As the scientific obstacles to developing a COVID-19 vaccine recede, the logistical hurdles to injecting it into the arms of billions of people worldwide are just beginning. The coronavirus vaccine developed by Moderna can be stored at standard refrigerator temperatures for up to a month. The vaccine announced by Pfizer and BioNTech, made from messenger RNA technology, will need to be kept at about minus 75 degrees Celsius, thawed and injected within five days — or else re-iced in under one minute — or it will go bad. That is much lower than the temperatures most frozen vaccine supply chains operate at and much more complex.
A Subzero Supply Chain
额外的制冷意味着政府，公司和卫生系统必须伪造新的Subxero供应链 - 或等待和赌博其他疫苗的有效性，这些疫苗是基于蛋白质的，不需要保持在这种低温下。为经合组织的37个国家开发这种深冻储，交付和应用网络将花费数十亿美元。即便如此，这是所需总资金的一小部分。
更大的挑战是管理一英里物流和培训人员，以便在每个阶段按比例所需的任务。如果在链中的任何地方出现问题，那将停止疫苗 - 这是稀缺和昂贵的 - 从潜入其注射的途径。为了使疫苗冷却到达后，疫苗接种中心将需要新设备，专门培训的员工和一个流畅，协调和无差的过程作为汽车生产。
That said, it can be done. Vast, one-off distribution operations have been successfully mobilized globally in the past — to deliver millions of new iPhone models in days and Harry Potter books in hours. The differences: The COVID-19 vaccine requires fragile cold storage and transportation; the supply chain will run for months and not a single day; specially trained staff need to administer the vaccine; and millions of people will have to line up in the right position at the right time — twice.
Here’s how getting the vaccine to billions of people globally could work.
A Global Network of Vaccination Centers
The first step to drawing up a deep freeze road map for the vaccine is to set up the simplest pathway to as many people as possible. Most hospitals will not be equipped to handle thousands of people arriving and leaving every day, as they are set up more for individual care of a few patients. But governments, companies, and health systems can organize vaccination networks now in large facilities located near where many people live and can reach them easily by public or private transportation.
Germany’s 100 or more such vaccination centers will be planned for a population of about 80 million. They will likely be set up in locations that can accommodate the flow of tens of thousands of people every day, arriving and departing by car or public transport. In sparsely populated rural regions, smaller centers will be needed, too, as people will not be able to travel to a large center near a city.
Vaccination Centers and Herd Immunity
如果牧群免疫力在经合组织国家是通过在70%左右of their populations immune, about 500 vaccination centers would be required in major cities, 1,000 in small cities, and hundreds in rural areas. North America could achieve 70% immunity if it set up around 200 centers in major cities, 300 in small cities and nearly 400 centers in rural areas. Europe could reach the same level of immunity with almost 100 urban centers, 200 in small cities and around 100 in rural areas.
But many more facilities would be required in Asia, because of its large population, much of which lives in sparsely populated areas without efficient transport links. To make only 46% of the population in Asia immune would require more than 1,000 vaccination centers in major cities, 1,000 in small cities and nearly 7,000 in rural areas. Forty-two percent immunity in Africa would require more than 300 vaccination centers in major cities, nearly 400 in small cities and more than 2,000 in rural areas. To get to 70%, these numbers would need to be 30% to 40% higher in Asia and Africa. In total, Asia and Africa will need 15 to 20 times as many distribution centers as OECD countries due to the sheer volumes of the vaccine that will need to be distributed across vast rural areas.
Deep Freeze Equipment and Trained Staff
After countries determine where the vaccines should be delivered, they have to distribute the dry-ice equipment required to keep the vaccines cold after arrival. Because they cannot risk the doses getting warm, they will need two dry-ice machines — one to act as backup. Typically, the machines cost about $40,000-$80,000 each, plus $40,000 for three months of liquid carbon dioxide, according to reports.
Training will also have to be organized. On top of doctors and nurses working in shifts to carry out the maximum number of daily injections, other staff must be in place to keep the vaccines cold — perhaps five per center, working in shifts. People will need to be trained and certified so that they can use the dry-ice machines and handle the vaccine doses in a way that keeps them cold. Staff will need training to administer the flow of people — all of whom must arrive for two injections, three weeks apart. Hospital backup must be planned in case of medical complications during a vaccination.
Finally, companies, governments and health systems will need to be vigilant in order to guarantee that the vaccines will safely reach their destinations.
Breakdowns in temperature control at transport connections cannot be allowed to happen. Pfizer suggests passive cooling for transportation, using dry ice, which would mean the vaccine has to be administered within five days of leaving the factory. That means a process of continuous delivery that adjusts based on vaccines administered will be important.
这应该是可能的 - 但如果有任何延迟，疫苗将必须重新冰，这需要熟悉该过程的人。因此，辉瑞已表示计划直接从工厂直接服用疫苗剂量，而不通过使用快递网络和空运来重新包装。这跳过了在长途旅行中中间停止期间重新结冰的问题。
Breakthrough Logistics for a Breakthrough Vaccine