Vaccine storage lawsuits could leave 3 billion people in the COVID-19 cold

GAMPELA, Burkina Faso: From factory to syringe, the world’s most promising coronavirus vaccine candidates need 24/7 sterile refrigeration to function.

But despite great strides in equipping developing countries to maintain the vaccine “cold chain”, nearly 3 billion of the world’s 7.8 billion people live in places with insufficient temperature storage. controlled for an immunization campaign to control COVID-19.

The result: the world’s poor are likely to be the last to emerge from the pandemic. The cold chain hurdle is just the latest disparity in the pandemic against the poor, who most often live and work in conditions that allow the virus to spread and whose health systems are not equipped for large-scale testing.

Maintaining the cold chain for coronavirus vaccines will not be easy in wealthier countries, especially when it comes to a handful of candidates who require ultra-cold temperatures of around minus 70 degrees Celsius.

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Logistics experts say that most of Africa and much of Southeast Asia, Central Asia and Latin America lack the infrastructure to preserve even more conventional vaccines.

A small medical clinic on the outskirts of Burkina Faso’s capital that went almost a year without a working refrigerator is a microcosm of how the cold chain can be broken.

The clinic in Gampela was unable to keep vaccinations in place after its refrigerator broke last fall, said nurse Julienne Zoungrana. Staff members use motorcycles to search for vials at a hospital in the capital, Ouagadougo, and must make a second trip to return unused doses.

When 24-year-old Adama Tapsoba needs to bring her baby for routine vaccinations, she walks four hours to get to the clinic and often waits hours for a doctor to arrive. The mother of two children believes it will be difficult for her family to get vaccinated against the coronavirus.

“People will have to wait in the hospital and they may leave without receiving it,” he said.

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To maintain the cold chain in developing countries, international organizations have overseen the installation of tens of thousands of solar-powered vaccine refrigerators.

Keeping temperature-sensitive vaccines safe from start to finish also requires reliable electricity, solid roads, and planning.

For poor countries like Burkina Faso, the best chance of receiving supplies of a coronavirus vaccine is through the COVAX initiative, led by the World Health Organization and the GAVI vaccine alliance. The goal of COVAX is to place orders from multiple promising candidates with the goal of distributing the successful ones equally.

The UN agency for children, UNICEF, began laying the groundwork for global distribution months ago in Copenhagen.

At the world’s largest humanitarian aid warehouse, logistics staff try to anticipate shortages in part by learning from the past, especially from the spring chaos surrounding masks and other protective gear that were confiscated from airport pallets or stolen. for trading on the black market.

Cracks in the cold chain begin once a vaccine leaves the factory. Cargo ships are too slow for vaccines with a limited shelf life. Getting vaccines by air in cold temperatures costs much more, and air cargo traffic is only now recovering from pandemic-related border closures.

The German logistics company DHL, which has expanded its cold storage capacity in response to the pandemic, estimated that 15,000 cargo flights would be needed to fully vaccinate the world against the coronavirus.

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For every gap in the cold chain, “we need to find a bridge,” said DHL commercial director Katja Busch.

Coronavirus vaccines will be one of the most sought after products in the world, so theft is also a danger.

“You can’t just leave them on a runway and fight over them because they would actually go bad and have no value, or worse, people would still be trying to distribute them,” said Glyn Hughes, global head of cargo for the International Air Transport Association. .

Johns Hopkins University researcher Tinglong Dai, who specializes in healthcare logistics, said creativity will be needed to keep the cold chain intact as coronavirus vaccines spread globally.

GAVI and UNICEF have experimented with delivering vaccines using drones. India’s largest food cold storage company is considering reserving space for vaccines.

“If people can figure out how to transport ice cream, they can transport vaccines,” Dai said.

Equivalent to bulk storage of vaccines, multidose vials reduce manufacturing and shipping costs. But if too few people show up in time for your jab, what’s left in the vials should be thrown away.

For now, UNICEF is betting on 20-dose vials and expects the amount wasted to stay below 15 percent for open ones, according to Michelle Siedel, one of the agency’s cold chain experts.

UNICEF also expects to have 520 million pre-placed syringes and maps of where refrigeration needs are greatest by the end of the year, “to ensure that these supplies reach countries when vaccines arrive,” said Executive Director Henrietta Fore.

If Burkina Faso received 1 million doses of a coronavirus vaccine today, the country would not be able to handle it, said Jean-Claude Mubalama, UNICEF’s chief of health and nutrition for the West African country.

“If we had to get vaccinated against the coronavirus now, at this time, it would be impossible,” he said.

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