The logistical conundrum of a Covid-19 vaccine

Coming up with a vaccine quickly is hard enough, but distributing one worldwide offers a host of other variables, and conflicting forces may work against the effort.
24 November 2020

The logistic conundrum of Covid-19 vaccine(Photo by Noel CELIS / AFP)

  • Vaccine supply chains are increasingly more complex than the PPE supply chain, and from the looks of it, the global supply chain is not ready.
  • There is also a limited number of airports around the world with carriers certified to handle pharmaceuticals.
  • Some governments may even just exert sovereignty over supply chains.

It has been a long and horrendous year solely because of the Covid-19 pandemic. The global economy and supply chain were unprepared. There were no contingency plans because what took place was unprecedented. The most crucial crisis faced at the very beginning of the pandemic was the PPE upheaval. It taught – the hard way – both governments and logistics providers as sourcing, pricing, and distribution caught everyone off guard. And now, if and when the vaccines arrive, governments will need to ensure adequate arrangements.

Undeniably, there has been fevered speculation about which Covid-19 vaccine will be successful and when will it hit the market. Only recently, when news on effective rates of certain vaccines making headlines, the focus was shifted towards a critical aspect of the equation: ensuring the right people get the right vaccine at the right time. To be frank, global logistics are already stretched thin by the pandemic, and freight companies are facing problems ranging from shrinking capacity on container ships and cargo aircraft to a lack of visibility when a vaccine arrives.

To put it simply, coming up with a vaccine quickly is hard enough but distributing one worldwide offers a host of other variables, and conflicting forces may work against the effort. As stated by Bloomberg, the infrastructure powering the global economy is scaling down for a protracted downturn just as pharmaceutical companies need to scale up for the biggest and most consequential product launch in modern history.

What does it take to transport vaccines?

Countries need to start preparing to distribute a vaccine to the right populations at an unprecedented pace. Under the WHO ACT-Accelerator framework, countries will initially receive doses for 3%, then 20% of the population, ultimately scaling up to full coverage.

Of course, no matter how brilliant the science, a vaccine is useless unless it can be administered while it is potent. The logistics of delivery are as critical as the pharmacology. As it is, there is a limited number of airports around the world with carriers certified to handle pharmaceuticals.

So far, three vaccines, Pfizer, Moderna, AstraZeneca have been announced with promising interim results, raising hopes in the US and abroad that the end of the pandemic may be in sight. Interim data suggests Oxford University’s AstraZeneca provides 70% protection, but the researchers say the figure may be as high as 90% by tweaking the dose, coming after Pfizer and Moderna vaccines that showed 95% protection.

AstraZeneca will have 200 million doses by the end of 2020, with 700 million doses ready globally by the end of the first quarter of 2021, operations executive Pam Cheng said. Meanwhile, Pfizer has said that it could have up to 50 million doses available by the end of the year, and up to 1.3 billion by the end of next year if the F.D.A. authorizes the two-dose vaccine.

An additional concern is that both vaccines must be stored and transported at low temperatures — minus 20 degrees celsius for Moderna, and minus 70 Celcius for Pfizer — which could complicate their distribution, particularly to low-income areas in hot climates. The AstraZeneca vaccine that showed a somewhat lower efficacy, is, however, less expensive and poses fewer issues involved in distribution and administration. It could produce up to 3 billion doses of the vaccine in 2021. 

Even if all three vaccines are ready and distributed in 2021, that won’t be enough to cover the global population of 7 billion people. This means that multiple companies working on multiple vaccines are vital to finally contain the pandemic. That brings us to our main concern, deploying a new vaccine to the world. It is a gigantic undertaking with challenges including sourcing the specialized glass that doses are stored in, making sufficient needles for injections, and ensuring vaccines are appropriately refrigerated throughout the supply chain.

The Pacific Economic Cooperation Council (PECC) emphasized the need for greater regional cooperation to identify chokepoints in the distribution of Covid-19 vaccines. Analysis in PECC’s latest State of the Region report has found that the distribution of the various vaccines once they are approved is going to require not only enormous transportation resources but vast policy coordination. 

For instance, many vaccines being trialed require different storage protocols, one of the most important being storage at temperatures ranging between minus 18°C to minus 80°C. Moving the “last mile” can be difficult, in places where infrastructure is lacking and it is the hardest to meet requirements for special equipment and training. By one estimate, airlifting vaccines to protect the world’s population would require about 8,000 cargo planes. Then, who gets the vaccine first will depend largely on deals that governments have made with drug companies. 

A collaboration called COVAX — led by the Oslo-based Coalition for Epidemic Preparedness Innovations, the World Health Organization and Gavi, a global non-profit group focused on vaccine delivery — aims to raise US$18 billion from high- and middle-income countries. Its goal is to ensure that all poor and contributing countries have access to a proven vaccine for those who are at the greatest risk, for example, health-care workers and the elderly. 

In short, there are many issues still to be resolved in what may shape up to be one of the biggest logistical challenges the world has ever seen. National allocation frameworks and distribution plans should be developed in a transparent manner. Given so much effort invested in developing a successful vaccine, we cannot afford to fail at the last mile.