The world breathed a sigh of relief when Pfizer made the first major breakthrough with its vaccine last month. Having been quickly approved by the UK, 40 million doses are being rolled out – and applied – as we speak. But, if life is to return to anything resembling the good old days anytime soon, the Pfizer vaccine, and any others that are approved, need to be distributed on a global scale as fast as possible. And this part of the challenge has only just begun.
The climb to the peak is really about delivering the vaccines.
The challenge is far from over
As Katherine O’Brien, the WHO’s Head of Immunization put it. Safe roll-out requires careful planning and close collaboration across worldwide delivery chains. So, what exactly are the challenges posed by the vaccine rollout?
Unlocking cargo capacity
Pfizer will ship over 1 billion doses by the end of next year, Moderna a further 500 million and AstraZeneca will manufacture 2 billion doses for low and middle-income nations. Potentially plugging the gap between these plans and the actual need, could be a total of thirteen pharma companies that have already made it to late-stage clinical trials. Delivering these doses across the world will put immense pressure on existing supply chains.
How much pressure? Consider this: currently, half of all air cargo worldwide is moved by around 2,000 air freighters and the other half by 22,000 regular jetliners. According to the International Air Transport Association (IATA), the theoretical equivalent of 8,000 full Boeing 747s would be needed to provide just one dose of a vaccine to each of the 7.8 billion of us.
To meet demand, companies like Delta and American Airlines have already announced they are prepared to handle the shipment of Pfizer’s drug using temperature-controlled containers. As the pandemic continues to severely impact airline balance sheets across the globe, shipping the vaccine could be the saving grace airline bosses have been hoping for. In the US alone, the five biggest airlines — American, Delta, United, Southwest, and JetBlue — have seen their financial health ratings plummet to below 40 putting them at high risk of default by the end of this year. Yet, American’s stock rose 10% to a near post-COVID high when it announced it was bringing its Boeing 737 Max fleet back into service to help distribute the vaccine. American Airlines Chairman and CEO Doug Parker, said: “Half the cargo around the world flies in the bellies of commercial aircraft. So we’re all going to be critical pieces of this vaccine distribution.”
Keeping it cool
Pfizer’s vaccine must be kept at minus 70°C, requiring a deep-freeze delivery chain. 5,000 doses will be shipped in dry ice packs and can be stored for 6 months at -70°C. From there, the vaccine has 10 days to reach a center where it can be stored for up to 5 days in a standard fridge at 2°C–8°C. But once thawed, the vials cannot be re-frozen. It’s a similar but slightly less challenging picture for the Moderna vaccine which requires a larger dose but stays stable at a conventional freezer temperature of -20°C for up to six months.
The bottom line? To roll out at speed, having deep-freeze production, storage, and transportation networks, or being able to build them quickly, will be key. For major cities across the globe, this is a viable option. In contrast, less developed countries and more rural areas are unlikely to be able to set up these delivery chains from scratch. For them, the Oxford University/AstraZeneca vaccine might be the biggest hope as it can be stored safely at 2°C and distributed to medical facilities using existing cold-chain delivery networks.
Specialized supply chains
Global spending on cold chain logistics has been increasing since 2016 and will continue to do so. These well-established networks will expedite the flow of doses.
Source: Statista
United Parcel Service already has deep-freeze facilities in Louisville, Kentucky, and in the Netherlands, capable of holding 48,000 vials each. German courier DHL has a Medical Express service that specializes in delivering products that need consistent and constant temperature control. FedEx also has an extensive cold-chain network in place, with freezers and refrigerated trucks ready to go.
Logistics companies across the globe need to react fast to make specialized investments to facilitate the roll-out. Thankfully, they are doing just that. Pharmaceutical freight firm Yusen Logistics has opened a new branch in Sunderland, UK, designed specifically for Covid-19. Lufthansa Cargo has opened dedicated pharma storage centers in Munich and Chicago, while Air France-KLM has invested in temperature-controlled infrastructure in Paris and Amsterdam.
There is also an increased need for security across the entire supply chain, The IATA has warned of the possibility of tampering, production of counterfeit shots, and purposeful disruption of distribution. Companies and logistics providers must implement end-to-end security measures and tracking technology to ensure the safe passage of the vaccine.
Are we looking at an e-pharma revolution?
The last few months have shown us exactly what e-commerce companies and pharma logistics providers can achieve in times of crisis. We’ve hailed the quick procurement and distribution of PPE, and similarly, expect the vaccines to be rolled out at lightning speeds.
But even before the Covid outbreak, the e-pharma market was already set for significant growth, with forecasts predicting them to treble in value from USD 34 billion in 2018 to USD 102 billion by 2026. This is largely due to increased demand and population aging.
Although just 1 in 10 patients in the US doesn’t pick up their prescription in person, the trend is obvious. In fact, sensing a significant shift in consumer behavior, Amazon set up its own e-pharmacy, Amazon Pharmacy, just last month.