It is likely that in order to get the vaccines to these areas, the ultra-cold consignments will have to be taken out of their special packaging, divided into smaller lots, and transported different distances – maybe a few kilometers, maybe a few hundred. This will start a countdown on the viability of the vaccine. The recipients may be small clinics that have only normal refrigerators. Or it can be local pharmacies or individual doctor’s offices, if applicable – 218 of 3,141 counties in the United States to have no doctor at all. Two national pharmacy chains have contracted with HHS to administer Covid-19 vaccines in nursing homes.
“Some of this information is going to be received by an employee of a CVS or Walgreens Pharmacy somewhere in rural America who has very little training or expertise in cold chain matters.” , predicts Joseph Battoe, CEO of Varcode, a Chicago-based company that makes barcodes that record when the cold chain of medical packaging has been broken. “The challenges are extraordinary.”
(No doubt taking note, Moderna ad in its release of preliminary data, its vaccine formulation can remain stable between 2 and 8 degrees Celsius, or between 36 and 46 degrees Fahrenheit, for up to 30 days. “The temperature of a standard home or medical refrigerator,” the company noted in its statement, tone down a few inches tall.)
There might be a tech fix coming. AeroSafe Global, based in Rochester, New York, manufactures complex frozen and refrigerated packaging for biologics and tissues, and it made packaging for delivery of certain Covid-19 vaccine formulations to certain testing sites in the United States. (The company declined to identify which vaccine companies it worked with.) Temperature-controlled boxes can be personalized, according to Jay McHarg, CEO of AeroSafe. “We ship heart valves in a container the size of a jewelry box,” he says.
A solution to the problem of splitting a large frozen cargo into smaller slices, he said, could be as simple as a smaller container that holds the vaccine at the same low temperature. Another may be a less complex container, similar to a tote bag or a suitcase, which holds about 100 doses at refrigerator temperature in which the vaccine lasts for a few days. “You tell the box what temperature it’s going to be maintained, by the coolants you use,” he says. “The box doesn’t care what temperature you specify.”
The challenge, of course, is that personalization costs money. AeroSafe’s thermal shippers are complex – they incorporate internal data loggers that indicate whether the package has remained frozen throughout transport, and are also linked to cloud-based demonstration and training videos for workers in the field. sites receiving the vaccine – and therefore are not disposable. Once the product they contain has been removed or used up, company staff collect the boxes, repackage them, and deploy them again. If AeroSafe’s containers were part of the pandemic vaccine supply chain, it’s unclear who would pay for their customization.
States are already strapped for cash: They’ve received $ 200 million in federal Covid-19 stimulus funding so far, but Hannan’s organization and the Association of State and Territory Health Officials estimate that the deployment of vaccines across the United States will require more than $ 3 billion. (Companies manufacturing vaccines received $ 10 billion thanks to the government’s Operation Warp Speed.) Additional funding for Covid-19 suspended in congressional negotiations that were delayed by electoral chaos; any potential deal wanders further into the lame session.
However, the boxes of vaccines could soon be on the move and part of the product they contain will be sent to rural areas where health authorities believe they are not equipped to receive them. At this point, no health official in the jurisdiction knows which vaccine will arrive, how much, or exactly when. “It’s like we’re trying to build a house without having received the architectural plans,” Lewandowski says. “And when I go get a hammer, maybe I offer pliers instead.”
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