers in Puurs and Kalamazoo to airports.
The UPS freezer farm in the Netherlands is being built on the company’s health care campus in Venlo and Roermond
Various logistics and delivery companies have also been preparing. UPS has built two freezer farms in the Netherlands and the US, while DHL has opened a new cold storage facility in Indianapolis.
Ultra-low temperature freezers are commercially available, although expensive, costing between € 10,000 ($ 11,800) and € 20,000. Germany plans to equip some 60 vaccination centers with these freezers.
Aviation companies have also been preparing. Joachim von Winning, chief executive of Air Cargo Community, told Reuters this week that his industry has been preparing to deliver vaccines by plane since March.
The poorest countries await other vaccines
However, as feared at the beginning of the vaccination race, such capabilities are beyond all but the wealthiest countries.
“Most of these vaccines need minus 70 degrees, which we just can’t do in India, just forget about it,” T. Sundararaman, coordinator of the People’s Health Movement in New Delhi, told Bloomberg.
When the third quarter results were released, BioNTech said it was working on developing a more stable version of its vaccine that could survive in a conventional refrigerator for longer. However, even such an outcome would not drastically change the existing logistics requirements.
A possibly more realistic hope for low-income countries lies in the many other vaccines that have shown promising results in the later stages of trials. Many of them will not require the same deep freeze storage technology and some may not need to be frozen.
However, for this first vaccine, the logistical requirements of getting it from production to the patient’s arm are exceptionally demanding. And even with the huge investment required to equip logistics networks with the necessary technology, there will still be unavoidable and uncontrollable setbacks: power outages, truck breakdowns, melting ice.
However, just as the virus spread around the world much faster than many expected, a vaccine or vaccines may end up doing the same.
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