The reaction from the global scientific research community in response to the COVID-19 pandemic has been incredible. Multiple companies were able to create and test viable vaccines with the support of governments under a year from the outbreak onset. Yet the development of the vaccine is only one part of the picture – distribution is just as important.
The greatest global vaccination effort in human history is currently underway. The speed at which citizens in many developed countries have been vaccinated is extraordinary. Several of the hardest-hit rich countries face the real possibility of having the vast majority of their populations fully vaccinated by the end of the summer.
However, the same cannot be said of the rest of the world, where many people are still suffering. A crucial problem is that several of the top vaccines require cold storage infrastructure – otherwise they spoil and are rendered unusable. Even countries such as the USA and UK have struggled with this issue in more rural areas, but the problem is far more acute in the developing world.
Take a look at the contrast in the stability of different vaccines at different temperatures:
- The Pfizer/BioNTech vaccine must be stored at -130 to -76 degrees Fahrenheit for optimum stability and lasts only six hours at room temperature.
- The Moderna vaccine lasts six months in a standard freezer but only 12 hours at room temperature.
- The AstraZeneca vaccine lasts six months refrigerated but only six hours at room temperature.
The effort to improve safe distribution in developing countries is gargantuan. Scientists around the world are conscious of the risk to everyone of high cases and the opportunity for the virus to further mutate.
We’ve witnessed the devastating effect of the Delta variant, having originated in India, which underscores the importance of immunizing the entire world as soon as possible, to avoid similar outbreaks.
The problem of cold storage facilities in developing countries is not new to medical circles. The WHO reported in 2018 that over half of all vaccines are wasted due to a lack of cold storage. Fortunately, innovation in response to the COVID outbreak could mean this figure will significantly drop in the future. This means not only will developing countries have the protection sorely needed from COVID-19 but the efforts against other preventable diseases could be boosted in the medium to long term.
Pfizer’s vaccine has the most extreme “ultra cold chain” needs of any of the producers. To keep a substance at -100 degrees Fahrenheit traditionally requires expensive equipment which many developing countries couldn’t afford in the numbers they would need.
Pfizer came up with a solution to help in the short term through the use of dry ice boxes. Vaccines can be stored in these for up to 10 days and the dry ice can be replaced several times to further extend the shelf life. Dry ice is being widely used by other companies charged with distributing vaccines both locally and internationally.
Even with the technical capability to store vaccines at extreme cold temperatures for this long, the practical realities are different. There are so many variables that could reduce the effectiveness of the dry ice, such as exposure to sunlight or unfortunate leaks. There are times when due to the stretching of resources in hospitals, vaccines are left out too long and need to be discarded because no one has enough time to monitor them.
Here’s where the next stage of innovation comes in. It’s critical that each individual vaccine administered is known to be safe and there is simply no scope for guesswork.
QR codes have been used to efficiently track the conditions of the extreme cold storage containers. The transporters are alerted if there are any issues and the receivers can easily check to see if all is well. The use of QR codes is particularly exciting because no special equipment is needed, which is especially helpful in developing countries, where smartphones are often the most reliable data network endpoints. This is a distinct advantage over RFID data loggers, which require expensive proprietary hardware systems.
One Finnish startup, Logmore, has created a dry ice solution that can track humidity, temperature, tilt, light, shocks and location data, sending vaccine shipment condition information to quality assurance analytics systems simply through a scannable QR code e-ink display on the outside of the box.
The company’s CEO Niko Polvinen puts forward the case for the importance of such detailed information. “Granular data is crucial for tailoring effective disaster response, and COVID-19 is no different,” he recently told TipRanks. “By unifying data collection and reporting technology, we can eliminate untold amounts of waste while guaranteeing a more transparent, visible process for supply chain monitoring.”
Another significant problem in delivering the vaccines to developing countries is the lack of trust in public services. Misinformation is rife and it means some people are refusing pristine vaccines because of fears about safety. It seems just delivering the containers safely is not enough if there’s no way to validate the conditions.
There has been “a surge in terms of vaccine hesitancy particularly in urban areas where there is a high penetration of social media” according to Dr. Richard Mihigo of WHO Africa. It’s saddening to know people’s lives could have been protected but weren’t.
Combating misinformation is surely a key element, as is extra vigilance with quality assurance. There is no simple solution, and the cooperation between local governments and international organizations is critical.
Everything possible needs to be done to ensure people get the protection they need. Local clinics and vaccination centers shouldn’t have to rely on the word of freight partners, if they can validate the safety themselves and pass this reassurance on to the local community.
If there are issues in the distribution, there will be less risk of spoiled doses being injected, and any negligence can be held accountable. Health officials will know if their delivery has been mishandled and can report this up the chain.
Thanks to the efforts of scientists, private companies and governments, it is possible to deliver more vaccines safely than the existing infrastructure in developing countries would suggest. The battle is far from over, but with smart innovation and vigilant cooperation, we can ensure that the people who need immunization have access to quality treatment.