Planes, dry ice and refrigerators: the enormous logistical challenge of vaccinating against the coronavirus

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Three simultaneous limitations complicate the task: the pressure of the schedule, the fact that most vaccines will require two doses, and refrigeration to low or even very low temperatures of certain types of them.

The United States could be the first country to launch one of the most ambitious vaccination operations in history: distribute and inject up to 600 million doses of the coronavirus vaccine in a few months.

Although the world has managed massive vaccination campaigns for decades, such as those for measles or the common flu, tThree simultaneous constraints complicate the task this time: the pressure of the calendar, the fact that most vaccines will require two doses and refrigeration at low or even very low temperature of certain vaccines: -70 ° C for the one developed by Pfizer and the German BioNTech, aimed to be the first authorized in the United States, against between 2 and 8 ° C (the temperature of a refrigerator) for vaccines against the common flu.

In the United States, the Pfizer doses would come from the final fill factory in Kalamazoo, Michigan (another is in Puurs, Belgium).

The group designed special boxes for shipping, 40x40x56cm, which will contain dry ice. Each box will have 975 bottles with capacity for five doses each, for a total of 4,875 doses.

Six trucks will leave Kalamazoo every day to deliver doses to airlines such as Fedex, UPS and DHL, who will quickly distribute them: in one or two days in the United States and in three days in the rest of the world, Pfizer told AFP. Twenty daily cargo flights will spread future doses around the globe.

Fedex told AFP that it obtained permission from the Federal Aviation Administration to carry more dry ice aboard their Boeing 767 and 777. Dry ice is solidified carbon dioxide, the sublimation of which (the transition from a solid to a gaseous state) can be dangerous for the crew.

Already in destination, Each box may only be briefly opened a maximum of twice a day.

“This suits large vaccination centers,” Julie Swann, a pandemic response expert at North Carolina State University, told AFP. But not to doctor’s offices or pharmacies.

At first, Americans will likely have to drive to hospitals and perhaps large parking lots, as is the case with clinical trials being conducted today, he explains.

An important precision is that doses may stay up to two weeks in its refrigerated box. Hospitals will not need a special freezer. “We do not recommend that hospitals and clinics buy ultra-cold equipment,” said Janell Routh of the Centers for Disease Control and Prevention (CDC).

The American pharmaceutical company Moderna is also developing a vaccine, which is stored at -20 ° C. A normal freezer will suffice.

It is the second largest volume purchased vaccine in the United States and the federal government will organize its distribution (free) between states and territories through the McKesson distributor. Each jurisdiction will then decide how to distribute doses to hospitals, pharmacies and doctors’ offices, as well as universities or companies.

It is a decentralized scheme, like the one used during the H1N1 flu pandemic in 2009.

“The federal government does not intend to touch, with very rare exceptions, a single dose of vaccine” and its distribution will be left to local governments, said Paul Mango, one of the officials in charge of Operation Warp Speed ​​( Maximum speed).

The objective: offer vaccines to the “most vulnerable” before the end of December, the health personnel before the end of January and the rest of the population there at the beginning of April.

Pfizer expects to produce 50 million doses this year and 1.3 billion in 2021. Many countries have already placed their orders: between 20 and 30 million before the end of December in the United States, 100 million in total; 200 million to the European Union, 120 million to Japan, 34 million to Mexico, 30 million to the United Kingdom, 20 million to Canada.


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