It may be a cold day in the UK when demand for vaccine cold chain equipment outstrips supply capabilities. Manufacturers of the specialist equipment needed to support the safe and effective transport of vaccines, that must be maintained at ultra-low temperatures throughout their journey from manufacturer to patient, warn that demand for ultra-low freezers is already 'off the charts'.
“Never before, and perhaps never again, will we have such a mammoth task on our hands as the one which all countries across the world, including the UK, are facing to get the Covid vaccines to their populations as quickly as possible,” says Luc Provost, Chief Executive Officer of Luxembourg-based B Medical Systems (BMS), global specialists in medical cold chain transportation and storage as the Pfizer vaccine starts to roll out across the UK.
The company is currently creating a 'Readiness Checklist' for the EU to help educate and help national authorities in establishing their logistics operations for Covid vaccines.
He adds: “In the UK alone we are talking about a logistics effort that will be bigger than any global humanitarian programme this century. Never before has a product been in demand by practically everyone the world over.”
Vaccine freezers in high demand
According to Provost, BMS has seen demand for its ultra-low freezers “go off the chart” in recent weeks. The innovative refrigeration technology developed by the company supports their Ultra Low Freezers to operate in the temperature range of -20°C to -86°C, there by enabling the use of these freezers for both the Pfizer and Moderna vaccine. The company has also developed another innovative product that can operate as a vaccine freezer and also as vaccine refrigerator. This enables the use of the product for the storage of both Moderna vaccine (that requires a -20C storage) and likes of Oxford/Astrazeneca vaccine that needs a storage temperature of 2-8°C
Good for business at BMS but just one of the logistics challenges the British government and devolved administrations will need to address is waiting times for ultra-low freezing units which will be lengthy.
Provost says: “Normally we would be supplying 2,000-3,000 units typically for a country. We expect this to increase 5-7 fold to some 15,000 units at least. In places like India we are seeing orders reach six figures.”
Securing an end-to-end unbroken cold chain
He adds: “The challenge is securing an end-to-end unbroken cold chain – from point of manufacture of the vaccine until administration in the arm of the patient. The issue is that the different legs of the supply chain are all integral to the successful distribution of the vast quantities of vaccines, yet they are distinct in terms of who coordinates them.”
Provost believes where logistics could fall down, if not thought through and coordinated effectively, is the in-country distribution, including storage and the last mile to the patient. “Get it wrong and the UK could suffer from a stockpile of vaccines that aren’t usable and slowdown the immunisation programme. It’s a very real threat to any country,” he says.
Preventing vaccine wastage
“Vaccine wastage happens in two areas – in-country transport and vaccine administration at health facilities. Most portable vaccine carriers and cold containers cannot keep cold beyond 12 hours, especially if it is hot outside. Transportation for the last mile to where the immunisation is happening – for example care home residents which will be amongst the first in the UK to get vaccinated – is time consuming and monitoring this journey presents a big problem.”
Raja Rao, Director, Cold Chain Strategy & Markets at B Medical Systems, who has led the cold chain programme at the Bill and Melinda Gates Foundation, adds: “All the studies I’ve been involved in with my work for the Foundation indicate that in the developing world about 50-75% of all vaccine wastage happened during in-country transport.”
Provost also points to the need for a centralised logistics information management system. He says: “This is crucial in terms of keeping track in real time of vaccine storage, demand and orders to enable a highly efficient supply chain. If this isn’t in place it could lead to costly vaccine wastage and stockpiling due to delays and slowdown in immunisation.
“Central government, devolved administrations in the UK and the NHS are going to have to work closely together along with other key stakeholders to ensure a logistics set-up that delivers vaccines on time, whilst preserving the quality and therefore the health of the patients.”
Strengthening the vaccine cold chain infrastructure
Since the beginning of the pandemic, B Medical Systems has been working with governments and major healthcare bodies across the world to cater for the various refrigeration requirements to fight the Covid-19. In the initial stages, it begun with refrigeration solutions for storing the test specimens, followed by the refrigeration requirements associated with therapeutic remedies, for instance convalescent plasma therapy. Today, with the impending arrival of vaccines, the company has been working together with various Governments across the world (USA, Germany, Grand Duchy of Luxembourg) to strengthen the vaccine cold chain infrastructure.
The company’s track record has also involved worked closely with prominent global organizations including international health organizations such as UNICEF, WHO, Gavi, the Red Cross, aid agencies and multinational companies, military customers and governments.