Not quite there, yet

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Irawan Ronodipuro INDEPENDENT OBSERVER

 IO – After an herculean effort by governments and pharmaceutical companies across the globe to develop an effective and safe Covid-19 vaccine, there is now hope that vaccines will soon be made available. 

But as the famous baseball coach Yogi Berra once quipped, it ain›t over ‹till it›s over. 

And the pandemic is far from over. While having vaccines brings us hope, the simple fact is vaccines don›t save lives–rather, it is vaccinations. 

The hard truth is that for the world to bring Covid-19 to its knees, even when we have vaccines being made available, poses a huge challenge in logistics. 

One first has to consider how many people need to be vaccinated to bring an end to the pandemic. According to public health experts, that number is 60 percent of the world›s 7.7 billion inhabitants. Most of the vaccine candidates in late-stage trials require more than one booster, which means the pharmaceuticals producing the vaccine will need to produce 9 billion doses. 

It is a staggering number of doses, and trying to get them produced at scale will take time, much longer than the entire world would like to believe. 

Then there is the need to package, ship and administer the doses. Of all the logistical challenges, shipping the vaccines is the least problematic since there is enough air cargo capacity in the world to ensure that once vaccines are leaving the production facilities it will only take 1-3 days to arrive at the final destination. 

According to one airline executive, delivering one dose of the vaccine to every person on the planet would require 80,000 Boeing 747 cargo planes. Most vaccines will require two doses, which means 160,000 air cargo deliveries will be needed. 

Luckily the air cargo industry has sufficient spare capacity to deliver the vaccines without any major bottlenecks. On the other hand, one must be mindful all of the vaccines require cold storage. 

 The Modena pharnaceutical company›s vaccine requires, for example, to be stored at -20C. Not a huge challenge since most household freezers reach those temperatures. But other vaccines require far more lower temperatures and hence more sophisticated storage units. Pfizer›s vaccine, for example, needs to be stored at -70C. 

The good news is that pharmaceuticais and other companies have been mapping out the infrastructure and capacity needed to ensure sufficient and proper cold storage units will be available. Pzifer, for instance, is having thermal shipping suitcases being made. Each suitcase can hold almost 5,000 vaccine doses. 

While getting cold storage units for air shipments should not be an issue, once the vaccine doses have landed things get trickier when they need to be transported on the road. Ensuring there are a suffucient number of freezer trucks available will be difficult for poorer developing countries. And then there is the problem of the so-called ‹last mile›, where typically drivers on motorcycles deliver vaccines to small villages in remote areas. 

The logistics equation also changes dramatically and becomes more complicated when one considers what is needed to administer the vaccine doses. One example is the need for the world to procure 3.6 billion syringes, which are bulkier than vaccines and need to shipped by sea. Syringe suppliers have been ramping up their production capacity in anticipation of a huge spike in demand. But sea cargo shipments take time to reach their destinations, hence supplies are already being shipped to warehouses around the world to prepare for the time when they will be needed. 

Such a complex and vast medical supply chain will require tremendous effort, and undoubtedly there will be disruptions once the vaccines are ready to be sent in cold storage units, transported to the point of use and administered. There will be instances of vaccine nationalism, and some countries won›t be able to find sufficient supplies of vaccine doses. There will instances of a lackage of cold storage units where they are needed and countries are unable to send vaccines to remote areas. In other cases, doctors and nurses will run short of syringes. 

Hence this is no time to become complacent simply because vaccines will soon become available. It is only half of the equation.