Challenges in Delivering Covid Vaccines for Mass Distribution
There is a complexity in distributing vaccines to places where there is a serious need for vaccination. Most vaccines are susceptible to heat exposure. That is why distribution storage that maintains necessary conditions is needed to protect quality and potency. This requires advanced and specialized cold chain equipment.
According to Hilde Stevens, a senior researcher at the Institute for Interdisciplinary Innovation in Healthcare, this risk is particularly high for the COVID-19 vaccine, which demands a global and immediate linkage to affected areas to conduct inoculations.
Challenges in Delivering Covid Vaccines were posed even before the distribution started.
The vaccine-producing countries will face the dilemma to meet national vaccine demand and ensure export to other countries. The question of price and demand risks leaving the poorest regions without access.Hilde Stevens
The COVID-19 pandemic has killed approximately 2.33 million people and pummeled the global economy. There is an urgency to distribute billions of vaccine doses to people in every corner of the world, especially the high-risk zones and remote areas. Finding suitable cold storage for vaccines during the journey and on arrival in such regions is a complex task.
There is a limited supply of vaccines to meet the growing demand in the markets where the vaccine is first introduced. A growing number of countries express frustration due to inadequate supply.
Packaging and Strict Storage Requirements.
Challenges in Delivering COVID-19 Vaccines is significant. All vaccine candidates under preliminary investigation lose their potency at temperatures above ten degrees Celsius, as the antigen — a substance that causes the immune system to produce antibodies against the virus — deteriorates. In the case of the Pfizer and Moderna vaccines based on mRNA technology, ultra cold temperature as low as -80°C are required. Several different protein antigens are currently put under observation and trials around the world, and even the most resilient ones need strict cooling.
This means that all current potential vaccine candidates for the disease will need cooling between two and 8° C, while some need freezing at up to -80° C throughout the transportation and distribution. Cold chain infrastructure exists in most developing countries but is insufficient in the last mile. For instance, the Pfizer vaccine which is made of genetic materials (mRNA) degrades once thawed. This became the stumbling block for existing vaccines particularly in rural areas and poverty-stricken countries where resources are tight.
Safety and Managing Programs.
Significant challenges in delivering COVID-19 vaccines arise because a large number of patients do not get the second vaccination. There is a problem in managing vaccinated individuals who may still be transmitting the virus, though some of these may have been individuals who only received one dose vs. two doses of vaccine. Results are vague and draw concerns about the vaccines’ safety and efficacy that lose consumer’s confidence to get vaccinated.
Problems with Technology and Cold Chain Capacity
According to Kostadin Fikiin, a professor of refrigeration technology at the Technical University of Sofia in Bulgaria, around 40% of existing vaccines are unusable in poor countries.
But, countries with strong food storage cold chains could adapt this to distribute vaccines, Fikiin says. He points to India as an example, which has the world’s fastest-growing cold chain progress in technology.
“The cold chain capacity depends on a country’s digitalization level and communication technologies, for example for tracking and tracing,” Fikiin tells SciDev.Net. “Many of these technologies are affordable enough and workable for the developing world, especially given the global coverage of satellite navigation systems.”
Is there a Light at the End of the Tunnel?
Cold chain technology is adapting to developing country settings. Fridges and freezers are becoming smaller and more efficient, and some can operate with batteries or solar panels to protect them from power outages. Some of these fridges now weigh five or ten kilograms, meaning responsible people can carry them on foot into hard-to-reach regions. They also have data connectivity to enable the remote monitoring of the vaccines inside. It sounds assuring to have advanced assets in rolling out vaccines.
But some specialists drop a warning note, saying that fixing the complicated last-mile problem alone will not be enough to ensure the distribution of vaccines everywhere in a fast and smooth manner. Earlier this year Richard Hatchett, chief executive at the Coalition for Epidemic Preparedness Innovations, warned of ‘vaccine nationalism’, a situation that occurs when governments sign agreements with pharmaceutical manufacturers to supply their populations with vaccines before making them available for other countries.
