The “cold chain” is just one challenge in distributing the vaccine worldwide.
There are many more: priorities to keep track of populations and databases, to keep track of who has been vaccinated, where and when. Additionally, different vaccines may have more or less efficacy with different population groups; And governments will need a PR campaign to explain whether it is safe to vaccinate people.
But the logistics of transporting and storing the vaccines – delivering them from the factory door to the patient’s hand – are serious. And while most vaccines are likely to require two doses, the entire chain needs to be repeated weekly.
The Pfizer-Bioentech vaccine needs to be kept at about -70 સે C (-94 ફેર F) when transported. It is 50 લ્સ C cooler than any other vaccine currently in use.
Moderna says its vaccine can usually be kept in a freezer available in pharmacies and in the refrigerator for 30 days. But Pfizer is likely to have lower doses of the Moderna vaccine than is available next year.
Both vaccines have been shown to be about 95% effective in Phase 3 trials, but the results have not yet been reviewed by regulators.
On Wednesday, the CEO of Bioentech, a German biotech company partnering with Pfizer, acknowledged the issue of temperature control.
“We are working on a formulation that will allow the vaccine to be sent even at room temperature,” Ugur Sahin told CNN. “We believe that in the second half of 2021 we will bring a formulation that is comparable to any other type of vaccine.”
But in the meantime, the U.S. Health and Human Services Secretary Alex Azar believes Moder’s candidate is “more flexible” for settings like the local pharmacist. Pfizer, he said Monday, said “the larger the institutional vaccination, the whole hospital setting, the more appropriate it is to say multiple nursing homes at once.”
Pfizer plans to build the ship up to 1.3 billion doses next year, which will require a lot of dry ice (carbon dioxide in solid form– degrees Celsius), and a lot of isothermic BX. The boxes will hold 975 vials (4,875 doses) and can be refilled with dry ice for up to 15 days of storage.
Pfizer is testing supply chains in four US states. Its CEO, Albert Borla, said Wednesday that he has “zero concern” about the needs of the cold chain.
But carrying such a vaccine can pose major challenges. “Rural and urban areas are not ready to administer the vaccine today in any country in the world,” Dr. Jarbas Barbosa, assistant director of the Pan American Health Organization, told CNN.
“So, who in the world is ready? No one.”
One issue is the availability of dry ice.
Sam Rushing, president of Florida-based Advanced Cryogenics, told CNN that U.S. There is already a regional shortage.
U.S. officials are confident that enough dry ice will be found. Paul Lust Strosky, director of supply, production and distribution of Operation Operation Warm Speed, told CNN last week that courier UPSA “promised to re-hip dry ice across the United States on demand.”
But rushing warns that dry ice is not very user-friendly and can be dangerous if stored improperly, especially in confined spaces. The Federal Aviation Administration classifies it as hazardous cargo.
Peter Gerber, CEO of Lufthansa Cargo, told CNN that the need for dry ice “clearly reduces transport capacity because you can’t load so much vaccine if you have to load more ice. And of course the procedures need to be very special.” That’s always cool. “
U.S. Courier D.H.L. According to the specifications of each vaccine corresponds to the distribution plan. Global Forwarding U.S. for the Company. “The use of dry ice on aircraft is prohibited – usually 500-1,000 kg, depending on a number of factors,” says David Goldberg, CEO of NA.
Once they arrive, Pfizer vials can be stored between 2 and 8 ડિગ્રી C for up to five days before spoiling. Pfizer says it has developed an “in-time system” that will deliver frozen vials directly to the vaccination site. “It will also monitor the temperature of each box sent.
Julie Swan, a supply chain specialist at North Carolina State University, says the largest hospital systems, which often have ultra-cool freezers, could play a role as a distribution hub. But all U.S. In the states it is not; Hawaii said last week that none of its hospitals had such freezers.
Breaking shipments of static vaccines for rural areas or small groups of needy workers – that would be another headache, Swan said.
