Delivery of COVID-19 vaccine needs ‘scaled-up’ medical supply chains

15,000 flights required to ensure global distribution of 10 billion doses over the next two years, according to a DHL study which also warns that insufficient ‘last mile’ cooling facilities and lack of storage at clinics in large parts of Africa, Asia, and South America would ‘pose the biggest challenge’ in logistics provision

It also warned that insufficient ‘last mile’ cooling facilities and a lack of storage at clinics in large parts of Africa, Asia, and South America would “pose the biggest challenge” in the delivery process.

“With first emergency use authorizations for COVID-19 vaccines expected to be effective in the last quarter of 2020, logistics providers are challenged to rapidly establish medical supply chains to deliver serums of unparalleled amounts of more than ten billion doses worldwide,” the German logistics giant said.

The white paper, entitled: Delivering pandemic resilience: How to Secure Stable Supply Chains for Vaccines and Medical Goods During the COVID-19 Crisis and Future Health Emergencies, identifies critical challenges in COVID-19 logistics while also providing a framework to ensure stable medical supply in any future crisis.

“Currently, more than 250 vaccines across seven platforms are being developed and trialed. As COVID-19 vaccines have leapfrogged development phases, stringent temperature requirements (up to -80°C) are likely to be imposed for certain vaccines to ensure that their efficacy is maintained during transportation and warehousing,” DHL explained.

“This poses novel logistics challenges to the existing medical supply chain that conventionally distributes vaccines at ~2–8°C. In the paper, DHL evaluates how the transport of vaccines as a highly temperature-sensitive product can be managed effectively to combat the further spread of the virus. The scope of this task is immense: to provide global coverage of COVID-19 vaccines, up to ~200,000 pallet shipments and ~15 million deliveries in cooling boxes as well as ~15,000 flights will be required across the various supply chain set-ups.”

According to a report in The Financial Times, one of the key takeaways in the study is that two-thirds of the world’s population is unlikely to have easy access to any Covid-19 vaccine that needs to be stored at freezing temperatures.

Insufficient ‘last mile’ cooling facilities and a lack of storage at clinics in large parts of Africa, Asia, and South America would “pose the biggest challenge” to delivering a vaccine at scale.

Existing ‘cold-chain’ infrastructure, which allows for temperatures to be controlled throughout the delivery process, is only sufficient to bring a frozen vaccine to 2.5 billion n people in approximately 25 developed countries, the research paper concluded.

“Governments and [non-governmental organizations] would need to implement special measures to ensure vaccine distribution,” the authors wrote, such as rapidly building storage capacity.

“We can bring the stuff there . . . but in the end, when we have delivered it to the doctor, what happens once they open the package?” Katja Busch, DHL’s chief commercial officer, told the Financial Times.

She added that the company was already in discussions with “some of the bigger governments” about solving such problems.

A wide variety of vaccine’ models are being tried, but one in particular, which uses mRNA molecules, is likely to require freezing or very cold storage during transportation, the report said.

Moderna and a partnership between BioNTech and Pfizer are developing mRNA vaccines. However, distribution is likely to become easier as more is discovered about how a particular vaccine survives.

“I believe that upcoming stability data will support storage conditions that are not much different from any other vaccine,” said Ugur Sahin, the chief executive of BioNTech. As a “matter of caution”, early batches of a vaccine are shipped in frozen temperatures, he added.

“The more stability data the manufacturers get, the less complicated the temperature ranges will be,” DHL’s Busch said.

Vaccines that can be stored at between 2 and 8 degrees Celsius would allow for “more efficient distribution”, DHL said, although this would still increase the share of the world’s population reachable using current infrastructure to only 70%, or around five billion people, the FT report underlined. “Feasibility for supplying substantial parts of Africa remains low,” the authors of the study noted.

As for the estimate in the study that 15,000 flights would be needed to ensure global distribution of a vaccine over the next two years and despite a reduction in freight capacity – with thousands of passenger planes, which often carry cargo, remaining grounded – Busch said DHL was confident this would not be a problem. “I strongly assume . . . that each and every commercial airline will raise their hand,” she said, to help deliver approved products.

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