One of the problems is the supply chain. Producing a vaccine is easy when researched, but getting it to people requires a complex network of transporting, storage, freezing, communication, and healthcare that will be difficult to deliver globally — especially on the last mile of the journey.
The deployment of COVID-19 vaccines will surely be one of the challenges due to the high global demand, but also involving the complexities of transportation and storage; testing the sturdiness of Global supply chains to the nth degree.
“It’s the biggest logistical challenge the world has ever seen,” says Toby Peters, professor of cold chain economy at the University of Birmingham. “You’ve got a volume of vaccines that have never been tackled before, the speed requirements and the problem of outreach.”
“No one’s ever done this before. It’s not about trying to vaccinate all the children, all the pregnant women. It’s about saying we’ve got to vaccinate everybody,” he adds.
Peters mentions there is another issue that has been rarely brought to a discussion—that is sustainability. He hopes that politicians and health organizations spending big on technology to discuss the tricky last mile will ensure that a certain infrastructure if already made, can sustain and will generate even as small an environmental impact as possible.
“And until we do it, the economy will not restart,” Peters says, emphasizing the vulnerable state that keeps the country running.
But, although the campaign to make a COVID-19 vaccine is spreading at a world-record pace, it is far from over, says Robin Townley in Washington, D.C., who heads special-projects logistics for A.P. Moller-Maersk, a company that handles supply chain logistics and transportation services for companies around the world.
“The vaccine race now is not a race out of the lab. It’s a race to the patient,” he says. And the most successful vaccines, Townley says, will be those made by the companies that pay the most focus on the last mile of the race.
The intensity of the task ahead is unpredictable, Townley says. “It is the largest product launch in the history of humankind.”
It is not only the vaccines themselves that need a smooth rollout. Many aspects need to be looked into like the suppliers of the glass vials that hold the vaccines have to make sure they have enough surgical-grade sand to make the vials. Nurses giving vaccine shots need medical help when it comes to medical materials like alcohol, wipes, syringes, needles, masks, and gloves, some of which are in short supply in places. Managing all those logistics is a sticky proposition, especially on the scale needed to immunize the world against COVID-19.
“The logistics keep going,” Turley says. From Borneo to Paris to Charlotte, N.C., how best to distribute vaccines is a problem people are facing everywhere, she says. “The only consolation is that everybody is grappling with this, and that’s no consolation to any of us.”
Even if everything goes smoothly, and the distribution happens as swiftly as the vaccines’ initial development, all are still reduced to nothing if people don’t take other basic safety measures, such as universal social distancing and wearing of a mask, that can help sedate the spread of the virus.
Jason Schwartz, the vaccination policy researcher at Yale, and his colleagues took virus spread into account when making their calculations. If things keep going as they have in the past few weeks or months for instance, as reported daily in the United States, j would need to move lightning fast to avoid millions of more deaths. “If we’re at that [high level of transmission], even the most effective vaccine will struggle to make a dent in the trajectory of the pandemic,” Schwartz says.
Systematic management of the vaccine rollout is a key and thick variable in determining how well a vaccine will subdue the pandemic, researchers reported November 19, 2020, in Health Affairs. Researchers considered different scenarios and settings, figuring in vaccine effectiveness, the pace at which people can receive the vaccines (depending both on delivery systems and public willingness), and how the virus spreads fast.
Even a vaccine that is only 50 percent effective in staving off the disease could quell the pandemic if there were a quick distribution process, says study co-author Jason Schwartz, a vaccination policy researcher at the Yale School of Public Health. “Implementation matters.”
Creating the vaccines is a remarkable scientific achievement, Schwartz says, but both technical and logistical loopholes of getting the vaccines where they need to be- places and people- that need the vaccines are going to be every bit as challenging as the scientific issues.
But, planning and systematic and collaborative actions can significantly contribute to patch up these last-mile delivery challenges.