Obstacles in Covid-19 Vaccines’ Logistic Distribution
The long-awaited COVID-19 vaccine has been developed. Vaccination programs are now ongoing in different parts of the globe. However, some countries have yet to receive vaccines. The global population needs to be vaccinated against COVID-19 to achieve herd immunity. Failure to do so will allow COVID-19 to spread. The scale of global vaccination required to reach the desired immunity is enormous. In India, around 900 million people need to be vaccinated to achieve mass immunity.
The development of vaccines is hard, but designing a cold chain system for global distribution might be harder. It needs to undergo a complicated web of shipping, storage, freezing, communication, and healthcare. Given the volume, the urgent need for covid-19 vaccines’ logistic distribution, and specific temperature requirements, its delivery might be a big logistical challenge.
COVID-19 vaccines lose their effectiveness at temperatures above 10°C. This is because antigen rapidly disintegrates if it is not kept frozen. The antigen is the primary component that allows immunization. All COVID-19 vaccines need to be kept cool at a temperature between 2°C and 8°C. Meanwhile, some will need to be frozen at up to -80°C throughout transportation.
Effective cold chain management is integral in ensuring vaccine safety and effectiveness. To accommodate the temperature-sensitive COVID-19 vaccines, necessary refrigeration levels need to be maintained. It will require the coordination of Pharmaceutical manufacturers, laboratory equipment manufacturers, logistics providers, and health care providers.
Cold chain management also needs to ensure that the proper technologies are in place. They should be installed throughout vaccine storage, transport, and distribution. This will ensure that the vaccines are adequately monitored. It will also aid in verifying whether temperatures remain stable throughout the process. Proper monitoring will prevent accidental delivery of degraded vaccines.
In developing countries, cold chain technology is continuously innovating. Fridges and freezers are becoming more compact and more efficient. They can also be powered with batteries or solar panels to avoid power outages. The weight of these fridges continues to decrease. Some weigh just five or ten kilograms. This means they are easier to carry and transport into hard-to-reach locations. Data connectivity can be used to monitor the vaccines inside remotely.
The storage requirements of the COVID-19 vaccines are not too demanding. Standard vaccine distribution channels can be used for their delivery. New infrastructure is not necessarily required if there is existing equipment already.
However, addressing cold chain last-mile challenges would not simply suffice in ensuring that the vaccines are swiftly delivered. A ‘vaccine nationalism’ situation can occur in countries. This refers to the countries that have the capability to distribute the vaccines globally but will prioritize their own markets first. This may occur especially for the COVID-19 vaccine due to its demand and urgent need. Vaccine-producing countries will now face the challenge of meeting their national vaccine demand while ensuring sufficient supply to other countries. However, price and demand risks might leave the poorer locations without access.
There are a lot of infrastructures involved in the vaccine cold chain. It is important that each is maintained properly. It is also essential to ensure that it will generate the least environmental impact possible.
In order to successfully implement COVID-19 immunization programs, proper vaccine storage, handling, and temperature regulation need to be executed. The COVID-19 vaccine is in high demand among all populations. It also has limited initial supplies. Therefore, these vaccines are a high-value target for theft and diversion. During transportation, vaccines may be stolen from the cold chain and transferred to the black market. Many countries lack well-functioning and integrated medicines regulatory systems as classified by WHO. Countries must have proper regulatory supervision, emergency prequalification, strong authentication measures, and quality procurement policies. Informal market and illegal online websites should be flagged as well. These measures will reduce falsified medical products.
The vaccines are temperature-sensitive. Therefore, it is important that temperature-controlled facilities or warehouses are readily available or rapidly developed for its storage. The guidelines of airplane manufacturers need to be updated in lieu of COVID-19. RFID or GPS data loggers integrated within storage boxes need to be approved in advance with their supply chain partners. Government guidelines need to be published as well to help compliance of vaccine shipment staff. This will avoid rejected shipments.
There should be less stringent border restrictions for COVID-19 vaccines, especially when declared as urgent shipments. Given the temperature-sensitive nature of vaccines, physical examinations of shipments should be limited. It should only be performed if there is a high risk involved in the shipment and only at the official storage facilities. Since vaccine transport needs special equipment, it is important that these are cleared inbound and outbound based on the transport guidelines.
