“This is likely to be one of the biggest logistical challenges we have faced this century.”
Those are the words of Professor Richard Wilding OBE, Professor of Supply Chain Strategy at Cranfield University, one of the world’s leading logistics and supply chain experts talking about vaccines for Covid-19.
Until recently, attention on the Covid-19 vaccines from Pfizer/BioNTech, Oxford University/AstraZeneca, and Moderna has focused on their effectiveness. But when it comes to returning society to something more like ‘normality’, the level of effectiveness isn't the key issue. Delivering a mass vaccination programme on the scale needed will be one of the biggest logistical challenges we have faced this century.
The challenges ahead
On 2 December, the UK became the first country in the world to approve the Pfizer/BioNTech vaccine for use, and stocks of the vaccine are expected to be available in large quantities from January 2021. But there are challenges:
- The vaccines come in packs of 975 doses, which at launch cannot yet be split into smaller batches. However on the 6th the MHRA (Medicines and Healthcare Products Regulatory Agency) announced an approved method for breaking into small batches.
- The vaccine needs to be stored at around -70°C during transport and long term storage.
- Those who receive it will need a second dose 21 days later to receive full protection.
Professor Wilding comments that: “A successful rapid deployment of any proven vaccine doesn’t just rely on the amount of vaccine that can be produced it relies on multiple factors such as infrastructure, information systems and having a workforce that can administer the vaccine.
“Reports that the Pfizer drug needs to be stored at -70°C will only add to the complexity around transportation and storage logistics with specialist storage needed.”
Traditional infrastructure for transporting frozen goods is based around temperatures of -20°C to -50°C. Therefore, the Pfizer/BioNTech vaccine will require specialist equipment and materials, such as freezers and boxes to keep the supplies at -70°C as they are transported around the world.
By contrast, the AstraZeneca vaccine can be stored in a standard fridge, critically making mass-scale supplies and distribution - and the vaccination process itself - far more straightforward.
But it’s not just about transporting frozen vaccines, there are a range of other considerations:
- What warehouses are available?
- What equipment, such as freezer boxes and syringes, needs to be manufactured and distributed?
- How much additional PPE will be needed and where does it need to get to?
- Is there enough safety equipment for individuals who are handling the vaccine in cold storage?
- What information systems are needed to manage geographical distribution and track who has had the vaccine and booster?
- Do we have enough people with the right skills to administer the vaccines?
Whichever vaccines are used, it’s highly likely that the specialist infrastructure, storage, and equipment will become a supply chain in its own right, with its own manufacturing and distribution processes attached to it. However, stresses on these supply chains will have an impact on how many vaccines you can distribute.
Learning from other sectors
“What we will see is essentially like a product launch, with a fast ramp-up, then a different supply chain for when it reaches a steady-state, then one for a decline in demand. Just like a product launch, as well as the availability of the product, you also have to generate demand by persuading the population that they must get the vaccine - the demand creation element. Logistics and supply chain is about fulfilling this demand,” says Professor Wilding.
With this in mind, Professor Wilding advises that Governments and health professionals need to seek out and listen to not just pharmaceutical supply chain experts but also those that are used to operating and releasing products at great speed such as technology companies like Apple, fashion companies and supermarkets.
When the pandemic hit, one thing was evident: that we are in an age of highly flexible logistics and systems that can innovate and adapt at lightning speeds. When people were instructed to stay at home, supermarkets recruited thousands of new staff to deliver on a new logistics model in just a couple of weeks. In addition, organisations such as the Chartered Institute of Logistics and Transport stepped in to organise a database matching transport resources and needs.
For supply chains, the scale and speed needed and the challenges they will face will be immense. However, Professor Wilding is confident that if knowledge and best practice is sought out from supply chain experts across industries then the challenges can be overcome. “An efficient, effective programme of defence against Covid-19 is well within reach - but it’s critical that debate and decision-making around vaccines is carried out in the context of logistics.”
General Dwight D. Eisenhower famously observed, “...wars have been won or lost primarily because of logistics.” Professor Wilding concludes, “The same applies to vaccines.”
Further updates can be found on Professor Wilding’s blog.