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Pfizer’s COVID-19 vaccine distribution to be “logistics nightmare”



The long wait for a vaccine that may eventually write the end of coronavirus pandemic looks on the horizon. Last week, Pfizer said its vaccine had been tested 90% effective in preventing COVID-19while Moderna announced similar on Monday encouraging results. Companies can receive urgent federal approval within weeks. However, it is only after drug manufacturers send millions of doses around the world that the crisis in vaccination efforts begins in real time.

The Pfizer vaccine must be maintained at almost minus 100 degrees Fahrenheit to remain effective. This is about 20 degrees colder than the extreme winter temperatures at the South Pole. Experts initially warned that the United States lacked the ultra-cold storage trucks and cargo planes needed to send hundreds of millions of doses in sub-zero temperatures.

To get around this, Pfizer has developed specially built deep-frozen suitcases that can be tightly closed and shipped even in uncooled trucks. But while Pfizer may have solved the problem of how to ship the frozen vaccine, these highly designed shipping containers pose other problems, especially for hospitals, pharmacies and outpatient clinics that will have to administer vaccinations to hundreds of millions of Americans.

“The reality is that there has never been a drug that requires storage at this temperature,”

; said Sumi Saha, a pharmacist and director of advocacy at Premier, who acts as a buying agent for hospitals across the country. “Administration and distribution efforts will require all hands on deck.”


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Among the many logistical and medical challenges that experts say will need to be addressed when vaccines are ready to be launched:

  • Pfizer delivery boxes, packaged with specially formulated dry ice and containing between 1,000 and 5,000 doses of vaccine, can only be opened twice a day for less than three minutes at a time, while maintaining temperature standards.
  • However, deep-frozen suitcases keep cool for only 10 days. And the watch starts ticking when they’re sealed, which for U.S. shipments will be at one of Pfizer’s two facilities, or in Kalamazoo, Michigan, or on the Pleasant Prairie, Wisconsin.
  • Dry ice is considered a dangerous material and is restricted to aircraft. Pfizer said its packages contained well below the limit. But given logistical challenges, Prime Minister Saha told CBS MoneyWatch that it could take up to four days for vaccines to reach their target. This gives many hospitals and pharmacies only six days to administer up to 5,000 doses before they get worse, or up to 833 a day. Vaccinations can be moved to a typical refrigerator, but only for five days.
  • The Pfizer shipping container can be refilled with dry ice. But it will most likely have to be in pellets, not blocks, and loading, which can cost several hundred dollars, will only extend the life of a deep-frozen suitcase by five days.
  • Hospitals can buy ultra-cold freezers that will support vaccinations for up to six months. But few hospitals or pharmacies have special freezers that can cost up to $ 20,000 each and are in short supply. The manufacturer K2 told CBS MoneyWatch that the wait for its over-cold freezers is already six weeks.
  • Pfizer vaccination requires two doses with an interval of 21 days, which makes it more difficult to deliver the required number of treatments with doses that go to waste.

Moderna vaccine should also be delivered frozen, although at a relatively low cold temperature of -4 degrees Fahrenheit. However, this will require the company to provide hundreds of refrigerated trucks, while the vaccine can only be stored in a standard refrigerator for up to seven days.

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Pfizer has designed a special box that can hold 1,000 doses of its COVID-19 vaccine at nearly 100 degrees below zero for up to 10 days.

Pfizer


Pfizer declined to offer details about the plan to distribute its vaccine. While the government is technically responsible for overall vaccination efforts, the company has chosen to distribute its own vaccine. Pfizer received $ 1.95 billion from Operation Warp Speed ​​to produce and distribute the first 100 million doses. The government will remain responsible for distributing syringes and other medical supplies needed for vaccination.

In a statement to CBS MoneyWatch, a Pfizer spokesman said the pharmaceutical giant had “developed detailed logistics plans and tools to support efficient transport, storage and continuous monitoring of vaccine temperatures.”

Emily Gerbers, business development director at MDLogistics, which specializes in cold store supply chains, said not only vaccines should be shipped, but also COVID-19 treatment and antibodies. The pandemic supply chain is growing and adapting, but it is difficult for companies like hers to keep up with demand, she said.

“Every day we talk to people who are looking for solutions,” Gerbers said. “There is so much need for COVID services. You can’t build it fast enough.”

Another possibility is to store the vaccines in centralized deep-freeze warehouses before moving them to hospitals. But real estate brokerage JLL said refrigeration equipment accounted for less than 2% of the total logistics warehouse market and that until recently there was very little investment in the market, making problem space available. The percentage of vacancies for existing refrigeration equipment is below 5%.

“The pandemic has thrown demand out of the cold supply network,” said Mehtab Randhava, a researcher at JLL. “The Pfizer vaccine requires a very specific requirement for cold storage, which may not be in line with what is there.”


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Prime Minister Saha said hospitals still did not have basic information from Pfizer about the transport container, such as its exact dimensions. Hospitals have also not yet been notified whether they will serve as distribution points. Many expect such a notice before deciding whether to invest in over-cold freezers or mass vaccination staff.

Saha said many university hospitals have ultra-cold freezers, but they are usually in their laboratories and will need permission from local health inspectors to be reassigned to store vaccines. And while the government has said it will cover the cost of the vaccine, it is unclear whether hospitals and other providers will be reimbursed for the additional costs needed to store and distribute the vaccines quickly.

Already struggling rural hospitals may not have the means to afford the extra costs or to serve large enough populations to make it possible to distribute 1,000 doses per week for up to 10 days, especially in the first phase of vaccination efforts, when not everyone will have right.

“It’s a logistical nightmare for rural communities,” Saha said. “But no one is immune to the challenges posed by the vaccine to the medical industry.”


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