The negative effects of the Covid-19 pandemic have necessitated various medical boards across the globe to begin the emergency usage of Covid-19 vaccines, bringing reprieve and optimism in 2021.
Pfizer-BioNtech is arguably one of the most effective Covid-19 vaccines, with a proven efficacy of 95 percent. The vaccine is, however, required to be stored between -80 degrees Celsius and -60 degrees Celsius. This implies that a home refrigerator cannot be used as a storage method given that its temperature is usually between 0 to -4 degrees Celsius.
The storage and the distribution of this vaccine, while maintaining its viability, will prove to be a challenge, and we are all wondering about the crucial question—how do you transport the temperature-sensitive vaccine from Pfizer's United States warehouse to the point of use in say, Pumwani Hospital in Nairobi?
Supply chain experts have adopted strategies such as the cold supply chain to distribute the vaccine across the world. Cold supply chains entail the transportation of the temperature-sensitive products along the supply chain through refrigerated packaging methods.
Refrigerated trucks fitted with dry ice will be required to transport the vaccine from the plant-attached cold storage to the airport or shipping companies. Dry ice is solid carbon dioxide, with a temperature of about -80C. Dry ice is preferred over regular ice or gel, simply because it does not melt. Its downside is that it sublimates when in contact with air. In preparing the refrigerated trucks to receive the consignment (vaccine), they are steam cleaned to reduce the risk of bacterial infections on the products. Insulated pieces, commonly referred to as quilts, are then placed over or around the consignment to act as a buffer in the event of temperature variations due to outside conditions. Once the temperature control measures are in place, the vaccine is then loaded to the trucks and transported to holding facilities, and customs clearance is taken care of while waiting for either ship or air travel. The holding facility should be a dedicated cold storage facility where the required temperature is maintained.
Most cold storage facilities are outsourced to third party logistics providers. There are various types of cold storage such as refrigerated containers, chillers, cold rooms, pharmaceutical grade cold storage, plant-attached cold storage etc. Specifically, for vaccines, transportation to a pharmaceutical grade cold storage would be ideal since they are custom made for the products' specifications. Once approval for shipping is received, the cargo is loaded.
Meticulous planning and preparation of the mode of transport and transit warehouse needs to be decided in advance. The pros and cons of shipping and air transportation need to be factored in. Some of the factors to consider are time to destination, cost, safety of the vaccines, route design and the environmental impact.
The demand for the Covid-19 vaccine is a lifeline to the airline industry, which for a major part of the year 2020 was faced with dwindling demand for passenger flights when compared to cargo and freight business. Kenya Airways has already remodeled some of their Boeing 787 airplanes to carry cargo. The route design for air transport is straightforward, simple and efficient. It simplifies transporting the vaccine from Airport A to B in the shortest possible time (reminds me of vector analysis!). The vaccines, to be transported by air, are packed with dry ice to act as a refrigerant. Data loggers and tracking devices are also packed to monitor the temperature and location of the vaccines during transport.
Data loggers are electronic devices that record data over time and have in-built sensors. The volume of vaccines to be transported requires an increase in the quantity of the dry ice that exceeds the previous amount allowed in airplanes during the pre-Covid-19 era. Data loggers and cargo tracking devices are powered by lithium batteries; hence, they have a high level of electromagnetic radiation that may interfere with aircraft systems. Aviators need to come up with the optimal balance of the vaccine quantity, dry ice, and sensors for safe air transport.
The route design for ship transport must consider the most secure and effective route, sea turbulence levels, and the port clearing efficiency at the port of delivery. Ocean shipments will take longer than air travel, although it is more cost effective. With respect to environmental impacts, ships generally emit fewer grams of exhaust gas emissions than air transport. The risk with the shipping transport is that the cooling system in the reefer container may fail while in the high seas, or the ship itself can fail. There is a need to consider how fast they can get spare parts or what arrangements have been made by the service provider to ensure the integrity of the product. Once the vaccines are on the high seas, there are many risks. One of the major risks is piracy, which is mitigated by ensuring the choice of the route is secure. Some of the other risk factors are theft, temperature performance and liability issues (in the event of vaccine integrity breach during transit).
For successful transportation of vaccines, it is imperative that the recipient countries invest in infrastructure (building of cold storage centres at airports and ports), seamless custom clearance systems, railway or road transport networks and skilled personnel.
Patrick Oweke, MKISM is a supply practitioner.