When vaccines need to be used in a few days, providers will need to make sure they are ready. “You just can’t wait to see who shows up,” Swann told CNN. “And we don’t have good data yet to determine where the priority population is and who it is.”
Prashant Yadav, a supply chain expert and senior fellow at the Center for Global Development, said, “It is a question of how soon we can start thinking about multiple packaging formats.”
U.S. Beyond
If vaccinating millions of people in an era is a challenge, it is a big problem for poor countries.
Transport links in the developing world are slower and medical facilities less equipped. Yadav says CO2 production is rare, and the costs and risks of transporting large amounts of dry ice are also a barrier, Yadav says.
David Gitlin, CEO of refrigeration experts Carrier, told CNN last week: “When you look at places like Africa and India, they don’t have cold chain infrastructure. The United States spends 300 times more per capita on cold chains.”
Peru is one of the many countries that has ordered the Pfizer vaccine. In the capital, Lima, where large-scale rapid administration can be effective, it should be effective, said Drs. Says the German Malaga. But while Lima has ultra0 ultra-cold freezers “there is nothing for 20 million and another 20 million Peruvians, including the rainforest.”
“In the rest of the country we can use vaccines like the Chinese [CoronaVac] “https://edition.cnn.com/2020/11/11/health/brazil-vaccine-sinovac-trials-covid-intl/index.html which requires 2 to 8 degrees which is more managed,” Malaga said. Said.
“It’s about cost effectiveness, not just about the vaccine but the whole process of vaccination,” Yadav said. But if Pfizer’s candidate proves to be the most effective, the demand for ultra-cold freezers will be huge.
Barbosa says the Pan American Health Organization is urging member states not to spend large sums to develop a vaccine but to join a multilateral facility called Kovacs – the clearing house needed to buy a vaccine run by the World Health Organization.
Beyond the cold chain, there is another rational barrier.
A huge airlift will be needed to get the vaccine where they need to go. Europe and the U.S. Pfizer, which has a production line in, says it expects an average of 20 daily cargo flights worldwide.
DHL expects to deliver 15 million cooling boxes on 15 million flights over the next two years. David Golberg told CNN that the company has established a high-quality cold-chain network and is adding flights between China, Europe and the US.
Many countries can call existing programs as models. Peru’s national vaccination program reaches about 75% of its population, Malaga said.
According to Gagandeep Kang of the Wellcome Trust Research Laboratory at Christian Medical College, Vellore, India’s polio vaccination program is ubiquitous, covering more than 90% of children so far this year.
“For polio programs, we have used boats and mule and adventure health workers,” Kang said. But such programs are designed for less than a tenth of the population, and the Covid-19 vaccine will need to focus on different groups, he said.
India will “need a series of waves addressed to each different group as soon as the vaccine becomes available,” he told CNN.
“We need to look at the performance characteristics of other vaccines and their delivery requirements before making a decision on what to keep,” said Kangana, who is also a member of the World Health Organization’s Global Advisory Committee on Vaccine Safety. .
In such a dynamic situation, keeping records becomes complicated. D Imp. Anna Blake, who is working on a vaccine developed by Imperial College London, said the U.S. There is no central infrastructure to monitor whether and when to meet, which he describes as a “really complex issue.”
Yadav says that even when the vaccine reaches its destination, some relief will be needed so that people can get their second dose at another place if they want. And it demands reliable databases.
Barbosa said that beyond the supply chain, governments must have “good communication to dispel public suspicions and conspiracy theories about vaccines.”
Blake agrees. “The process [of vaccine development] It’s been so fast that people aren’t surprised that they read about safety and possible side effects because they’re skeptical. “Blackney is part of an international effort launched by re-discovery scientists to reassure people through social media about the safety and effectiveness of COVD-19 vaccine.
Getting enough dry ice is one of the challenges in order to vaccinate the world against Covid-19.
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