Cold chain: storage problems could leave 3 billion people vaccinated against coronavirus

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From the factory to the syringe, vaccines need uninterrupted sterile refrigeration to remain powerful and safe. And that is very difficult to achieve, especially in poor countries.

The chain is broken here, in a small Burkina Faso medical clinic that spent almost a year without a refrigerator working.

From factory to syringe, the world’s most promising coronavirus vaccine candidates need uninterrupted sterile refrigeration to stay powerful and safe. But despite enormous advances in equipping developing countries to maintain the vaccine “cold chain”, almost 3 billion of the 7.8 billion inhabitants of the world live in places where temperature-controlled storage is insufficient to control COVID-19 through an immunization campaign.

Result: the world’s poor who were among the hardest hit by the virus pandemic they are also likely to be the last to recover from it.

The vaccine cold chain hurdle is just the latest pandemic disparity weighing on the poor, who most often live and work in crowded conditions that allow the virus to spread. have little access to medical oxygen vital for the treatment of COVID-19 and whose health systems lack the laboratories, supplies or technicians to carry out large-scale tests.

Maintain the cold chain For coronavirus vaccines it will not be easy even in the richest countries, especially when it comes to those that require ultra-cold temperatures of around 70 degrees Celsius below zero. Investment in refrigeration infrastructure and technology is lagging behind the rapid jump in vaccine development this year due to the virus.

With the pandemic now in its eighth month, logistics experts warn that vast parts of the world lack cooling necessary to administer an effective vaccination program. This includes most of Central Asia, much of India and Southeast Asia, Latin America except the largest countries, and all of Africa except a very small sector.

The medical clinic on the outskirts of Burkina Faso’s capital, a dusty building serving a population of 11,000, is a microcosm of obstacles.

Already when the refrigerator broke last fall, the clinic could not keep the vaccines well against tetanus, yellow fever, tuberculosis and other common diseases in the area, says nurse Julienne Zoungrana. In response, staff used motorcycles to collect jars from an Ouagadougou hospital on isolated transporters, making a 40-minute round trip down a narrow road that varies between dust, gravel and pavement.

A mother of two visiting the Gampela clinic says she believes an inoculation program against the coronavirus will be a real challenge in this part of the world. Adama Tapsoba, 24, walks for four hours in the scorching sun to give her baby routine vaccinations and often waits a few more hours to see a doctor. A week earlier, her 5-month-old son was left without a scheduled vaccination because Tapsoba’s daughter became ill and she could only carry a child on foot.

“It will be difficult to get a vaccine (COVID-19),” says Tapsoba, cradling her 5-month-old son in her lap outside the clinic. “People will have to wait in the hospital and they may leave without getting vaccinated.” To maintain the cold chain in developing nations, international organizations have supervised the installation of tens of thousands of vaccine refrigerators powered by solar energy. Keeping vaccines at stable temperatures from the moment they are manufactured until they are delivered to patients also requires mobile refrigeration, reliable electricity, firm roads, and most of all, advance planning.

For poor countries like Burkina Faso, the best chance of receiving a coronavirus vaccine is through the Covax initiative, led by the World Health Organization and the Gavi Vaccine Alliance. Covax’s goal is to order vaccines from multiple promising candidates in development and to equitably allocate those that have been successful.

The United Nations agency for children, UNICEF, began laying the foundation for global distribution months ago, in Copenhagen. At the world’s largest humanitarian depot, logistics personnel are trying to foresee deficiencies learning from the pastespecially from the spring chaos surrounding the global shortage of masks and other protective items that were seized on airport runways or stolen and traded on the black market.

Currently 42 Candidate Coronavirus Vaccines in Clinical Trials and another 151 are in preclinical evaluation, according to the WHO. Those most likely to be included in the Covax combination should be stored between 2 and 8 degrees Celsius.

An advanced candidate vaccine from Pfizer is among those requiring storage at ultra cold temperatures. The laboratory, which designed a special kit for its vaccine, has expressed interest in Covax and has signed contracts with the United States, Europe and Japan.

Medical freezers that reach minus 70 degrees Celsius are rare even in hospitals in the US and Europe. Many experts believe that West African countries that experienced an Ebola outbreak between 2014 and 2016 may be the best positioned, because the Ebola vaccine also requires deep-frozen storage.

However, for more than two-thirds of the world advanced technology is not in sight, according to a study by the German logistics company DHL. Meanwhile, billions of people live in countries that they don’t have the necessary infrastructure to maintain the cold chain, both for existing vaccines and for more conventional candidates against coronavirus, according to the study.


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