The Pfizer / BioNTech vaccine hasjust approvedfor widespread use in the UK and the government has ordered 40 million doses – enough to vaccinate 20 million people. The first800,000 dosesare expected to be delivered in the UK in the coming days.
The Modern and Oxford / AstraZeneca vaccines also seem to be getting to the point of regulatory approval. The vaccines promise a return to normalcy for billions of people around the world if the pandemic ends.
After the great effort put into developing and testing these vaccines, we have another major task ahead of us: the logistics of vaccine distribution.
A supply chain like no other
This is the biggest challenge in the vaccine supply chain ever, but the challenges are not new. Ebola vaccine distribution was based on setting up ultra-cold chains in remote parts of the world. By pooling the knowledge and experience of the public and private sectors and humanitarian organizations, the vital supply chain for COVID vaccines can be successful.
Vaccine logistics need to consider a few key issues: international transportation requirements, storage needs, local distribution needs, and manufacturing sites. And these problems can vary from vaccine to vaccine.
The Moderna COVID vaccine must be shipped and stored at -20 ℃ and has a shelf life of six months. At its final destination, such as a clinic or pharmacy, it can be stored in a regular refrigerator, but must be used within 30 days. The Pfizer / BioNTech Vaccine should be kept at –70 ℃ and can be kept in a regular refrigerator for only five days.
If the right infrastructure is not in place, a lot of waste can be generated. According to the World Health Organization to 50% of the vaccines are wasted worldwide due to inadequate logistics infrastructure. When applied to COVID-19, this could translate into the loss of billions of vaccine doses – a costly mistake in logistics planning and execution.
Vaccine hesitation can also lead to waste. Many of the COVID vaccines being developed require two injections. If people who hesitate about the vaccine change their minds after the first injection and don’t return a second time, the vaccine will become ineffective – and many doses will be wasted.
The international transport capacity required to distribute a COVID vaccine is estimated to be between 8,000 (IATA) and 15,000 (DHL) flights. Details depend on the precise requirements for storage, packaging and transportation. For example, using dry ice to achieve consistent temperatures of -80 ° C limits the capacity on board an aircraft.
The decline in passenger flights as a result of the pandemic could also be a problem; most air cargo is carried in the cargo hold of passenger aircraft.
Frankfurt Airport in Germany, which fielded 120,000 tons of pharmaceutical products in 2019, significantly increased its capacity in 2020. The task force anticipates the increasing demand for temperature-controlled storage and handling.
Storage requirements are also likely to affect local distribution networks. Some countries are already setting up large vaccination centers to ensure that the necessary infrastructure is in place and that the vaccine will not spoil due to poor storage conditions at GP practices.
In the UK it has been suggested that a range of health professionals such as dentists and health scientists, will administer COVID vaccines, so local logistics and storage in many locations will need to be coordinated.
And worldwide central vaccination sites are not an option for much less densely populated areas, but also for mountainous regions or areas with many islands. There are also concerns that many would not be able to travel to get vaccinated – for example, the elderly or people in war-torn areas.
Learning from the automotive industry
Some vaccines, such as the mRNA vaccines that Pfizer and Moderna have developed, are known as ‘labile’. That is, they degrade every time they are moved and may eventually become inactive. One solution to this problem is to move production facilities closer to those to be immunized.
This has been done successfully by the automotive industry and many others who have moved their factories to countries with large consumer markets. Coupled with the risk of vaccines becoming ineffective due to a lack of proper temperature-controlled storage and logistics, this makes the distribution of some of these COVID vaccines a risky business.
Reaching the vulnerable
This pandemic is a global crisis and calls for global responses are strong. Indeed, several of the promising vaccines have been developed through international collaborations. Much cooperation will be needed to ensure that the most vulnerable are vaccinated – and not just in rich countries. But in addition to all the inspiring stories about collaboration, it’s important to remember that national and commercial interests are great and will continue to determine the international response, especially in logistics.
These are not entirely unprecedented times. While the size of the vaccine supply chain required is enormous, the challenges are not new. By leveraging expertise from a variety of industries and working together globally, COVID-19 vaccines can reach everyone who needs them.
Liz Breen, Director of the Digital Health Enterprise Zone (DHEZ), University of Bradford, Reader in Health Service Operations, University of Bradford and Sarah Schiffling, Associate Professor of Supply Chain Management, Liverpool John Moores University