Which Vaccine Carrier is Best for their Price?
Which vaccine carrier and containers are best for their price? To deliver vaccines safely, they need to be stored and transported in containers that can maintain a stable cold life. An inconsistent cooling could lead to temperature excursions or temperatures going beyond the safe range, which can accelerate the loss of product stability and ultimately endanger the patients.
Maintaining a cold temperature of specifically between 2°C to 8°C (36°F to 46°F) comes at a hefty cost. Imagine keeping products inside a box and trucks cold for several days. It surely requires not just an immense amount of energy, but also expensive equipment and devices tailored for the job.
So to answer this problem, PATH, a non-profit organization, and the World Health Organization (WHO) conducted a cost-comparison study where they weigh the costs of vaccine containers and vehicles. Named as the Project Optimize, the goal is to help countries identify cheaper methods of transporting vaccines from the national store to subnational facilities.
Vaccine containers and their characteristics
Project Optimize focused on four main vaccine containers that are more often used in the global immunization programs. However, not all countries have necessarily purchased one or all of these containers. The products range from the smallest and the cheapest to the biggest and the most expensive.
Dometic RCW 25 – Despite being the smallest, this container has the longest cold life. And because it’s a passive cooling device, it can maintain low temperatures for four days without an electrical connection. Dometic and its kind are mostly used in developing countries and resource-poor settings where it’s difficult to traverse roads and electricity is scarce. This option is the cheapest too with the lowest purchasing price. That’s why it’s prevalent in most immunization programs.
Aircontainer Big Box – This vaccine container can be pallet-based or with an optional wheelbase. It has a bigger vaccine volume and because it’s bigger than the Dometic, it’s a tad more expensive. But stability and laboratory tests confirmed it can maintain stable temperatures for days.
Pallet-based international vaccine shipping container – It’s made of insulated foam and cardboard together on a pallet. Some vaccine manufacturers used this container for larger shipments as they offer a better product volume ratio. This option offers greater vaccine volume capacity and cold life durability than most of the other options in the cost-comparison. However, the reusability of pallet shippers limits its lifespan and until a certain number of reuse, it loses its structural stability.
Iveco 16 m3 refrigerated vehicle or similar size refrigerated vehicle – Since it’s the largest of the options, this container has the biggest volume capacity and the highest purchase price per unit. Because of the high upfront and maintenance costs of this vehicle, many organizations have shied away from using this transport method.
The WHO Process, Quality, and Safety (PQS) prequalification requires vaccine containers to have a minimum lifespan of ten years. Knowing this information, researchers assumed the containers have the same lifespan with the exception, however, of the pallet shippers. They can only remain stable for up to four reuses.
Routine Immunization in Senegal
Project Optimize chose Senegal as the focus of the study because of its financial and geographical challenges. Choosing the most challenging location will lead to results that will be suitable not only to developed countries but also to third world countries and resource-poor settings.
In Senegal, their immunization programs include several types of vaccines. To better understand the cost-efficiency of the containers, the study gathered information about the region’s immunization programs, not just the kind of vaccines but also their volumes, wastage rates, and price per doses.
By integrating the information on vaccines, containers, and locations, PATH recommends the most cost-efficient containers for developing countries like Senegal where the cost of vaccine containers is a big deal.
The first recommendation is the use of refrigerated trucks. Because of its enormous size, it offers the lowest cost per volume. This means the price enables more vaccines inside. Apart from that, the cost depreciates as the vehicle ages.
The catch is that upfront cost is much more expensive than other options, keeping most immunization programs from purchasing them. Aside from the purchase price, some underlying costs are not mentioned in the study such as maintenance costs for potential breakdowns.
Although refrigerated trucks provide a stable cooling from its trusted cooling mechanisms, it’s still prone to breakdowns. The study did not include additional secondary packaging inside the refrigerated truck. If there’s no extra vaccine packaging like Dometic or other cold boxes then breakdowns of trucks could lead to the degradation of vaccines.
To prevent this, the management should still use passive packaging that can maintain a cold life in absence of electricity. But it’s worth mentioning that added equipment translates to additional costs, which the management should include in their cost assessment.
The second recommendation is the use of cold boxes or Dometic if the only available vehicle is a standard four-wheel-drive cab. This can accommodate 360 liters of vaccines in a single trip. But compared with refrigerated vehicles and Camion trucks, this option has higher costs per liter of vaccines due to its relatively smaller capacity.
Using pallet shippers is the third recommendation. In using the Isuzu Camion truck or similar vehicles, the cheapest container is the reusable pallet shippers. This option is low-cost as it does not require additional expenses on containers.
This cost comparison may be tailored to Senegal’s unique situations but this provides a starting point for vaccine programs around the world weighing the costs of their vaccine containers and transport options. Some different and country-specific factors may affect their decisions such as vaccine introduction policies, timelines, geography, etc.
Before arriving at a decision, it’s important that the health officials assess their future vaccine capacity requirements, evaluate distribution scenarios, and test pilot routes to better understand performance, security, and costs.
Safe and stable vaccine delivery is as important as vaccines themselves. No matter how powerful these life-saving biological substances, without proper and safe transport and storage, vaccines will be ineffective in its immunization role. But since storing and transporting them comes with expenses, health management has to consider the most cost-efficient options. Apart from guaranteeing safe delivery, cost-effective transport and storage options not only ensure the longevity of vaccines but also of immunization programs, letting them reach more people, and save more lives.