Supply Chain Challenges for the Covid Vaccine Cold Chain

The Challenges of the Vaccine Cold Chain

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With vaccines front-and-center, the Cold Chain will take on new importance in the coming year. Supply chain management is hard enough, but keeping the entire chain continuously temperature controlled is much more challenging. Yet that’s exactly what’s required for temperature-sensitive products like vaccines, medicines, foods, and some chemical products.

As with temperature-sensitive products like seafood and steak, vaccines are perishable and require a low temperature environment to maintain quality. The majority of COVID-19 vaccines currently under development, including the Moderna and Pfizer vaccines, are RNA-based and will require constant refrigeration at very low temperatures so they stay effective. And as with fresh foods, they can spoil.

“This [extreme cold chain] is completely new territory for health care supply chains. So this is a brand new logistical challenge, to distribute this vaccine and get it to the right place, while maintaining the integrity of the product.”

Soumi Saha, pharmacist, Premier (Source: CNBC)

Stray outside the prescribed temperature limits, and the result will be a lot of discarded vaccine. A 2019 study estimated that 25% of vaccines are degraded by the time they arrive at their destination. This is largely due to mishandling and poor shipping procedures, which costs companies US $34.1 billion annually. Compared to these direct costs, the cost of shutdowns to economies worldwide in response to COVID-19 is immeasurably greater. And these numbers do not even take into account the human cost – physically as well as financially – of illness that could have been prevented by timely delivery of high-quality vaccines.

Conquering the Cold Chain Challenge

The need for a trusted, secure cold chain will be large, as experts estimate that somewhere between 12 billion and 15 billion COVID-19 vaccines are needed globally.  Given these facts, what are the cold chain implications?

The Covid Vaccine Cold Chain Challenge: There is a need for a high capacity, trusted, secure cold chain, as experts estimate that somewhere between 12 billion and 15 billion COVID-19 vaccines are needed globally. Click To Tweet

Expect a need to handle diverse cold chain product requirements. With multiple vaccine developments in play, there is uncertainty about which COVID-19 vaccine will be approved first and in which countries. The most likely scenario is that multiple treatments will exist. In that case, different vaccines may require different temperatures and different handling procedures. Hence, supply chains would need the facilities to handle such situations, and staff throughout the cold chain would need appropriate training on how to handle each vaccine properly.

With more than 30 vaccines in the testing pipeline worldwide, it’s not yet possible to tell at which temperatures an approved vaccine will need to be stored. Certain candidates will require ultra-low temperature storage (-80°C storage), while others may only require -50°C to -40°C and some may allow storage at normal refrigeration temperatures. The smart move is to plan for these now, and be ready when vaccine approval arrives.

Capacity constrained last mile deliveries. Another question is how frequently deliveries will need to be made to points of care. This will depend on the refrigeration capacity of health care organizations and hospitals, staffing resources, and the locations where vaccines will be given and many other factors, including the shelf life of the vaccine itself and timing of follow-up dosing, if required.

The Covid Vaccine Cold Chain Challenge: It may not be a single dose. Some vaccines require follow dosing, so delivery and timing must be carefully coordinated. Click To Tweet

Prepare for the initial demand and dependent demand. In all likelihood, certain vaccines will require booster shots, where the booster shot will need to be delivered weeks or months after the initial dose and will need to be the same vaccine type as the first shot. The interval between first and second doses will likely vary for different vaccines. So, demand planning will need to take this into account, as well as the fact that people tend to be unreliable when it comes to scheduling follow ups on time. This forecast inaccuracy means that dynamic supply chain re-allocations are likely needed to match supply with actual demand in near real time to minimize waste/spoilage due to under or over supply at delivery points.

Expect substantial cold chain investment. Expansion will likely be needed in shipping and storage capacity – planes, trucks and cold storage warehouses, but also cars, vessels, and donkey-capable technology to the far reaches. This is a global problem impacting every global community. In the end, the determining factor regarding investment will be how the infrastructure is connected and utilized between the vaccine production location and the points of consumption for each vaccine type.

Recommended: New Opportunities for Healthcare Suppliers in Demand-Driven Healthcare

Expect a surge in related supply. The supply chain scale will be essential to accommodate the other supplies needed for both the production and treatment services. Short supplies are already a concern for vials, bioreactors in the production lines. Immunization programs require the vaccine dose and essential supplies at the sites such syringes, needles, swabs etc.

Secure your supply chain. To make matters worse, criminals are targeting pharmaceutical companies, their systems and supply chains. To combat this threat, and assure customers and patients of the authenticity and quality of their products, companies need full monitoring, track-and-trace, chain of custody, and point of origin information across all sites and parties to ensure integrity of supply. This includes maintaining product quality with security measures and tracking to combat the problem of counterfeit products entering the supply network.

Plan beyond year one. Of course, the world hopes this first round of vaccine development will be enormously successful, yet this is not likely to be a “one-and-done” situation. As with the annual recurrence of the flu, the expanded need for cold chain capabilities is likely to persist as a multi-year effort.

Part 2 of this series is now live: Part 2: Solving the Vaccine Cold Chain Challenges

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Diane Reynolds
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