Much has been said about the enormous challenge in transporting and storing anti-Covid vaccines once they leave the factory due to the low temperatures required for its storage and transportation. This is especially true in developing countries with few or even no ultra-low temperature cold storage facilities, with not very many refrigerated vans for transport and with not much developed road network to reach the rural areas. Even hospitals may now have to set up cold storage facilities considering that they need to store two vials per patient with the second dose to be delivered about 2 to 3 weeks after the first dose. Finally, considering that without ultra-low cold storage facilities, the vaccine has a limited shelf life. So, the supply chain to cover the 7,100 islands of the Philippines must be seamless and trouble-free.
So, the big questions is: are we ready with a transport solution to the supply chain that can handle the anti-Covid vaccines once they are unloaded at our airports? Before we venture to guess for an answer, let us first look at what needs to be had and what has to be done. Here are six things you should know about transporting anti-Covid vaccines as researched by the technical staff of Centro Nippon Fruehauf Cooltech Inc. (CFCI), a Filipino-Japanese joint venture company that pioneered in the local manufacturing of insulated sandwich panels and the local assembly of refrigerated vans.
- Uses of ref vans in the vaccine supply chain:
Ref vans will be needed to transport the vaccine vials and dry ice in the following stages of the supply chain:- from the factory to the airport at the source country
- from the airport to the cold storage facilities at the recipient country
- from the cold storage facilities to the domestic airport or the provinces
- from the provincial airport to regional storage facilities
- and finally, from the regional storage facilities to the hospital, clinics and other vaccination centers for inoculation.
- Different cold storage temperatures required:
The storage temperature for the vaccine will depend on the brand and the medical technology used:
Note that since most ordinary cold storage facilities can maintain only up to -20 C room temperature, although this will not be a problem for the other vaccines, the Pfizer vaccine might cause some problems in the storage. This might require investments in new ultra-low temperature cold storage facilities. Furthermore, can Pfizer vaccines be transported by ref vans that can maintain a box temperature of only -20 C?VACCINE STORAGE TEMPERATURE TRANSPORT CONTAINER TRANSPORT TEMP.
(Ref vans)Pfizer/BioNTech -70 C Portable thermal storage units with dry ice to maintain the desired storage temperatures shown on left column -20 C to -25 C temperature provided the portable thermal storage unit is not opened Moderna -20 C Astra Zeneca +2 to 8 C Sinovac/Sinopharm +2 to 8 C
- Use of portable thermal storage units:
This could be the solution. To ensure a stable temperature required while in transport, the vials will be stored in portable thermal storage units roughly the size of a suitcase to maintain the required storage temperature. It can hold about 975 to 1,000 vials with the desired temperature controlled by dry ice. However, these thermal storage units should never be opened unless ready to use. The initial dry ice supply will be good for ten days only. These can however be “recharged” by replacing the dry ice every five days but up to six times only for an additional 30 days.
- Three storage options before vaccination
At the recipient country, there are three options for cold storage of the vaccines:- Use the portable thermal storage units in the absence of any ultra-low temperature cold storage facility. However, replace the dry ice every five (5) days for up to six times only.
- For Pfizer vaccines, use ultra-low temperature cold storage facilities for the -70 C storage temperature required. This can hold the vaccine for up to six months. If stored at a cold storage facility at only -20 C, it will have to be used within 5 days.
- For other vaccines, use cold storage facilities for the required storage temperatures of -20 C or +2 to +8 C. It can have a storage life of up to six months.
- Worst case scenario for Pfizer vaccine: shelf life of 45 days only from factory
In the event of a worst case scenario where the vaccine is Pfizer and there is no ultra-low cold temperature storage facility available, the vaccine must be used within 45 days after leaving the factory abroad.
Air and land transport from factory in source country to recipient country 10 days Storage using the portable thermal storage units but replacing the dry ice every five days 30 days Storage in a cold storage facility at -20 C to -25 C 5 days TOTAL: 45 days
- Current capabilities of ref vans:
CFCI has been in consultation with its Japanese partners both in Japan and Thailand on the best practices and storage and transporting conditions of vaccines there. It is looking at the possibility of using the locally manufactured ref vans to transport the vaccines. Regardless of the truck brand (whether Isuzu, Fuso, Hino, Mitsubishi, Suzuki, Hyundai, Kia, Foton and the like), CFCI ref system suppliers Denso, Sanden, Mit-Air and Thermal Master can possibly supply CFCI with the ref system that can consistently maintain a box temperature range of -20 to -25 C. They are now studying if this is enough to handle the portable thermal storage units of Pfizer vaccines that are maintained at -70 C using dry ice and unopened.
It is therefore evident that the type of cold storage infrastructure needed and the corresponding transport solution required for the supply chain will depend a lot on the brand of vaccine to be used. At any rate, CFCI is now studying with its Japanese partners how it can possibly provide the locally-manufactured ref vans required for the project.
REFERENCES:
- Very Well Health: How does Pfizer’s BNT162b2 stack up to its competitors?
- Fierce Pharma: AstraZeneca’s Covid vaccine candidate (AZD1222)
- Pfizer-BioNTech Covid-19 vaccine U.S. distribution fact sheet
- The new Pfizer vaccine would need a deep-freeze delivery chain