Well-coordinated global production, distribution, and postmarket surveillance are essential. This will prevent cold chain failures, lacking manufacturing protocols, and the distribution of fake products. The failure of the COVID-19 cold chain will cause a massive distrust among the population. This will, in effect, worsen the pandemic and cost lives in the process. Vaccines might also be weaponized by powerful states to further their geopolitical influence. If there are no stable oversight measures in place, vaccine supplies may also be put at risk in hospitals and health facilities. Health care staff may also try to steal the vaccines for reselling. Well-off citizens may attempt to bribe healthcare staff to secure a vaccine. Since the supplies are limited, and demand is high, the risk is more evident and pronounced.
The procurement modality in which the vaccines will be acquired also subjects the vaccine cold chain to corruption risks. This is amplified by the urgency of needs, needed flexibility, and required speed.
There are also track-and-trace technologies embedded within the COVID-19 vaccine cold chain. This means that there is a need for more robust cybersecurity measures. Cold chain processes may become hacking targets by malicious infiltrators. Hackers have already started targeting the vaccines’ cold chain. The GPS trackers installed in the transport vaccines could be vulnerable. Previously, UCSF encountered a ransomware attack. Hackers launched a malware program that encrypted some servers. This prevented UCSF from unlocking important data crucial to their public health studies. They made the decision to pay the hackers $1.14 million. Cyberattacks have been increasing with the onset of the COVID-19 pandemic, with malicious actors targeting hospitals, research organizations, and health agencies.
Since the COVID-19 vaccines’ logistic distribution is not an ordinary operation, issues should be urgently addressed. Proper cooperation between the regulators and the private sectors is needed, specifically in pharma and logistics. Processes to control supply and mitigate distribution risks should be established by manufacturers. In order to control supply risks, the development of a reliable manufacturer and supplier network is needed, composed of strong internal manufacturing capabilities and contract manufacturing organizations. This will avoid disruptions in the processes. Manufacturers should also invest in equipment intended for preventive measures. Some examples are infrastructure, updated technology, business continuity plans, inventory management, and diversification. There needs to be an agile warehouse as well that allows a direct-to-patient cold chains strategy. This can be made possible through multiple distribution sites and warehouses.
Strategic Covid-19 Vaccines’ Logistic Distribution Plan
Prior to distribution, preemptively addressing manufacturing, business, economic, and security issues will help mitigate potential risks from arising. Preemptive planning helps optimize covid-19 vaccines’ logistic distribution. It is important to ensure that air cargo operators are authorized to fly additional flights for vaccine transport. Landing, overflight, and airport slot permits need to be secured for cargo flights. Airports should be prepared to accommodate stringent operations. The crew should be fit to travel as well.
Governments need to arrange cross-border road haulage. They also need to open dedicated lanes for COVID-19 cold chain transport at land crossings. Meeting border requirements is essential to prevent interruptions in vaccine transport. The government may require licenses or approvals before the vaccines are released for distribution, storage, or other logistical concerns. This is why a coordinated review effort should be made. It will help establish whether the current practices are applicable in the present situation that we are in.
Centralized And Decentralized Options
Single-use and continuous manufacturing technologies now have the ability to support more agile manufacturing scale-up, sterility, and possibly a decentralized manufacturing approach. Many companies have been starting to adopt this approach with experienced suppliers.
A centralized manufacturing approach in collaboration with experts in distribution and the proper regulatory authorities is needed. This can help effectively deliver vaccines across the globe despite challenging cold chain requirements.
Manufacturers utilize single-use or continuous technologies in order to keep up with the urgent demand. The use of single-use technology also reduces the risk of bacterial contamination since they do not need to be re-sterilized. There are extremely short timelines expected for the production of COVID-19 vaccines. Despite this, its safe distribution must not be compromised. It is vital to mitigate COVID-19 vaccine delivery and administration risks to stop the pandemic from ensuing further. This can be done by using the necessary equipment, instituting proper monitoring systems, and providing adequate training to the cold chain staff. The effectiveness of the COVID-19 immunization programs will heavily rely on the successful implementation of the vaccine cold chain.